The Indian operation of couching for cataractElliot, Robert Henry
History
The Indian operation of couching for cataract
Elliot, Robert Henry
Cataract -- Surgery -- India; Ophthalmology -- India -- History
Fig. 18: Specimen No. 99.--A large lens in its capsule is dislocated
upward and inward, and is adherent to the retina by inflammatory bands.
The retina shows very numerous white dots. There is a tendency to
equatorial scleral staphyloma.
Fig. 19: Specimen No. 171.--The retina is totally detached and rolled
up tight; cysts both false and true are to be seen in it. The lens is
imbedded in a mass of inflammatory exudate, matted to the iris and
ciliary body in front, and to the retina behind; the ciliary body
is detached. The coagulated subretinal exudate gives the specimen
the appearance of a half-marble. The sclera is folded owing to the
shrinking of the eyeball.
Fig. 20: Specimen No. 119.--From before backwards can be seen the iris,
the remains of the lens capsule, and the thickened anterior layer of
the hyaloid. The lens is dislocated backward between the second and
third of these, and is wedging them apart. The retina is detached over
nearly half the globe; this is in large part determined by the pull of
the shrinking thickened anterior hyaloid layer.
Fig. 21: Specimen No. 46.--The hard dark nuclear cataract had been
depressed; it lies in front of the unruptured anterior hyaloid
membrane, and therefore outside the vitreous cavity.
[Illustration: PLATE III.
Fig. 16 (No. 197).--Left eye, lower half.
Fig. 17 (No. 37).--Left eye, lower half.
Fig. 18 (No. 99).--Left eye, upper half.
Fig. 19 (No. 171).--Left eye, upper half.
Fig. 20 (No. 119).--Right eye, upper half.
Fig. 21 (No. 46).--Left eye, lower half.]
When we come to speak of the changes found in the vitreous, we shall
have occasion to refer to the frequency with which the hyaloid body is
represented by a shrunken cone with its apex at the optic nerve and
its base in the neighbourhood of the ora serrata. This form, which is
well known to pathologists, is due to the anatomical attachments of
the vitreous body, and to the fact that the latter undergoes shrinkage
after being thickened and opacified by the presence of inflammatory
exudate. In studying the present collection, one cannot fail to be
struck with the fact that the exudate, which fixes, or helps to
fix, the lens in its pathologic position, is one with, and part of,
this cone-shaped new formation. Before leaving the consideration of
this group, we must once again point out that no hard-and-fast line
separates it from the preceding one, and that intermediate links
between the two can easily be pointed to.
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