Disease of the optic nerve in myxedema : its relationship to the thyroid gland and to the hypophysis / George S. Derby.

  • Derby, George S.
Date:
1912
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Licence: In copyright

Credit: Disease of the optic nerve in myxedema : its relationship to the thyroid gland and to the hypophysis / George S. Derby. 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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    . Case 12.—Hennicke' reports the case of C. V., a man aged 53, school teaclier, who came in October, 1907, complaining that he had lost the outer lialf of the field of vision in his right eye. His face was swollen; the eyelids were thickened; and gait was unsteady. The speech was slow and stumbling. Eye examination showed vision 6/9 in each eye. Ophthalmo- scopic examination normal in the left eye. In the right eye, the disk was somewhat reddened and the outlines blurred; arteries narrow; veins normal. His physician reported that he treated the patient for myxe- dema for five and one-half years, and during that time there had been marked progress in the disease. On July 23, 1910, he appeared again, complaining of flashes of light in front of both eyes. Right vision was 6/3C; the outer half of the field of vision was completely lacking; left vision equaled 6/12; field of vision about normal. The oph- thalmoscopic finding was the same as in 1907. Since 1903, he had been treated with a thyroid preparation which improved his condition. If he did not take it, he was unable to work. He returned two months later. During this time, the con- dition of the eyes had become very much worse. Right vision equaled hand movements; left vision, 6/24. In the.left side now, the outer half of the field of vision was contracted. The right optic disk was pale; the edges blurred. The arteries could hardly be seen. In the left eye, the disk was swollen and reddened; the edges blurred; and the surroundings of the disk were opaque; the arteries were small and the veins full. Hennicke advised that the thyroid preparation should be omitted, as he believed that it caused the ocular disease. Patient was placed on Fowler's solution. Under this treat- ment some improvement took place. Jan. 27, 1911, right vision was 6/30; left, 6/12. The field of vision in both eyes showed an absence of the outer half of the field. Patient was again taking thyroid preparation. Z-ray examination was totally negative. Hennicke is of the opinion that, in this case, it was not the myxedema that was responsible for the disease, but the thyroid preparation. Improvement in the vision took place when this preparation was left off, but the patient^s general condition became so poor that it had to be taken up again. Hennicke based his views on the work of Coppez^ 21. Honnicke : Tu^^rankuns bei Mysoedem, Klin. Monatsbl. f. Augenhellk.. November, 1911, p. 589.