A handbook of ophthalmic science and practice / by Henry E. Juler.

  • Juler, Henry E. (Henry Edward), 1866-1921.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of ophthalmic science and practice / by Henry E. Juler. 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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    abscess of the orbit; indeed, pus very rapidly forms beneath the periosteum, dissecting it from the bone, causing the death of the latter, and not unfrequently leading to the formation of an abscess in the anterior lobe of the brain, or to meningitis. Treatmerd consists in making an early and free incision down to the bone. The inflammation is of a low erysipelatous type, and antiphlogistic measures are not well borne. A careful watch must be kept for the onset of cerebral symptoms. Chronic periostitis is usually the result of syphilis, rheu- matism, or scrofula. The pain is of a dull aching character, and is worse at night. When it affects the margin of the orbit there are oedema of the eyelid and tenderness on pressure. When deeply seated there is frequently paralysis of one or more of the ocular muscles, and sometimes prominence of the eyeball. The treatment consists in giving full doses of iodide of potassium, and counter-irritation is sometimes useful. In scrofulous cases it is nearly always the margin of the orbit that is affected; the treatment must then of course be directed to the general disease. (Edema of the orbital cellular tissue with exophthalmos occasionally occurs, and usually indicates deep-seated trouble in the circulation of the ophthalmic vein. This condition may be brought about by any pressure upon the vein in its passage through the sphenoidal fissure, such as often takes place in the case of periostitis, tumours of the optic nerve, and such like, and is then only a sign of embarrassed circulation; but when, in addition to these signs, we find the pupil widely dilated, the globe quite immovable, and that cerebral symptoms are becoming manifest, the case is much more serious, and is indicative of thrombosis of the cavernous sinus. Emphysema, or the infiltration of air into the cellular tissues of the orbit, may be caused by rupture of the ethmoidal cells, or of the lachrymal sac. It may give rise to considerable proptosis, with swelling of the conjunctiva and eyelids. Tha swelling is increased when the patient makes a forcible expira- tion with the anterior nares closed, as in blowing the nose. It is characterised by a crackling sensation on digital examination, and can be reduced by firm pressure exercised over several days.