Polycoria

iritis, iris, uveitis, causes, treatment, deposits and eyes

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Microscopical study of an eye with supposed tubercular iritis, in a girl, 15 years of age, without definite tubercular history. The affection began as a broNA n spot at the base of the iris and was fol lowed by the appearance of other shnilar areas, and, later, by blindness. The growth consisted of a granulomatous looking mass (with a few ill-defiped giant-cells) situated near the base of the iris and blocking the angle of the anterior chamber. Benson (Dublin Jour. Med. Science, Jan., '95).

Painless iritis, easily mistaken for less serious diseases, and readily diagnosed by the instillation of a mydriatie, is an insidious and dangerous affection, be cause not brought to the notice of the oculist until late in the disease, when synechi hare formed. G. Walker (Phila. Polyclinic, Jan. 9, '97).

Importance of clearly separating from iritis of the ordinary type certain cases hitherto classified with it, but in which only the posterior layer of the iris, the uvea, is involved. These cases grouped under the term "uveitis." The two affec tions differ in all respects as to symp toms, course, causes, and cure.

Uveitis is observed exclusively among women; iritis is more frequent among men. Uveitis always affects both eyes; iritis often affects but one. Uveitis lasts for years, and is manifested by slight periodical exacerbations, lasting five or six days; iritis is far more violent in its manifestations, but is cured in a month or two. The usual causes of iritis are syphilis, rheumatism, and gout. These are not the causes of uvcitis, whose causes are unknown. Atropine is of great value in the local treatment of iritis; but iridectomy is the only effective local treatment for uveitis.

The differential diagnosis during the attack inay be made by noting that in iritis there is always marked discolora ti m of the ant,rior surface of the iris, 1%1 ieti in II\ MA perceptible. In iritis 11,0 pain and hyper,cmia are violent; uNeitis pain is almost or quite absent and liyi er.einia slight. In iritis, even .11 art from adhesions. the pupil dilates it. perfeLtly ith atropine; in uveitis it dilates freely. except in so far as it is

1-,iind down by old syneclihr. Grand clOnt nt Lyon xxxii, No. 34).

—Iritis is a s‘ow painful. disease dangerous to the future usefulnesz. of the eye. Eyes that do well may take many weeks to recover; and pain may continue or increase many days after efficient treatment is begun. It is liable to relapse or recur, especially in rheumatic or eachectic patients. When the whole margin of the pupil is bound down to the lens, exclusion of the pupil, the forward current of fluid from the psterior chamber is obstructed, pushes rward the iris. and causes secondary glaucoma. Extensive plastic deposits about the lens and in the vitreous are lowed by softening. and shrinking of the eyeball with detachment of the retina, blindness. and degenerative changes in all parts of the eye. Few cases of iritis recover absolute13-, although many eyes remain quiet and useful throughout life.

In New Orleans cases of iritis are of much shorter duration (average of eight eases 12.6 days) than at other places NI here the relative humidity of the at nicsphere is greater. Ayres (New Or leans -Med. and Surg. Jour., Aug., 'SS).

The only case in ophthalmic literature of vascular formation of the lens-capsule during chronic iritis. The iris had been the subject of repeated attacks of inflam mation leading to extensive synechire. The new veins and arteries were dis tinctly .sPen ramifying on the lower outer sectirn of the capsule. Darier (Ann. crOcul., Jan.. '95).

Corneal complications occuring in the course of or after plastic iritis: fine dust-like deposits upon the membrane of Descemet, large deposits similarly lo cated (descematiti,), linear infiltration of the substantia propria, times as suming the appearance of circumscribed selerotizing keratitis, and in one case re sembling keratitis punctata vera. Frie denwald (Arch. Otol., Apr., '96).

Serous iritis never exists without coin cident cyclitis and choroiditis, and some times hyalitis. AV. Cheatham (Ophth. Rec., Aug., '97).

Sometimes iritis causes a myopia that may last for some months.

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