Glioma of the Retina— or, more strictly, gliosarcoma of the retina—is a malignant new growth occurring. in early childhood.
SYMPTOMS.—Attention is usually first attracted by the appearance of a yellow ish reflex in the somewhat dilated pupil, and the eye is found to be blind. On ex amination the reflex is found to be due to a growth situated back of the lens. It has a silvery or yellow, shining ap pearance, and small blood-vessels may be seen on it. As it increases the lens and iris are pushed forward, the tension of the eyeball becomes elevated (second, or glaucomatous, stage), and symptoms of irritation and inflammation appear. When the growth perforates the sclera (third stage) the tension falls, and for a few days the symptoms may seem to abate. Soon, however, the growth causes a noticeable tumor in the orbit, which increases more and more rapidly. In volvement of the brain through the op tic nerve or of other organs (fourth stage) quickly occurs, and causes death. Sometimes the growth sets up an irido cyclitis that leads to diminished ten sion and shrinking of the eyeball (crypto glioma), which, however, ends in the further extension of the tumor. In a
large proportion of cases both eyes are affected.
DIAGNOSIS.—The only affection liable to be confused with typical glioma of the retina is chronic purulent accumu lation in the vitreous, or pseudoglioma. This gives rise to a yellow reflex back of the lens, commonly exhibiting no ves sels. Such an accumulation follows purulent. retinitis or choroiditis, gener ally as a sequel to some acute febrile dis ease, as scarlet fever and cerebro-spinal meningitis. Glioma gives no history of antecedent disease. In pseudoglioma the tension of the eyeball is almost al ways diminished. In glioma it is normal or elevated. Pseudoglioma remains stationary; glioma is progressive. In cryptoglioma diagnosis may, for a time, be impossible. But, the eye being blind, to treat it as the scat of glioma is proper in any doubtful case.