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Memphis Society of Ophthalmology and Otolaryngology
606
OMAHA AND COUNCIL BLUFFS SOCIETY
in the other. These remained healed for over a year. He recently saw a case reported in which the treatment of Schoeller was used with success. It consists of removing the epithelium and painting the surface with fresh acquori. Dr. Dean reported a similar case before the society some time ago, in which he applied 10% cocain to loosen the epithelium and then pulled the whole epithelium off. Iritis, Corneal Lesions. DR. HOLST presented a farmer, nine teen years old, with an unusual form of iritis. He was first seen six months ago when he had a severe iritis, two weeks after having a foreign body in his eye. The immediate attack seemed to yield to salicylates and atropin, but after two weeks a yellowish nodule two millimeters in diameter developed above the pupil. This suggested a diagnosis of tuberculosis, but the com plement fixation tests for tuberculosis were negative. He was, however, given a course of guaiacol. Now, five months after his last visit, he shows two small calcareous areas at the site of the former nodule, and a very simi lar area which was seen by slit lamp illumination to rest on the surface of the iris. He wished to ask the socie ty's opinion whether or not this was the site of a former tubercle. Discussion. — DR.
HAROLD
GIFFORD
asked if there was any possibility that the nodule could have represented an encapsulated foreign body. DR. HOLTZ said that there was no break in the cornea at the time of the injury, which would have suggested such a possibility. D R . BANISTER advised a Wassermann. D R . HOLST thinks that the fact that the lesion has cleared up so well without any specific treatment is against lues and rather in favor of tuberculosis.
MEMPHIS SOCIETY OF OPH THALMOLOGY A N D OTOLARYNGOLOGY. March, 1923. Parenchymatous Keratitis, D R . J. A. HUGHES presented the case: A. T., white, female age 8 years, came to my office on Oct. 22, 1922, to see about her eye. On examination I
found a fairly well developed child, but thin and pale and gives history as follows: Family history: Father and mother both living and in good health, never had syphilis. This is the only child born to them. Past history: Has had all diseases of childhood. Started to school when she was six years old and kept up her school work as other children. Present history: Right eye burning and photophobia began Oct. 20th and gradually grew worse. When seen in my office on Oct. 22nd could not stand light, and on examination of right eye I found three or four small dim gray maculae making their appearance near the center of the cornea, and every day since I have noticed new maculae come and their density increase and spread out toward the margin of the cornea, especially on the temporal side. You can now see any number of blood vessels as they come up over the cor nea. Vision in this eye was 20/40 the first time I saw her, and now she can not count fingers with that eye. About four weeks after onset of right eye, the left eye became involved very similar to the right, except the first maculae began near the margin of temporal side of cornea and is now gradually spreading to center. And in both eyes you can find most all the stages of parenchymatous keratitis, and in the mouth almost typical (Hutchinson's) teeth. Etiology: As a rule parenchyma tous keratitis is a disease of children from 6 to 12 years of age, and usually more prevalent in females. It is usually caused by hereditary syphilis. Treatment, local: Dark glasses, Moist hot compresses, atropin and iodin. Internally: Mixed treatment three times a day and mercury inunc tions once a day. I consulted Dr. Haase in regard to 606, and he advised continuing mercury inunction for a few weeks. In his opinion it is better than salvarsan as it is not eliminated so quickly. Discussion by E. C. Ellett and J. B.
Blue.
D. H. ANTHONY,
Secretary.
OMAHA AND COUNCIL BLUFFS SOCIETY
in the other. These remained healed for over a year. He recently saw a case reported in which the treatment of Schoeller was used with success. It consists of removing the epithelium and painting the surface with fresh acquori. Dr. Dean reported a similar case before the society some time ago, in which he applied 10% cocain to loosen the epithelium and then pulled the whole epithelium off. Iritis, Corneal Lesions. DR. HOLST presented a farmer, nine teen years old, with an unusual form of iritis. He was first seen six months ago when he had a severe iritis, two weeks after having a foreign body in his eye. The immediate attack seemed to yield to salicylates and atropin, but after two weeks a yellowish nodule two millimeters in diameter developed above the pupil. This suggested a diagnosis of tuberculosis, but the com plement fixation tests for tuberculosis were negative. He was, however, given a course of guaiacol. Now, five months after his last visit, he shows two small calcareous areas at the site of the former nodule, and a very simi lar area which was seen by slit lamp illumination to rest on the surface of the iris. He wished to ask the socie ty's opinion whether or not this was the site of a former tubercle. Discussion. — DR.
HAROLD
GIFFORD
asked if there was any possibility that the nodule could have represented an encapsulated foreign body. DR. HOLTZ said that there was no break in the cornea at the time of the injury, which would have suggested such a possibility. D R . BANISTER advised a Wassermann. D R . HOLST thinks that the fact that the lesion has cleared up so well without any specific treatment is against lues and rather in favor of tuberculosis.
MEMPHIS SOCIETY OF OPH THALMOLOGY A N D OTOLARYNGOLOGY. March, 1923. Parenchymatous Keratitis, D R . J. A. HUGHES presented the case: A. T., white, female age 8 years, came to my office on Oct. 22, 1922, to see about her eye. On examination I
found a fairly well developed child, but thin and pale and gives history as follows: Family history: Father and mother both living and in good health, never had syphilis. This is the only child born to them. Past history: Has had all diseases of childhood. Started to school when she was six years old and kept up her school work as other children. Present history: Right eye burning and photophobia began Oct. 20th and gradually grew worse. When seen in my office on Oct. 22nd could not stand light, and on examination of right eye I found three or four small dim gray maculae making their appearance near the center of the cornea, and every day since I have noticed new maculae come and their density increase and spread out toward the margin of the cornea, especially on the temporal side. You can now see any number of blood vessels as they come up over the cor nea. Vision in this eye was 20/40 the first time I saw her, and now she can not count fingers with that eye. About four weeks after onset of right eye, the left eye became involved very similar to the right, except the first maculae began near the margin of temporal side of cornea and is now gradually spreading to center. And in both eyes you can find most all the stages of parenchymatous keratitis, and in the mouth almost typical (Hutchinson's) teeth. Etiology: As a rule parenchyma tous keratitis is a disease of children from 6 to 12 years of age, and usually more prevalent in females. It is usually caused by hereditary syphilis. Treatment, local: Dark glasses, Moist hot compresses, atropin and iodin. Internally: Mixed treatment three times a day and mercury inunc tions once a day. I consulted Dr. Haase in regard to 606, and he advised continuing mercury inunction for a few weeks. In his opinion it is better than salvarsan as it is not eliminated so quickly. Discussion by E. C. Ellett and J. B.
Blue.
D. H. ANTHONY,
Secretary.