OPHTHALMIA (derived from the Greek word orhthalmos, the eye) was originally and still is sometimes used to denote inflammation of the eye generally, but it is at the present time usually restricted to designate inflammatory affections of the mucous coat of the eye, termed the conjunctiva.
There are several important and distinct varieties of ophthalmia (in the restricted sense of the word) which require special notice.
Catarrhal Ophthalmia.—Its leading symptoms are redness of the surface of the eye (the redness being superficial. of a bright scarlet color, and usually diffused in. patches), sensations of uneasiness, stiffness and dryness, with slight pain, especially when the eye is exposed to the light; an increased discharge, not of tears, except at the beginning of the attack. but of mucus, which at. first is thin, but soon becomes opaque, yellow, and thicker; pus (or matter, as it is popularly termed) being seen at the corner of the eye, or between the eyelashes along the edges of the lids, which it glues together dining the night. The disease results in most cases from exposure to cold and damp, and is very apt to be excited by exposure to a draught of aic, especially during sleep. It is popu larly known as a cold or a blight in the eye. With regard to treatment, the patient should remain in rooms of a uniform temperature, and should at once take about five grains of calomel, followed by a black draught. The dye should be frequently bathed with poppy decoction, lukewarm or cold as the patient prefers. If the affection does not readily yield to these measures, a drop of a solution of nitrate of silver (four grains of the nitrate to an ounce of distilled water) should be let fall into the eye twice or thrice a day. It usually causes a smarting sensation for about ten minutes. after which the eye feels much easier than, it did before the, drop was applied. The adhesion of the eyelids in the morning may be avoided by smearing their edges at bedtime with a little spermaceti ointment.
Purulent ophthalmia differs from catarrhal ophthalmia in the severity of its symptoms, and in its exciting causes. it is a violent form of inflammation of the conjunctiva; is accompanied with a thick purulent discharge on the first or second day of its com mencement, and is very apt to occasion loss if vision. There. are three remarkable varieties of this affection, called respectively (1) purulent ophthalmia of adults, or Egyptian ophthalmia, or contagious ophthalmia; (2) gonorrheal ophthalmia; and (3) puru lent ophthalmia of newly-born children. (1) Purulent ophthalmia of adults bezius with the same symptoms as catarrhal ophthalmia, but in a very exaggerated form. .`Pte con junctiva rapidly becomes intensely red, and soon appears raised front the sclerotic by the effusion of serum between them, projecting around the cornea, which remains buried, as it were, in a pit. Similar effusion takes place beneath the mucous membrane lining the eyelids, causing them to project forwards in large livid convex masses, which often entirely conceal the globe of the eye. These symptoms are accompanied by severe burn ing pain, great headache, fever, and prostration. When the disease is unchecked, it is liable to produce ulceration or sloughing of the cornea, with the escape of the aqueous humor and protrusion of the iris; and even when these results do not follow, vision is often destroyed by permanent opacity of the cornea. It is a common disease in Indium, Persia, and Egypt; and in consequence of its having been imported from the last named country into England by our troops in the beginning of the present century, it got the name of Egyptian ophthalmia. Some idea of its prevalence and of its danger may be formed from the facts (1) that two-thirds of the French army in Egypt were laboring under it at the same time, and (2) that in the military hospitals at Chelsea and Kihnain ham there were, in Dec., 1810, no fewer than 2,317 soldiers who had lost the sight of
both eyes from this disease. Until after the war in Egypt, the disease was unknown in Europe. Since that time it bas not unfrequently broken out in this country—not only among troops, but in schools, asylums, etc. The disease is unquestionably contagious, but there are good reasons for believing that it often arises, independently of contagion, from severe catarrhal ophthalmia under unfavorable atmospheric and other conditions; and that having so originated, it possesses contagious properties. Gonorrheal ophthalmia arises front the application of gonorrheal discharge or matter to the surface of the eye; and hence is most common in persons suffering from the disease from which this variety obtains its specific name. It is, moreover, not unfrequently occasioned by the common but disgusting practice adopted by the poorer classes, of bathing the eyes in human urine, under the idea that by this procedure they strengthen the sight In its symptoms. it is almost identical with ordinary purulent ophthalmia. The purulent ophthalmia of children usually begins to appear about the third day after birth. It is a very common affection, and Its importance is apt to be overlooked until it has made considerable pro gress. If the edges of the lids appear red and glued together, and if the eye, when the lids are separated, shows redness and swelling of the conjunctiva, there is no doubt of the nature of the disease, which, if not checked, progresses in much the same way as in adults. It is, however, much more amenable to treatment, and with proper care the sense of sight is seldom impaired, provided the disease. has not extended to the cornea before medleal aid is sought. Of the treatment of purulent ophthalmia in these various forms, we shall say nothing more than that it must be left exclusively to the medical practitioner, whose advice should be sought as soon as there is the slightest suspicion of the nature of the case.
There is one more form of this disease which is of very common oceurence, and has received the vat-ions names of strununms (or serffalous), pustular, and phlgetenod r ephthnlmin. It is intimately connected with the scrofulous constitution, and is most pre valent in children from -1 to 10 or twelve years of age. The most prominent symptom is extreme intolerance of light, the lids being kept spasmodically closed. When they are forcibly separated, a slight vascularity, usually stopping at the edge of the cornea. is observed, and at or about the line of separation between the cornea and sclerotic small opaque pimples or pustules appear. The treatment consists (1) in improving the general health by dime attention to the secretions, and the subsequent administration of tonics (such as mininin and cod-liver oil). and change of air; and (2) in local applications, such as solution of nit of silver, or wine of opium. dropped into the eye. or stimulating ointments (such as (ilium eitrimm ointment) smeared over the edges of the lids at bedtime. This form of disease-. being dependent on constitutional causes, is often very obstinate. and is always liable to recur. It is not unfrequently attended with the annoying com plication of a skin disease. known fis crasta lactea, on the cheeks, in consequence of the irritation eau-sed by the flow of so.ddin,g tears. The crusts or scabs are easily removed by a poultice or warm water dressing after which the part must be bathed by a lotion, consisting of a dram of oxide of zinc in four ounces of either pump or rose water.