Right eye: linear pletion of which the
incision made in cornea,
on
com-
lens
spontaneously escaped with its capsule unruptured ; iridectomy was not performed. Left eye: linear incision, iridectomy and scoop extraction ; both eyes did well. 23.?Mussummat Kanee ; set. 45 ; female ; Brahmin ; of Gonda ; no occupation ; hard cataract in right eye, left
good ; 3 years' duration ; linear extraction performed right eye on 15th September 1878 ; cured. This was a black cataract; good vision on third day. 24.?Mussummat Mara; set. 45; female; Mussulmanee ; of Gonda; no occupation ; hard cataract in left eye, right eye good ; 2 years' duration ; linear extraction performed on left eye on 17th September 1878 ; cured. eye
on
25.?Peer Bux; ast. 50 ; male ; Mussulman ; of Gonda ;
A
RECORD
OF
OPHTHALMIC PRACTICE IN OUDH.
By G. D. MacReddie, M. Civil
Surgeon,
D.,
Gonda.
( Concluded from page 5.J 15.?Mussummat Ghana ; aat. 60 ; female; Mussulraanee ; of Gonda ; no occupation; hard cataract in both eyes ; l? year's duration ; linear extraction performed on left eye on 30th August 1878 ; cured. No complication ; good vision on third day. 16.?Mahabir; set. 45 ; male ; Brahmin ; of Gonda ; peon ; hard cataract in right eye, left eye good ; one year's duration; linear incision performed on right eye 31st August 1878 ; cured. Good vision on the second day ; was long under treatment for slight, but obstinate conjunctivitis ; sight con-
on
tinued excellent. set. 50 ; male ; Kaith ; of Gonda ; culticataract in both eyes ; one year's duration ;
17.?Gopal; vator ; hard
linear extraction performed on right eye on 1st September 1878 ; relieved. Slight escape of vitreous occurred. Some soft lens matter was left in the anterior chamber, which was in course of absorption when last examined ; pupil was drawn
; cornea clear ; vision
but sufficient to find his way in daylight ; will improve in time. 18.?Kalka ; set. 45 ; male ; Ahir ; of Sultanpur ; cultivator ; hard cataract m left eye, right eye good ; 1^ year's
upwards
indistinct,
duration; linear extraction performed 2nd September 1873 ; cured.
on
left eye
on
No complication ; good vision on second day. 19.?Mussummat Dinmanee ; set. 60 ; female ; Kaharin; of Gouda ; no occupation ; hard cataract in both eyes ; 1? year's duration ; linear extraction performed on right eye on
September 1878 ; cured. complication, ; good vision
6th
No
on
second
day.
20.?Mussummat Dulannee ; ait. 50 ; female ; Mussulmanee ; of Gonda ; no occupation ; soft cataract in right
eye, 10 years' duration ; hard cataract in left eye; 5 years' duration ; linear extraction performed on right eye on 7th September 1878, and on left eye on 5th October 1878 ;
cured.
shopkeeper ; hard cataract in right eye, left eye good ; one year's duration ; linear extraction performed on right eye ou 17th September 1878 ; cured. A little vitreous escaped; some cortical matter was left in the anterior chamber. The patient left the dispensary on the fourth day after operation ; intense conjunctivitis set in by exposure to the sun and wind. For this he was treated with belladonna lotion and ointment and mild astringents; the pupil was somewhat drawn up, but he had very good sight. 26?Bankay Singh ; set. 40 ; male ; Chatri; of Gonda ; peon ; hard cataract in left eye, incipient cataract in right eye; of 10 months' duration in left eye; linear extraction performed on left eye on 18th September 1878; cured. No complication ; good vision on third day. 27.?Boodhaie ; est. 50 ; male; Pasee; of Gonda ; syce ; hard cataract in left eye, right eye good ; one year's duraion ; linear extraction performed on left eye on 24th Sep-
tember 1878; cured. No complication ; good vision on third day. 28.?Dabee ; ?et. 45 ; male ; Koree; of Gonda ; no occupation ; hard cataract in right eye, left eye lost; 3 years' duration ; linear extraction performed on right eye on 21st September 1878; cured. was left in the anterior chamber, obstruct vision ; he had good vision He left hospital on the 10th day with-
Some cortical matter
this, however, did on the third day.
not
out leave.
29.?Hirae ; sat-. 60; male ; Ahir; of Gonda; cultivator ; hard cataract in right eye, left eye good; one year's duration ; linear extraction performed on right eye on 23rd
September 1878; cured. No complication ; good vision on second day. 30.?Mussummat Hingun ; aat. 60 ; female ; Mussalmanee ; of Gonda ; no occupation ; hard cataract in right eye, left eye good ; said to be of 3 months' duration ; linear extraction on right eye performed on 24th September 1878 ; cured. No complication ; good vision on third day. 31.?Mussummat Phooloo ; ost. 50 ; female ; sweeper ; of Gonda ; no occupation ; hard cataract, perfect in left, imperfect in right eye ; 8 months' duration ; linear extraction performed on left eye on 4th October 1878; cured. Some cortical matter was left in the anterior chamber, but this on
produced no complication. day.
the second
She had
good
vision
March 1,
1879.]
A RECORD OP OPHTHALMIC PRACTICE.?BY G. D.
32.?Mussummat Moona ; set. 45 ; female ; Brahmin ; of Gonda ; no occupation ; hard cataract in both eyes ; 3 years' duration ; linear extraction performed on left eye on 6th October 1878 ; cured.
complication ; good vision on the second day. 33.?Rughbur ; set. 60 ; male ; Brahmin ; of Gonda ; no occupation ; hard cataract in both eyes, imperfect in left eye; 3 years' duration ; linear extraction performed on right eye on 8th October 1878 ; cured. No complication ; good vision on the second day. No
; set. 50 ; male ; Mali; of Gonda ; no occu. ; hard cataract in left eye, right eye lost ; 1 year's duration ; linear extraction performed on left eye on
34.?Doorga
pation
Cth October 1878 ; unsuccessful. Patient is totally blind in right eye ; no tension of eyeball ; pupil somewhat dilated ; media clear. The opthalmoscope shows that this amaurotic condition is due to choroiditis and
atrophy of retinal vessels. Left eye.? Senile cataract; pupil dilated readily with atropine. When under examination with the oblique illumination the patient saw the light of the candlo ; it was hence determined to extract the cataract. Immediately on of the corneal incision there was an escape of vitreous ; the iridectomy and removal of the lens were rapidly performed, and the eye was at once band-
completion
aged. But, notwithstanding careful pressure and cold, intraocular hsemorrhage could not be arrested. 35.?Mussummat Bipta; jet. 50; female ; Mussulmanee; of Gonda ; no occupation ; right eye lost; hard cataract in left eye ; 10 years' duration ; linear extraction performed on
12th October 1878 ; unsuccessful. had had iritis complicating the cataract posterior synechia; tiie result of atropine
left eye This
on
woman
causing was
to dilate
had
some
the
pupil only to a small extent; she of light, as she saw the flame of in oblique illumination. I had the
perception
used a consultation with a medical friend from opportunity and we considered it safe to a neighbouring station, operate ; linear extraction was performed and the lens the candle
of
removed by scoop. On the third day she got an attack of intermittent fever : chemosis set in ; cornea remained clear. On the 17th chemosis advanced, cornea became of a dense opacity, and the eye was lost. From the accession of the severe symptoms the patient, an irritable old woman, would hardly allow her eye to be touched ; had she submitted to treatment, some degree of vision might have been preserved. In future, however, I shall always divide the treatment of cases complicated with the sequelse of iritis into two stages?
making an iridectomy and breaking down adhesions in the 1st stage and extracting the lens in the 2nd stage ; performing in fact Mooren's operation. 36.?Syed Ali Hussein; a^t. 50 ; male ; Mussulman; of .Faizabad; zemindar; hard cataract (both eyes); 5 years' linear extraction performed 14th October 1878 ; cured. No complication occurred, but some
duration;
on
right
eye
on
capsule remained behind after removal of lens ; on endeavouring to remove this an escape of vitreous took place : notwithmy fears, the patient recovered without any bad symptoms.
standing
MacREDDIE,M.D.
65
; set. 60 ; male; Mussulman; of Gonda; occupation ; hard cataract in right eye, left eye lost; 10 years' duration ; linear extraction performed on right
37.?Hyder
no
eye on lltlx October 1878 ; cured. The patient was operated on 10 years ago for cataract by the native method of reclination. His sight was restored by the operation, and remained good until 7 months ago, when the depressed lens rose from its bed and occupied its present position in the lower section of the anterior chamber, anterior to the iris, which is pushed back in a portion of its circumference, i. e., its outer and upper circumference lies in a more posterior than its inner circumference, which is in its natural site; the lens is seen pressing against the cronea. There is a quantity of liquid cortical matter in a fine
plane
capsule occupying three-fourths of the area of the pupil, leaving a fourth in the inner part of the area unobstructed, from which the patient has a little vision ; this amount of vision, however, is of no use to him, as he has barely the perception of large bodies standing in the sun light or against white surfaces; it was therefore determined to remove the dislocated lens. This was done by linear incision in the outer circumference of the cornea : an iridectomy was next performed, and lastly, the lens was removed with the scoop : the capsule ruptured and its contents escaped with the aqueous humour. The dislocated lens, though it was pressing on the iris, had not given rise to iritis. The
patient on
made
the 2nd
an
excellent recovery ;
he had
good
vision
day.
38.?Mussummat Birmya; ast. 5'1; female ; Dhobin ; of Gonda ; no occupation ; hard cataract in both eyes; 1 year's duration ; linear extraction performed on left eye on 20th October 1878 ; cured. In this case I made the incision in the cornea with the lance-shaped iridectomy-knife, but found that the wound would not admit the scoop; it had to be enlarged with the narrow knife and scissors ; on the 2nd day iritis set in, this was treated energetically by fomentations continued for half an hour at a time, and subsequently by the application of atropine (gr. iv. to 3 1) for half
hour, repeated every 5 minutes; treatment repeated a day. After 36 hours of such treatment the iritis was fortunately arrested, and she made an excellent
an
twice
recovery.
39.?Madhoopershad's mother ; set. 55 ; female ; Kaith; Bareily ; no occupation ; left eye hard cataract, (right eye blind) ; 9 years' duration ; linear extraction performed on left eye on 23rd October 1878 ; cured. No complication ; she obtained good vision. of Rai
40.?Mussummat Kishundaie ; ?t. 60 ; female ; Putliar ; of Gonda ; no occupation ; hard cataract (both eyes) ; H years' duration ; linear extraction performed on left eye on 1st November 1878 ; cured. No complication ; good vision on the third day. 41.?Mussummat Kaola ; set. 50 ; female ; Kaharin ; of Gonda ; no occupation ; chronic glaucoma ; 4 months' duration ; iridectomy performed on 28th August 1878, and repeated on 27th October 1878 ; cured. Both eyes in this patient were attacked with chronic glaucoma. She had completely lost sight in the left
THE INDIAN MEDICAL GAZETTE.
G6
eye, which presented marked glaucomatous appearances. Tension, T 3 ; pupil dilated and fixed ; aqueous and vitreous ; cloudy, preventing a view of fundus ; no pain. In the right eye tension T 2 pain ; vision confined to bare perception of bright day-light or the light of a candle ; fundus not
sufficiently perceptible to trace the vessels. hoped that a large upward iridectomy would restore a certain degree of sight; it was hence performed. Atropine was daily instilled into the eye for a fortnight; pain was relieved by morphia in ? gr. doses by the mouth :
It
was
tension became normal in the eye operated on, and she was free from pain ; but her sight did not return. On the 26th October she was carefully examined, and it was
found that the upward iridectomy did not include the pupillary margin, but that she could count fingers with light falling on the retina through the artificial pupil ; further, that the pupil did not dilate with atropine,
owing
to
synechia posterior. On 27th October a large was performed with the satisfactory degree of vision being thereby
ontward iridectomy result of a useful restored.
42.?Barisal; set. 35 ; male ; ivlussulman ; of Qonda occupation ; opacity of cornea ; 13 years' duration iridectomy performed on 3rd October 1878 ; cured.
no
; ;
The patient had bad ophthalmia 13 years ago, the result of which was rupture and sinking of the globe of the right eye, with dense opacity of the left cornea, confined however to the inner section, leaving a tract of healthy It was determined cornea in the outer and upper part. to try the effect of an artificial pupil in the outer part of the clear oornea; a small iucision was made with an iridectomy knife and a piece of their is excised : atropine On examining the eye the was dropped into the eye. next
of
day the patient
light;
he
was
found to have good perception and left the dispen-
quite regained sight
sary on the 8th. 43.?Girhoo ; jet. 16 ; male; Kahar ; of Gonda ; service ; strabismus convergens and sarsumvergens ; congenital; tenotomy performed on 9th and 23rd September 1878 ;
relieved. This was a case of congenital strabismus of a comolicated character, the internal and superior rectimuscles being both at fault. It was ascertained that a certain degree of binocular vision existed. It took two operations to rectify the disorder of the internal rectus (diviThe effect of the sion of tendon of the muscle.) was enhanced by a suture being inserted in " the ocular conjunctiva, near the outer cauthus ; a needle armed with silk thread was pushed towards the cornea beneath the conjunctiva to an extent of 4'" or h"' and then removed. In this way a broad fold of conjunctiva was included within the loop of the silk, which was then drawn tightly together and firmly knotted : this caused the eye to roll outwards." The suture remained in for three days. A shade was also worn for several days which excluded from vision the inner half of the right
tenotomy
(diseased) eye and outer half of the left (sound) eye, compelling the patient to exercise the external rectus of the right eye. 44 and 45.?These cases were children, aged respectively 2 and 3 years ; convergent strabismus ; congenital;
thus
[March 1,
tenotomy (tendon of internal recti) performed August and 3rd September 1878 ; cured.
1879.
on
24th
4G.?Odassia ; set. 3 ; female ; Koree ; of Gonda; no ; divergent strabismus ; congenital; tenotomy of external rectus) performed on 28th October (tendon 1878 ; cured. Operations Nos. 1?11 were performed at Pertabgurh, the rest at Gonda. Nos. 41?46 are selections from Case
occupation
Book. 8th November 1878.
J
incision made in cornea,
on
com-
lens
spontaneously escaped with its capsule unruptured ; iridectomy was not performed. Left eye: linear incision, iridectomy and scoop extraction ; both eyes did well. 23.?Mussummat Kanee ; set. 45 ; female ; Brahmin ; of Gonda ; no occupation ; hard cataract in right eye, left
good ; 3 years' duration ; linear extraction performed right eye on 15th September 1878 ; cured. This was a black cataract; good vision on third day. 24.?Mussummat Mara; set. 45; female; Mussulmanee ; of Gonda; no occupation ; hard cataract in left eye, right eye good ; 2 years' duration ; linear extraction performed on left eye on 17th September 1878 ; cured. eye
on
25.?Peer Bux; ast. 50 ; male ; Mussulman ; of Gonda ;
A
RECORD
OF
OPHTHALMIC PRACTICE IN OUDH.
By G. D. MacReddie, M. Civil
Surgeon,
D.,
Gonda.
( Concluded from page 5.J 15.?Mussummat Ghana ; aat. 60 ; female; Mussulraanee ; of Gonda ; no occupation; hard cataract in both eyes ; l? year's duration ; linear extraction performed on left eye on 30th August 1878 ; cured. No complication ; good vision on third day. 16.?Mahabir; set. 45 ; male ; Brahmin ; of Gonda ; peon ; hard cataract in right eye, left eye good ; one year's duration; linear incision performed on right eye 31st August 1878 ; cured. Good vision on the second day ; was long under treatment for slight, but obstinate conjunctivitis ; sight con-
on
tinued excellent. set. 50 ; male ; Kaith ; of Gonda ; culticataract in both eyes ; one year's duration ;
17.?Gopal; vator ; hard
linear extraction performed on right eye on 1st September 1878 ; relieved. Slight escape of vitreous occurred. Some soft lens matter was left in the anterior chamber, which was in course of absorption when last examined ; pupil was drawn
; cornea clear ; vision
but sufficient to find his way in daylight ; will improve in time. 18.?Kalka ; set. 45 ; male ; Ahir ; of Sultanpur ; cultivator ; hard cataract m left eye, right eye good ; 1^ year's
upwards
indistinct,
duration; linear extraction performed 2nd September 1873 ; cured.
on
left eye
on
No complication ; good vision on second day. 19.?Mussummat Dinmanee ; set. 60 ; female ; Kaharin; of Gouda ; no occupation ; hard cataract in both eyes ; 1? year's duration ; linear extraction performed on right eye on
September 1878 ; cured. complication, ; good vision
6th
No
on
second
day.
20.?Mussummat Dulannee ; ait. 50 ; female ; Mussulmanee ; of Gonda ; no occupation ; soft cataract in right
eye, 10 years' duration ; hard cataract in left eye; 5 years' duration ; linear extraction performed on right eye on 7th September 1878, and on left eye on 5th October 1878 ;
cured.
shopkeeper ; hard cataract in right eye, left eye good ; one year's duration ; linear extraction performed on right eye ou 17th September 1878 ; cured. A little vitreous escaped; some cortical matter was left in the anterior chamber. The patient left the dispensary on the fourth day after operation ; intense conjunctivitis set in by exposure to the sun and wind. For this he was treated with belladonna lotion and ointment and mild astringents; the pupil was somewhat drawn up, but he had very good sight. 26?Bankay Singh ; set. 40 ; male ; Chatri; of Gonda ; peon ; hard cataract in left eye, incipient cataract in right eye; of 10 months' duration in left eye; linear extraction performed on left eye on 18th September 1878; cured. No complication ; good vision on third day. 27.?Boodhaie ; est. 50 ; male; Pasee; of Gonda ; syce ; hard cataract in left eye, right eye good ; one year's duraion ; linear extraction performed on left eye on 24th Sep-
tember 1878; cured. No complication ; good vision on third day. 28.?Dabee ; ?et. 45 ; male ; Koree; of Gonda ; no occupation ; hard cataract in right eye, left eye lost; 3 years' duration ; linear extraction performed on right eye on 21st September 1878; cured. was left in the anterior chamber, obstruct vision ; he had good vision He left hospital on the 10th day with-
Some cortical matter
this, however, did on the third day.
not
out leave.
29.?Hirae ; sat-. 60; male ; Ahir; of Gonda; cultivator ; hard cataract in right eye, left eye good; one year's duration ; linear extraction performed on right eye on 23rd
September 1878; cured. No complication ; good vision on second day. 30.?Mussummat Hingun ; aat. 60 ; female ; Mussalmanee ; of Gonda ; no occupation ; hard cataract in right eye, left eye good ; said to be of 3 months' duration ; linear extraction on right eye performed on 24th September 1878 ; cured. No complication ; good vision on third day. 31.?Mussummat Phooloo ; ost. 50 ; female ; sweeper ; of Gonda ; no occupation ; hard cataract, perfect in left, imperfect in right eye ; 8 months' duration ; linear extraction performed on left eye on 4th October 1878; cured. Some cortical matter was left in the anterior chamber, but this on
produced no complication. day.
the second
She had
good
vision
March 1,
1879.]
A RECORD OP OPHTHALMIC PRACTICE.?BY G. D.
32.?Mussummat Moona ; set. 45 ; female ; Brahmin ; of Gonda ; no occupation ; hard cataract in both eyes ; 3 years' duration ; linear extraction performed on left eye on 6th October 1878 ; cured.
complication ; good vision on the second day. 33.?Rughbur ; set. 60 ; male ; Brahmin ; of Gonda ; no occupation ; hard cataract in both eyes, imperfect in left eye; 3 years' duration ; linear extraction performed on right eye on 8th October 1878 ; cured. No complication ; good vision on the second day. No
; set. 50 ; male ; Mali; of Gonda ; no occu. ; hard cataract in left eye, right eye lost ; 1 year's duration ; linear extraction performed on left eye on
34.?Doorga
pation
Cth October 1878 ; unsuccessful. Patient is totally blind in right eye ; no tension of eyeball ; pupil somewhat dilated ; media clear. The opthalmoscope shows that this amaurotic condition is due to choroiditis and
atrophy of retinal vessels. Left eye.? Senile cataract; pupil dilated readily with atropine. When under examination with the oblique illumination the patient saw the light of the candlo ; it was hence determined to extract the cataract. Immediately on of the corneal incision there was an escape of vitreous ; the iridectomy and removal of the lens were rapidly performed, and the eye was at once band-
completion
aged. But, notwithstanding careful pressure and cold, intraocular hsemorrhage could not be arrested. 35.?Mussummat Bipta; jet. 50; female ; Mussulmanee; of Gonda ; no occupation ; right eye lost; hard cataract in left eye ; 10 years' duration ; linear extraction performed on
12th October 1878 ; unsuccessful. had had iritis complicating the cataract posterior synechia; tiie result of atropine
left eye This
on
woman
causing was
to dilate
had
some
the
pupil only to a small extent; she of light, as she saw the flame of in oblique illumination. I had the
perception
used a consultation with a medical friend from opportunity and we considered it safe to a neighbouring station, operate ; linear extraction was performed and the lens the candle
of
removed by scoop. On the third day she got an attack of intermittent fever : chemosis set in ; cornea remained clear. On the 17th chemosis advanced, cornea became of a dense opacity, and the eye was lost. From the accession of the severe symptoms the patient, an irritable old woman, would hardly allow her eye to be touched ; had she submitted to treatment, some degree of vision might have been preserved. In future, however, I shall always divide the treatment of cases complicated with the sequelse of iritis into two stages?
making an iridectomy and breaking down adhesions in the 1st stage and extracting the lens in the 2nd stage ; performing in fact Mooren's operation. 36.?Syed Ali Hussein; a^t. 50 ; male ; Mussulman; of .Faizabad; zemindar; hard cataract (both eyes); 5 years' linear extraction performed 14th October 1878 ; cured. No complication occurred, but some
duration;
on
right
eye
on
capsule remained behind after removal of lens ; on endeavouring to remove this an escape of vitreous took place : notwithmy fears, the patient recovered without any bad symptoms.
standing
MacREDDIE,M.D.
65
; set. 60 ; male; Mussulman; of Gonda; occupation ; hard cataract in right eye, left eye lost; 10 years' duration ; linear extraction performed on right
37.?Hyder
no
eye on lltlx October 1878 ; cured. The patient was operated on 10 years ago for cataract by the native method of reclination. His sight was restored by the operation, and remained good until 7 months ago, when the depressed lens rose from its bed and occupied its present position in the lower section of the anterior chamber, anterior to the iris, which is pushed back in a portion of its circumference, i. e., its outer and upper circumference lies in a more posterior than its inner circumference, which is in its natural site; the lens is seen pressing against the cronea. There is a quantity of liquid cortical matter in a fine
plane
capsule occupying three-fourths of the area of the pupil, leaving a fourth in the inner part of the area unobstructed, from which the patient has a little vision ; this amount of vision, however, is of no use to him, as he has barely the perception of large bodies standing in the sun light or against white surfaces; it was therefore determined to remove the dislocated lens. This was done by linear incision in the outer circumference of the cornea : an iridectomy was next performed, and lastly, the lens was removed with the scoop : the capsule ruptured and its contents escaped with the aqueous humour. The dislocated lens, though it was pressing on the iris, had not given rise to iritis. The
patient on
made
the 2nd
an
excellent recovery ;
he had
good
vision
day.
38.?Mussummat Birmya; ast. 5'1; female ; Dhobin ; of Gonda ; no occupation ; hard cataract in both eyes; 1 year's duration ; linear extraction performed on left eye on 20th October 1878 ; cured. In this case I made the incision in the cornea with the lance-shaped iridectomy-knife, but found that the wound would not admit the scoop; it had to be enlarged with the narrow knife and scissors ; on the 2nd day iritis set in, this was treated energetically by fomentations continued for half an hour at a time, and subsequently by the application of atropine (gr. iv. to 3 1) for half
hour, repeated every 5 minutes; treatment repeated a day. After 36 hours of such treatment the iritis was fortunately arrested, and she made an excellent
an
twice
recovery.
39.?Madhoopershad's mother ; set. 55 ; female ; Kaith; Bareily ; no occupation ; left eye hard cataract, (right eye blind) ; 9 years' duration ; linear extraction performed on left eye on 23rd October 1878 ; cured. No complication ; she obtained good vision. of Rai
40.?Mussummat Kishundaie ; ?t. 60 ; female ; Putliar ; of Gonda ; no occupation ; hard cataract (both eyes) ; H years' duration ; linear extraction performed on left eye on 1st November 1878 ; cured. No complication ; good vision on the third day. 41.?Mussummat Kaola ; set. 50 ; female ; Kaharin ; of Gonda ; no occupation ; chronic glaucoma ; 4 months' duration ; iridectomy performed on 28th August 1878, and repeated on 27th October 1878 ; cured. Both eyes in this patient were attacked with chronic glaucoma. She had completely lost sight in the left
THE INDIAN MEDICAL GAZETTE.
G6
eye, which presented marked glaucomatous appearances. Tension, T 3 ; pupil dilated and fixed ; aqueous and vitreous ; cloudy, preventing a view of fundus ; no pain. In the right eye tension T 2 pain ; vision confined to bare perception of bright day-light or the light of a candle ; fundus not
sufficiently perceptible to trace the vessels. hoped that a large upward iridectomy would restore a certain degree of sight; it was hence performed. Atropine was daily instilled into the eye for a fortnight; pain was relieved by morphia in ? gr. doses by the mouth :
It
was
tension became normal in the eye operated on, and she was free from pain ; but her sight did not return. On the 26th October she was carefully examined, and it was
found that the upward iridectomy did not include the pupillary margin, but that she could count fingers with light falling on the retina through the artificial pupil ; further, that the pupil did not dilate with atropine,
owing
to
synechia posterior. On 27th October a large was performed with the satisfactory degree of vision being thereby
ontward iridectomy result of a useful restored.
42.?Barisal; set. 35 ; male ; ivlussulman ; of Qonda occupation ; opacity of cornea ; 13 years' duration iridectomy performed on 3rd October 1878 ; cured.
no
; ;
The patient had bad ophthalmia 13 years ago, the result of which was rupture and sinking of the globe of the right eye, with dense opacity of the left cornea, confined however to the inner section, leaving a tract of healthy It was determined cornea in the outer and upper part. to try the effect of an artificial pupil in the outer part of the clear oornea; a small iucision was made with an iridectomy knife and a piece of their is excised : atropine On examining the eye the was dropped into the eye. next
of
day the patient
light;
he
was
found to have good perception and left the dispen-
quite regained sight
sary on the 8th. 43.?Girhoo ; jet. 16 ; male; Kahar ; of Gonda ; service ; strabismus convergens and sarsumvergens ; congenital; tenotomy performed on 9th and 23rd September 1878 ;
relieved. This was a case of congenital strabismus of a comolicated character, the internal and superior rectimuscles being both at fault. It was ascertained that a certain degree of binocular vision existed. It took two operations to rectify the disorder of the internal rectus (diviThe effect of the sion of tendon of the muscle.) was enhanced by a suture being inserted in " the ocular conjunctiva, near the outer cauthus ; a needle armed with silk thread was pushed towards the cornea beneath the conjunctiva to an extent of 4'" or h"' and then removed. In this way a broad fold of conjunctiva was included within the loop of the silk, which was then drawn tightly together and firmly knotted : this caused the eye to roll outwards." The suture remained in for three days. A shade was also worn for several days which excluded from vision the inner half of the right
tenotomy
(diseased) eye and outer half of the left (sound) eye, compelling the patient to exercise the external rectus of the right eye. 44 and 45.?These cases were children, aged respectively 2 and 3 years ; convergent strabismus ; congenital;
thus
[March 1,
tenotomy (tendon of internal recti) performed August and 3rd September 1878 ; cured.
1879.
on
24th
4G.?Odassia ; set. 3 ; female ; Koree ; of Gonda; no ; divergent strabismus ; congenital; tenotomy of external rectus) performed on 28th October (tendon 1878 ; cured. Operations Nos. 1?11 were performed at Pertabgurh, the rest at Gonda. Nos. 41?46 are selections from Case
occupation
Book. 8th November 1878.
J
