Opacity following the use of a lead lotion upon an ulcerated cornea has long been recognized and ascribed to the de posit of metallic lead in the denuded corneal tissue. But this explanation is now shown to be incorrect, for at least some of these cases.
A case of corneal ulceration was treated with iodoform ointment, but no preparation of lead was used. The lower half of the cornea presented a white metallic appearance like that ascribed to the use of a lead lotion. Darier (Rev. Gfin. d'Ophtal., July 31, '96).
Iodine-vasogen is a valuable applica tion in infiltrated and spreading ulcers of the cornea, whether associated with purulent conjunctival secretion or not. It is particularly indicated in those eases in which the galvanocautery is contra-indicated by the situation of the infiltrate. It rarely causes pain, if not applied in excess, and never causes any unpleasant reaction or untoward effects. Preliminary auresthetization of the cor nea with cocaine is rarely required, and in general is better omitted. The appli cation is best made every other day until the infiltrate begins to shrink de cidedly, and then should be made every three or four days until the infiltrate disappears. Alexander Duane (Ar chives of Ophthalmology, vol. xxxi, No. 5, 1902).
Opacity from pigment-deposit in the cornea is of two kinds. In one, small spots of black or brown pigment are de posited in the cornea, late in the history of an intra-ocular inflammation which has usually been attended with high ten sion. Such pigment-deposits are likely to be permanent. A temporary general staining of the cornea by blood-pigment occurs after extensive limmorrhage within the eyeball. The staining is at first comparatively uniform, and clears up from the margin of the cornea.
An acute glaucoma of eight weeks' standing had been treated with iridec tomy, which was followed by a hwrnor rhage filling the anterior chamber. When the lilernorrhage was absorbed and the cornea cleared up, pigment-masses were noticed near the centre of the cornea and below it. These had their origin in dots of gray opacity, which were seen to become pigmented, and change in color from gray to brown and black. C. A. -Wood (Annals of Ophth., Apr., '96).
An extensive prolapse of the iris through \vound of the eye by scissors was removed by iridectomy. This was followed by repeated hmmorrhages into the anterior chamber, and subsequently the patient, a girl of 3 Vr„ years, had measles. There was marked discolora tion of the cornea beginning the tenth , day after operation, and increasing until the membrane assumed a greenish brown color, except near the cornea.1
margin. At the end of fifteen months the blood-staining of the cornea had cleared up except at the centre, where there was an oval patch of brownish hue with sharply-marked edges; and this part had also become translucent. G. E. de Schweinitz (Ophthal. Record, Dec., '97).
Haziness of the cornea due to inflam matory deposit tends to clear up at first rapidly and then more slowly after the subsidence of the inflammation causing it. This tendency to clear up may be accelerated, or continued after it would otherwise cease, by certain applications to the cornea. One of the oldest, the Zusting of calomel upon the surface, is still useful in the opacities left by phlyc tenular keratitis. Other irritants have been used in a similar manner. Massage of the cornea, either by rubbing through the closed lid, or by stroking and rubbing the cornea with a corneal spatula, or specially devised instrument, has also a positive effect in renewing the process of absorption -when this becomes slug gish. Electrolysis is also of marked value in clearing up such opacities, if they are unattended with anterior synechim, and especially if due to infiltration of the cornea rather than repair of extensive loss of substance by ulceration.
Men it is impossible to secure further absorption of the opacity, it may be ren dered less noticeable and annoying by tattooing the affected region.
[L. de Wecker insists that tattooing for optical purposes should be recognized as distinct from tattooing merely to im prove the appearance of a sightless eye. He believes that, by rendering opaque the semitransparent corneal tissue in front of the pupil, the diffusion of lig,ht can be diminished and the acuteness of vision improved. Tattooing for this pur pose may require to he combined with optical iridectomy or the division of the sphincter of the iris. In performing the operation the area to be tattooed must first be distinctly- marked out, and then must be colored a uniform intense black. EDWARD JACKSON.] Iridectomy should not be performed for optical purposes in children whose corneas are opaque; yellow ointment should be used, followed by massage through the closed lids for thirty seconds, the eye being washed afterward with boric-acid solution. This treatment is repeated daily until the eye is injected, and then discontinued, to be renewed when the irritation disappears. Of 112 children with leucomas of different ex tent and depth, 91 were cured, 11 im proved, and 10 did not continue treat ment. I. Malgat (Rec. d'Ophtal., Mar., '9S).