PHLYCTENULAR KER.A.TITIS occurs conunonly in young children, in close association with phlyctenular conjunc tivitis. The phlyetenule containing cells and fluid arises on the surface of the cornea, and in a few hours, or a day or two, ruptures and gives rise to a small ulcer. Later a few branching vessels forming a long narrow leash, usually somewhat in a direction of a radius of the cornea, may make their way out from the nearest portion of the Embus to the region of the ulcer. This is especially likely to occur if several phlyctenules have successively arisen on the same part of the cornea. The condition is then spoken of as superficial vascular or fascic ular keratitis. The ulcers rarely perfo rate the cornea, but may do so. This form is particularly liable to relapse. It is often attended by the most severe and obstinate photophobia.
Bummus KERATITIS is marked by re current attacks of severe burning pain followed quickly by the raising up of a large bleb or bulla on some part of the cornea. The epithelium forming the anterior wall of the bleb quickly rupt ures, leaving loose shreds of epithelium and a broad abraded surface, which in a few days heals over, and some months may pass before there is a recurrence. TWO forms of the disease are recognized: one occurring in eyeballs that have been the seat of severe inflammation of the uveal tract, and have undergone degen erative changes; and the other due to previous wounds of the cornea causing extensive loss of the corneal surface in an otherwise-healthy eye.
Primary bullous keratitis arises as fol lows: Some variable times after an abra sion of the cornea by the finger-nail, a twig, or such object, there occurs an at tack of set. tie pain in the eye, \\
s begins In the morning a lien the pa tittit aakts tip. It usually lasts it few Inioutt s. ceasing \\jilt the occurrence of an atundant flow of tears. These at tneks recur ith varying frequency.
ri“ re pilOt01,110111:1, hyperiumia, (edema ci the lids. ete. At this stage there is disti vtred a larg,c bulla of the cornea, hidi is frequently only half-filled With le.ir tluid and can be displaced on move num of the loacr eyelid; a small spot jS SCV11 to he dull, and the bleb r its remains can be picked off with it,rti s, leaving a large, denuded surface midi uneven ntarg,ins extending to one fifth or even as much fIS one-balf of the area of the cornea. After three days or a little more, the denuded surface is again covered. but may break down soon there after, and the same process be 7:Tented ntany times. There is usually several months' delay from the titne of the origi nal accident until the development of the bulia. Edmund Jensen (Arch. d'Ophtal., Apr., '9S).
keratitis; a case of this rare affection due to cataract and complete synechia of the iris. The usual treatment of opening the bullm and touching the raw spots with nitrate-of silver solution was first adopted. This, together with atropine, was fruitless. Iridectorny was then done under cocaine. At first this promised success, but sud denly new bullm appeared and the eye ans enueleated. E. O. Sisson (Jour. Amer. Alcd. Assoc., Aug. 25, 1900).