Some recent theories regarding the pathogeny of sympathetic ophthalmia, viewed from a macroscopic standpoint / by Samuel Theobald.

  • Theobald, Samuel, 1846-1930.
Date:
[1884]
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Licence: Public Domain Mark

Credit: Some recent theories regarding the pathogeny of sympathetic ophthalmia, viewed from a macroscopic standpoint / by Samuel Theobald. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    Tn a word, we fail to find any justification, whatever, for the conclusion reached by Alt (and which has been accepted by so many), that the data he has brought together strongly sustain the view that the optic nerve plays an important part in the transmission of sympathetic ophthalmia; but, on the contrary, we are convinced that if his statistics be examined in an unbiassed spirit it will be found that it is the old theory, which attributes to the ciliary nerves the impor- tant part in the production of sympathetic ophthalmia, that is, in reality, strongly sustained. As to the clinical evidence which has been relied upon to support the view that sympathetic ophthalmitis is the result of a progressive optic neuritis which extends from the primarily to the secondarily affected eye, it proves upon examination to be as inconclusive as the pathological testi- mony which we have just examined. Vose Solomon and Mooren, for example, each report a case in which sympa- thetic inflammation appeared after enucleation of the ex- citing eye, and as they had the misfortune to employ defective scissors to divide the optic nerve with, they rush to the absurd conclusion that the sympathetic affection was due to the bruising of the optic-nerve fibres, and hence that the inflammation must have spread by this route. It is scarcely necessary to point out, as Brudenell Carter has already done in alluding to Solomon's case,1 that the ciliary nerves must have participated in the unusual laceration to which the optic nerve was subjected; so that as far as the question of transmission is concerned, these cases are with- out significance, and may be quoted with the same show of reason in support of either the ciliary-nerve or the optic- nerve hypothesis. It may be remarked also in regard to these cases, as well as of the frequently quoted cases of Colsmann and Hugo Muller (in which a neuro-retinitis developed in the uninjured eye a few days after the enucle- ation of the other), that not only is there no ground for supposing that the sympathetic outbreak was in any way dependent upon the cutting of the optic nerve, but that it is not improbable that the attack would have occurred, exactly Diseases of the Eye, Am. edition, p. 115.