The pearly speck which remains after cicatrisation of a corneal sore
is termed _Leucoma_, and is permanent. It is generally of an uniform
colour, but occasionally a black speck is perceptible in some part of
it. For, when an ulcer lays open the anterior chamber, part or the
whole of the aqueous humour is evacuated, and the iris falls forward;
a portion of the iris falling into the opening, provided this is
not in the centre of the cornea, closes it up, and becomes adherent
to that part. If the opening is large, the prolapsus of the iris is
considerable; and in some cases this membrane, being pressed on by the
humours, is forced through the opening in the form of a small bag.
This change of position is termed _Hernia of the Iris_; and the dark
sacculated portion of the iris which projects from the surface of
the cornea is called _Myocephalon_, from its resemblance to the head
of a fly. The myocephalon may remain for a considerable time, or may
sphacelate and drop away. The pupil is thus rendered irregular, is
perhaps nearly obliterated, or is drawn down behind the opaque part,
and thereby rendered totally useless to the patient. The impairment
of vision caused by Leucoma depends on the size and situation of the
speck. The disease is irremediable, though the thin cloudy opacity,
which frequently surrounds the leucoma, may be dissipated. The
operation of artificial pupil is sometimes required, in order to afford
a degree of vision in this affection of the cornea,—as well as in the
speck of a similar appearance occasioned by effusion and organisation
of lymph betwixt the deep lamellæ of the cornea, and which is termed
_Albugo_.
[Illustration]
Albugo occurs during the intensity of inflammatory attacks. It also
is surrounded occasionally by thinner opacity, but not depressed and
unequal on the surface, as leucoma sometimes is. Large and tortuous
vessels are generally seen passing into albugines, but meshes of dilated
vessels are seldom present. When the affection is recent, it sometimes
disappears under proper treatment, especially in young subjects; but
the albugo is by no means so readily removed as the _Nebula_, or thin
cloudy opacity which is the frequent consequence of obstinate chronic
dilatation of the conjunctival vessels. Nebula is superficial, and
consists of mere thickening of the conjunctival covering, from lymph
having been effused. It impairs vision, but does not destroy it, for
the affected part remains semitransparent.
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