In weak constitutions _Ulcers of the Cornea_ occur from slight
causes,—exposure to strong light, intemperance, inverted or irregular
ciliæ, a granulated state of the lining of the lids, or from momentary
irritation of the part by extraneous matter. The ulcer appears at first
circular, but during its progress it often becomes of an irregular
form; its surface is depressed and ragged, and can readily be seen by
directing the patient to fix the eye, and then looking at the part
from one side. The edges are elevated; and the surface, which is of
an ash colour, discharges an acrid colourless fluid, as in similar
affections of all surfaces that are covered with a delicate, tense,
and exquisitely sensible expansion. Sometimes the ulcer is very minute
and superficial, and enlarges very slowly, if at all; but in other
instances it extends rapidly in depth and size, with great pain and
irritability of the organ, and intolerance of light. Occasionally their
increase is expedited by partial sloughing. At first, when the ulcer
is minute, the part often retains its natural transparency. But as the
disease advances, when the sore spreads superficially either by the
sloughing or the ulcerative process, or by both, the cornea becomes
opaque, often to a considerable extent, around the ulcerated part;
and if the ulcer extends deeply, so as to perforate the tunics, the
aqueous humour escapes, the iris falls forward, and the pupil becomes
distorted: in either case vision is impaired or destroyed. In some
cases great relief follows discharge of the humour, and the consequent
flaccidity of the cornea, the ulcers seeming to have been prolonged
and irritated by the fulness of the chamber. Sometimes an ulcer will
penetrate the laminæ of the cornea, even to the aqueous membrane. This
latter tissue may resist the ulcerative process, and will then be
pushed forward into the opening by the pressure of the aqueous fluid.
This is _the hernia of the aqueous membrane_, so called, instances of
which have been known to acquire a considerable size before the bag has
given way.
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