Download PDF by J. L. C. Martin-Doyle and Martin H. Kemp (Auth.): A Synopsis of Ophthalmology

By J. L. C. Martin-Doyle and Martin H. Kemp (Auth.)

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There is marked redness of the lids and Chemosis of the conjunctiva, with marked ciliary injection. The cornea becomes hazy, the iris muddy, the intra-ocular fluid is cloudy, later frankly purulent. By this time, sight in the eye is lost and the purulent infection involves the vitreous, the eye thus becoming a bag of pus. PATHOLOGY : Exogenous infections enter through perforated wounds, especially those which have a prolapsed iris, the vitreous acting as a culture medium. Endogenous infections are usually through the bloodstream in septicaemic conditions and occasionally by local spread from cellulitis of the orbit, meningitis, etc.

Atropine and antibiotic ointment should be instilled into the eye. In very small wounds a miotic should be used (instead of atropine) to prevent iris prolapse. WOUNDS INVOLVING IRIS PROLAPSE : In a large wound there are nearly always some complications, the commonest of all being iris prolapse. The prolapse should be excised and never replaced owing to the risk of carrying infection into the eye. If the iris is adherent to the posterior surface of the cornea an attempt should be made at freeing it with an iris repositor inserted through the corneal wound.

ANTICHOLINESTERASE: These drugs neutralize the enzyme Cholinesterase which limits the action of acetylcholine. Eserine is the most used drug in this group. It is very powerful in action and can cause spasm of accommodation. Prostigmin has a similar action but is less powerful. D F P and phospholine iodide are also in this group. 3. Sympatholytic Drugs: These are not very frequently used. They produce miosis by antagonizing the sympathetic nerve-endings. The best examples of these drugs are priscol and ergotamine which are used for various purposes in ophthalmology, but their miotic action is only incidental.

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