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Polycoria

iritis, iris, pupil, ciliary, iridocyclitis, plastic and occurs

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POLYCORIA, multiple pupils, may be caused by division of the normal pupil into two by a band of persistent pupillary membrane, or it may be from openings in other parts of the iris. Only the cen tral or true pupil is furnished with a sphincter muscle.

Iritis; Cyclitis; Iridocyclitis.

Plastic inflammation of the iris and ciliary body includes iritis, cyclitis, iridocyclitis, parenchymatous and serous iritis, and the varieties of iritis named syphilitic, rheumatic, etc., according to the supposed cause.

SYMPTOMS.—Pain in and about the eye becoming severe, worse at night, and preventing sleep, is rarely absent. Red ness is seen in the pericorneal zone; and the color of the iris is altered and the pupil contracted by hyperfemia. The iris is thickened and its surface dull. Vision is impaired by haziness of the media, plastic exudate causes the iris to adhere to the anterior capsule of the lens, posterior synechia. When. the ciliary body is much involved, dots of exudate are deposited on the posterior surface of the cornea, usually on a triangular area at the lower part, "keratitis punctata"; and the ciliary region is tender to touch.

The incipient symptoms of syphilitic iritis are generally very insidious, and consist in subjective sensations of light rather than failure of visual power. Almost every part of the eye is more or less affected. The retinitis may be rnonolateral. Hirschberg (Deutsche med. Woch., Oct. 25, '88).

The cornea is affected in every case of iritis. In no case does it retain its per fect transparency. The opacities consist of deposits upon Descemet's membrane and infiltrations in the substantia propria. It is these deposits which cause the pupil and iris to appear blurred and hazy, and which are often referred to as muddiness of the aqueous humor. Frie denwald (Arch. of Ophth., Apr., '96).

Two cases of painful iritis. In both the only sign of iritis was a slight slug gishness of the pupil. There was almost no injection, and what was present was not characteristic. In the first case synechim were found and the pupil was irregular. In the second the whole pupil lary border was adherent to the lens. Walker (Phila. Polyclinic, Jan. 9, '97).

The synechife prevent the dilatation of the pupil under a mydriatic, which there fore becomes irregular in shape. In a few cases general adhesion of the iris tc the lens occurs without much pain or redness of the eye.

ETIOLOGY.—Iritis may be caused by traumatism, but usually arises from some dyscrasia. Half of all cases are due to syphilis; other causes in the order of their frequency are rheumatism. anfemia.

acute febrile diseases, diabetes, rhoea, gout, and new growths in the iris. In syphilis it occurs in the secondary n (lir after infeetion. With ,t oicur with Or be :1M1 Cr! 1,:St r Of till.' iS (Wee. 1 t a s ri convalescence -FAO \ 1011, forms of iritis nil in igctions. 1% here the condition occurs as rtault of syphilis, 'qt.., it may be re gardtd .t, an attempt at elimination by ti.e gland ithe tiveal tract being con sidtred as such). Lapersonnc (f.c 13u11. Mtt1. Feb. 21, '921.

Three cases of iritis liremorrhagiea, in tthiali the anttrior chamber was filled iiith blood. %Odell WaR filially totally alasotbed. ln all three there was a dis Ono. rheumatic history. Reche (Zehen der'a klin. :Monats. f. Augenli.. 'May, '92).

Case of recurrent iritis occurring in a woman who was subject to attacks f subacute rheumatism. The ocular iymptoms yielded to salicylic acid. Foltz :Med. Times, Dec., '93).

Case of successful extraction of a piece cf steel from an iris in which a plastic inflammation had been established. with rompt subsidence of the inflammatory reactitn and restoration of full vision. Heckel sEull. de la Soc. de Mt"..d. de Rouen, Oct., '95).

Most forms of iridocyclitis result from the action of micro-organisms. Sydney Stephenson 'Lancet, Feb. 29, '96).

Most inflammatory affections of the iris and ciliary hody are the outcome of con stitutional ailments. which are in turn due to mierobic infection. In certain frrnis of iridoeyclitis specific micro organisms have been found in the an terior chamber. There exist g,00d grounds fir believing the proximate cause of all eases of endogenous iridocyclitis to be the excretion by the ciliary body of micro organisms or their products. Therefore b•etPriological examination of the ague c,us humor might furnish a ready means cf detecting an organism in those mala dies thought to be of infectious nature, such as rheumatism. It might also lead to a cerrect conclusion as to the cause of doubtful cases of iridocyclitis. Stephen son I Lancet, Feb. 29, '96).

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