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
1. _Scantiness of Contents._--One chamber was quite empty, due to
the presence of a corneal fistula (Pl. IV., Fig. 23). In
a number of cases the chamber was greatly shallowed, owing to the
encroachment of the vitreous body upon it. In these the filtering angle
was sealed by adhesion over a wide area. In a few cases _l’iris bombé_
was responsible for the shallowing of the chamber (Pl. VI.,
Fig. 34). In yet others a severe plastic inflammation had involved
the structures, lying in and posterior to the aqueous chamber, and
had matted them to the posterior surface of the cornea, thus almost
obliterating the cavity. This union had been so strong that in the
process of hardening the membrane of Descemet remained adherent to the
organised exudate beneath it, and a spurious chamber was thus formed
lying in the substance of the cornea (Pl. VI., Figs. 35 and
36).
2. _Hypopyon_ was present in 6 specimens, and in one the pus was mixed
with blood. The length of histories in these cases varied from a matter
of months up to twenty years.
3. _Hyphæma._--Blood was present in the anterior chamber in 9
specimens. In some of them it was fresh, whilst in others it was
altered and decolorised. The long histories given by a number of
these cases suggest either that there had been some recent cause
for hæmorrhage, or else that a leakage of blood had been constantly
occurring. In 2 of the eyes the iris had been torn; in every one of the
others there was evidence that severe iritis had been present.
4. _Vitreous in the Anterior Chamber._--In 4 eyeballs the aqueous
and vitreous cavities appear to have been in free communication with
each other, and filaments of the vitreous body can be traced into the
anterior chamber. In 2 of these the angle was widely open, and in the
other 2 it was closed by irido-corneal adhesions.
5. _Lens Matter in the Chamber_ (Pl. II., _Figs. 10, 12,
and 13_).--In 4 eyes lens matter was found in the anterior chamber.
In one the history showed that a nucleus had passed freely backwards
and forwards between the two chambers (Pl. II., Fig. 11). In
another a Morgagnian cataract was wedged in the angle of the chamber,
but had contracted no adhesions; in the remaining 2 the nuclear masses
were firmly fixed in position by an abundant quantity of exudate.
6. _Albuminous Exudates in the Anterior Chamber._--These were found
in 3 cases; few or no structural elements were present. During life
the contents of the chamber were fluid, but they had coagulated under
the influence of the formalin preparation of the specimens; they were
probably derived from the iris and ciliary body.
PLATE VI
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