Persons affected with gout rarely be come tuberculous, and some patients with tuberculosis have had that disease decidedly checked on the supervention of an attack of gout, be'cause uric acid and urates are antagonistic, not only to the pyogenic micro-organisms, but to the bacillus tuberculosis. MoMere (Le Bull. Mc•d., No. IS, 'SS).
Obesity and diabetes mellitus are often associated with gout. 1Tratic deposits have been found in the cornea and con junctiva; uratic keratitis and iritis and gouty inflammation of the vitreous body have been observed.
Case of a gouty patient, of 54 years, who presented, in the anterior elastic lamina and in the proper tissue of each cornea, several opaque foci, connected by anastomosing lines. These opacities were proved to be due to a deposit of mate of soda. Chevallerean (Recueil d'Oplital., Apr., '91).
Following conclusions reached after careful study of five cases of gouty reti nitis and neuroretinitis: 1. The changes in the fundus are always bilateral, though rarely symmetrical in the two eyes. 2. The degeneration in the walls of the blood-vessels and in the retina cause marked impairment of central vision, little or no loss of peripheral vision, and never end in blindness. 3. The loss of central vision is always pro gressive up to a certain point, unless the cause of the lesion is recognized early in the onset and immediately and properly handled. Improvement in the vision after the disease is established cannot be expected. 4. themorrhages into the retina are rare except in the early stage of the disease. 5. The most marked feature in the fundus is the development of arteriosclerosis and phlehosclerosis. 6. Another almost equally pathognomonic symptom is the peculiar, yellowish, gran ular exudation in the retina, located by the ophthalmoscope around the posterior pole of the eye and generally leaving the macula intact. 7. The changes in the optic-nerve fibres seem to be almost en tirely intra-ocular, and cannot be traced for any great distance back of the eye ball. Bull (N. Y. Med. Jour., Aug. 12, '93).
Gouty eye diseases occur intermit tently, often once a year,—are very pain ful, but subside completely after a time.
The subjects are usually adult men, who, though not liable to gout, have suffered from sciatica and the like. A some what peculiar form of destructive iritis, usually symmetrical, is occasionally met with in women who inherit gouty tend encies and have arrived at the climac teric period. It is sometimes almost painless. In men, the subjects -of ac quired gout, we sometimes see acute and very painful ulceration of the margin of the cornea of a definitely gouty nature, and curable by treatment suited to that diagnosis. Jonathan Hutchinson (Ar chives of Snrg., July, '95).
The changes induced by the gouty diathesis may consist in seroplastic in flammations, with or without perceptible excretion of uric acid. As examples are reported cases of scleritis, iridocyclitis with deposits between the choroid and retina, nodules within the sclera, and one typical instance of episcleritis periodica fugal. Moreover, gout may be the in direct cause of ocular affections, espe cially in consequence of certain vascular changes, particularly precocious ather mita. To this category belong cases of severe relapsing disease of the vitreous humor, which finally leads to cataract, detachment of the retina, and retinitis hmmorrhagica. Certain sclerotizing af fections of the cornea come under the same head. Some cases of glaucoma exhibit a relationship to gout. Wagen mann (Deutsche med. Woch., No. 36, '90).
A frequent lesion is an insidious variety of exudative choroiditis, which appears under the clinical picture of so-called serous iritis or iridochoroiditis, usually occurring during the intervals between acute attacks.
Of all the obscure ocular lesions caused by an outbreak of gout this is the most treacherous.
This lesion of the uveal tract is the most frequent expression of the gouty diathesis.
Another less frequent lesion is iritis, associated with zona ophthalmica, or herpes zoster of the eye.
Another rare expression of gouty di athesis appears under the guise of a low grade of iritis, or of the iridochoroiditis referred to, the process being secondary to degenerative changes which affect the retina, and finally resulting in glaucoma.