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intraocular pressure, so that these are only momentarily filled at
each cardiac systole.
Ophthalmologists recognize three varieties of glaucoma: acute
inflammatory glaucoma, simple glaucoma without apparent
inflammation, and secondary glaucoma, the result of another
disease.
Acute inflammatory glaucoma is the one condition in which,
in the absence of a midriatic, inflammation is associated with dilated
pupil. It is liable to occur in a series of attacks, which increase in
severity, hence its supposed identity with recurrent ophthalmia in
the horse. The entire group of symptoms have, however, been rarely
or never seen in the horse. They are distinctly more common in dogs.
Simple glaucoma comes on more slowly, becomes chronic and
is to be recognized by the physical symptoms in the absence of
inflammation, notably by tension of the bulb, diminution of the
anterior chamber and cupping of the optic disc.
Secondary glaucoma is the direct result of some other disease
of the eye:
Complete posterior synechia acts by confining the liquid which is
secreted, to the posterior chamber whence it finds no ready outlet
through the pupil, and causes a marked bulging forward of the iris
and tension of the eyeball.
Slighter anterior synechia in the form of cicatricial adhesions
between iris and cornea in the sclero-corneal margin, acts by
blocking the principal drainage canal of the aqueous humor, which
lies in this angle.
Traumatic injuries implicating the capsule of the lens and
admitting the aqueous humor freely to the lens substance determines
softening, swelling and so much irritation as to increase the secretion
largely and determine intraocular tension.
The same may result from luxation of the lens and irritation of the
ciliary circle by dragging.
Other causes are disease (atheroma) of the retinal vessels and the
growth of tumors in the interior of the eye.
Lesions. These are very varied. Inflammation of the iris, ciliary
body and choroid and even of the cornea is not uncommon. The iris
and ciliary body show round cell infiltration, as may also the choroid.
In the ciliary body this is likely to be especially abundant along the
drainage canal (canal of Schlemm) thereby reducing its calibre.
Leber and Fuchs found drops of liquid in the epithelium and cornea.
One of the most significant lesions in man is the cupping or
depression of the lamina cribrosa of a depth in ratio with the force of
the intraocular pressure, and inflammation or atrophy of the optic
nerve, back of the eye. Möller, however, has never been able to find
actual cupping of the optic papilla in animals, but instead thereof a
general distension of the outer coats of the eye, a hydrophthalmos. In
view of the fact that these coats have the same structure and nearly
the same relative thickness as in man, this throws considerable
doubt on the supposed identity of glaucoma in man and cases which
have been considered such in the lower animals. The comparative
absence of pulsations in the retinal arteries in animals adds to the
uncertainty.
Treatment. Although such cases lack some of the diagnostic
symptoms of glaucoma in man, yet they agree with that in the
increase of the intraocular pressure, and demand similar measures
for relief. Some reduction of the tension can be secured by careful
massage over the eyeball so as to favor the progress of the lymph out
of the bulb. A prompt but rather transient relief can be obtained from
evacuation of the aqueous humor by puncture with a lancet close to
and parallel with the margin of the cornea. The most effective
treatment is, however, by iridectomy. On account of the great power
of the muscles in the lower animals it is usually desirable to
anæsthetize the patient and then fixing the eyeball with a pair of rat-
tooth forceps, an incision is made close in front of the upper border
of the cornea, and the lancet slowly withdrawn. A pair of iridectomy
forceps are then introduced and the iris seized and drawn out
through the wound, and a portion snipped off with a pair of fine
scissors. The iris is then pushed back into the anterior chamber, and
a drop of eserin solution placed in the eye. The parts and
instruments must be rendered thoroughly aseptic before the
operation, and the eye cocainized both before and after. The eye
should be kept covered for some time with a cloth wet with a solution
of mercuric chloride (1 ∶ 5000) or other antiseptic.
Appropriate treatment may be employed in case of coexistent
inflammation, or to improve the general health.
EXOPHTHALMOS.

This consists in an increase of the media of the eye so as to cause


an excessive increase in size, and an unsightly bulging outward from
the orbit and between the lids. It may be said to be a more
exaggerated enlargement of the eye ball, than has been already
noticed under glaucoma.
It has been seen in nearly all classes of domestic animals.
Everhardt and Möller reports it in horses, Hausmann, Pradal, etc., in
cattle, LaNotte, in lambs, Cöster, Trasbot, etc., in dogs, and Trasbot,
in birds (chickens and parrots). It has been found congenitally in
lambs and at a few days old in foals, especially when weak and puny;
in older animals it appears to be most frequent in the anæmic or
starved animal, in the lymphatic, or, as in man, in the goitrous.
The manifest projection outward of the eye may occur as a nervous
phenomenon, without intraocular pressure, and without abscess,
neoplasm, or inflammation in the depth of the orbit. In a case of
tuberculosis in a three year old cow, I have found this condition, with
normal tension of the eyeball, but with acute tubercular meningitis of
the pia, surrounding the pons and crura cerebri, a grayish exudate
with lighter miliary centres, and a considerable clot of extravasated
blood.
Symptoms. Mostly without any febrile reaction, there is a manifest
enlargement and bulging of the globe of the eye, so that it stands out
between the lids which can no longer cover it. The cornea, aqueous,
lens, and vitreous are not usually opaque, but show only a pale, blue,
opalescent tint. The pupil is often widely dilated so as to show clearly
the interior of the eye. Vertiginous symptoms have been observed in
the cow (Pradal), the supposed result of intraocular pressure.
Treatment has had little effect when it stops short of puncture of
the cornea or iridectomy.
HYDROPHTHALMOS OR BUPHTHALMUS
CONGENITUS.

This has been applied to a congenital enlargement of the eyes from


internal distension in children. The cases in lambs and foals quoted
in the last article were evidently of this nature. They are charged on
intraocular pressure acting on the delicate tissues of the embryo or
unborn animal. There is not necessarily cupping of the optic disc so
that persistent tension after birth cannot be insisted on.
Cases occurring in older animals, may be forms of secondary
glaucoma though classed under hydrophthalmos by Mayer and
others.
Treatment when demanded is along the same lines as in glaucoma.
CATARACT. OPACITY OF THE LENS OR ITS
CAPSULE.

Definition. Forms: lenticular, capsular, cortical, nuclear, polar, black, diabetic,


traumatic, immature, mature, senile. Causes: impaired nutrition of lens,
inflammation of iris, choroid, ciliary body, retina; recurrent ophthalmia.
Proliferation of cells. Increased density, chemical changes, degenerations. Sugar,
sodium chloride, naphthalin. Rachitis. Senile. Blood pigment. Symptoms:
shrunken bulb, opalescent zone around cornea, angle on upper lid, shying, extra
ear activity, high stepping, better sight in twilight, homatropia, examination facing
the light, Purkinje’s images, ophthalmoscopic examination. Prognosis hopeless.
Treatment: phosphureted oil, massage, operation in horses, discission, under
antiseptic precautions, extraction under careful antisepsis, suction.

Definition. Any pathological change in the lens or its capsule


diminishing its transparency.
Varieties. The opacity may be situated either in the lens
(lenticular) or in its capsule (capsular). Again, it may be in the
outer part (cortical) or in the central part (nuclear) of the lens. If
the opacity is on the capsule in front of the lens it is anterior
capsular; if on the portion behind the lens it is posterior
capsular. If the opacity is caused by black iris pigment adherent to
the capsule it has been called black cataract. If the lenticular
cataract is small and round, it is polar, and it may be anterior or
posterior polar according as it is situated near the front or back of
the lens. Diabetic cataract is one associated with mellituria. A
traumatic cataract is one resulting from a wound of the lens
which admits the aqueous humor and causes softening, swelling and
finally solution of the substance of the lens. The immature or
unripe cataract is one in which the lens is not yet wholly involved
and indurated; the mature or ripe, when such consolidation has
extended throughout. Senile Cataract is seen in old horses, dogs,
cats, birds and very exceptionally in cows. This usually attacks both
eyes at once. A degeneration takes place in the fibres of the lens,
which are invaded by sclerosis beginning at the centre of the organ.
Causes. In domestic animals cataracts are commonly the result of
impairment of the nutrition of the lens in connection with
inflammation of the iris, choroid, ciliary body, retina, or hyaloid
membrane, and above all, in solipeds, in recurrent ophthalmia. It
may be assumed that a transparent tissue composed of cells can only
maintain its translucency so long as the most perfect equilibrium is
maintained as regards the mutual relation of the cells, the pressure
of its interstitial plasma, and the chemical composition of both
plasma and cell structures. The slightest deviation in any direction
will impair or abolish the transparency of the tissue. In inflammation
this occurs in various ways, through the increased cell multiplication
and the change in the nature of the cells, through the increased
exudation and the alteration of the solid parts as regards
compression and relative position, and through chemical changes in
the exudate which contains more salts, fibrinogenous material, etc.,
than the normal plasma. The same is true of all the post
inflammatory degenerative processes that take place in the lens.
The formation of cataract from chemical alteration in the fluids is
familiar in diabetic subjects,—man or beast (Altenhof). It can be
produced experimentally in frogs by injecting sugar, common salt or
any other readily diffusible saline solution under the skin (Kunde).
Rabbits that are fed naphthalin develop cataract which radiates in
lines and streaks from the pole towards the periphery and in the
cortical portion of the lens. Perhaps the lamellar cataract of rachitic
patients is also to be attributed to the lack of earthy salts in the
plasma of the lens.
Senile cataract may be hypothetically attributed to impaired
nutrition, degeneration in the lens or its capsule, or less commonly to
disease of the blood vessels of the eye, or gradual changes in the
plasma. It occurs in horse, ox or dog at ten years old and upward.
Anterior Capsular Cataract sometimes results from the
deposition of blood pigment on the capsule in cases of
extravasation into the anterior chamber. This is closely allied to the
black or spurious cataract which consists in the adhesion of the uveal
pigment to the capsule, and its detachment from the iris.
Kunde who caused cataract in frogs by injection, subcutem or
ingestion of concentrated solutions of sugar or salt, attributes the
result to the sudden abstraction of water from the crystalline lens.
Even the cell multiplication in inflammatory cases, he holds to favor
this, since the new cells having little vitality are especially subject to
granular and other deposits and degenerations, with loss of water or
of transparency.
Symptoms and diagnosis. The examiner should apprehend
cataract after internal ophthalmia. Much more so, if there is
apparent diminution of the bulb, an opalescent zone around the
outer border of the cornea, or a marked angle in the curvature of the
upper eyelid, as usually occurs in recurrent ophthalmia. When a
horse suddenly acquires a habit of shying, of starting back or to one
side when approached, when confronted with strange or unexpected
objects, or with deep shadows like those from electric lights, he is to
be suspected. When he carries his ears in an unusually alert manner,
turning one forward and the other back, when he steps higher than
before to avoid unseen objects, suspicion should attach to him. If he
sees better in twilight than in the full sunlight, central cataract may
be feared, while the periphery which is exposed by the dilatation of
the pupil in semi-darkness is still clear. In all examinations for
soundness, the greatest care should be taken to exclude the
possibility of overlooking an existing cataract.
In the very early stages, while internal inflammation and
photophobia are still present, the pupil may be contracted so that
lesion can easily escape notice. Any contraction of the pupil therefore
disproportionately to the light, should demand a careful examination
with the pupil dilated in darkness or by the action of atropia or
homatropin. In the more advanced cases with no persistent
inflammation and an advanced opacity of the lens, sensitiveness to
light is greatly lessened, the pupil is dilated and the cataract is easily
detected.
In cases approximating to the condition last named it is usually
only necessary to place the animal in a sombre or dark building, with
his head facing the light at an open door, or window and best with
full sunlight. Let this fall full upon the eye, and let the observer view
the pupil diagonally from each side when any opacity may be
detected.
When the pupil is too narrow, several drops of a one per cent.
solution of atropia sulphate may be dropped within the lower lid and
left for ten minutes until the pupil is widely dilated. Then the
examination may be made as above, or still better the animal may be
taken into a dark chamber and examined by one of the following
methods:
A light, preferably a candle, is placed in front of the eye and moved
from side to side, upward and downward, so as to bring its images
over all parts of the cornea and lens. In the normal eye there are
reflected three images of the light, one large, clear, and upright from
the anterior surface of the cornea, one, much smaller but still
upright, from the anterior capsule of the lens, and one, small and
inverted, from the posterior surface of the lens and capsule. Any
opacity in the lens or on its posterior capsule, will cause the posterior
(inverted) image to become indistinct, and as it were a diffuse white
blur, as it passes over that spot. The other small (erect) image may be
even clearer than normal in passing over the opaque area because of
the mirror-like reflecting action of the white cloud behind it. The
movement of the light so as to pass its image over all parts of its
surface in succession will certainly reveal the existence and seat of
the cataract, by the blurring of the inverted image of the flame.
Another method is by oblique illumination, the patient’s head
being turned away from the light and the interior of the eye being
lighted up by reflection from a mirror. If the pupil has been
sufficiently dilated all parts of the lens can be scrutinized in this way
and the slightest opacity detected by the grayish or whitish haze.
If there is still doubt as to the nature of such appearances, it may
be set at rest by illuminating the depth of the eye with the
ophthalmoscope when the opacities will appear as dark areas in the
general red ground. (See Systematic Examination of the Eye.)
The prognosis of cataract is almost invariably hopeless. I have
seen newly formed opacities of the capsule clear up in a day or two,
and such recovery in very slight traumatic injury and superficial
exudation is recognized as possible, but a slowly forming cataract is
usually there to stay. Those that clear are presumably only exudates
on the capsule and not true cataracts.
Treatment. While exudates on the capsule may disappear under a
course of purgatives and diuretics, practically nothing is to be
expected from medical treatment in true cataract. The instillation of
phosphorated oil (1–2 per cent.) daily into the conjunctival sac as
formerly recommended, may be helpful in some of the superficially
opaque membranes, but for formed cataract it has proved useless.
Massage with, or without ointments can temporarily lessen ocular
tension and reduce the liquids in the zonula of Zinn, and canal of
Schlemm, but it is only in very exceptional recent cases, in which it
has given permanent benefit, and even these were probably spurious
cataracts.
The question then is essentially whether we should operate or not.
In the horse the objections to operation are almost conclusive in all
cases. The eye in which the lens has been depressed or extracted can
never see objects clearly without the aid of biconvex glasses, and it is
impossible to fit these to the animal. The horse that is blind can go to
pasture or be driven in harness with safety, but the one that sees all
objects distorted or blurred is liable to become a shyer endangering
the life of his rider or driver. The greater number of cataracts in
horses come from recurrent ophthalmia and are associated with
opacity of the vitreous, detachment of the retina, exudates in the
choroid, degeneration of the optic nerve, or other lesion which of
itself would destroy vision. Almost the only object of removal of the
lens in such cases would be to make an unsound horse pass for a
sound one. Even this is usually unattainable because the thickened
capsule remains as a dense white cloud or the opacity of the vitreous
shines through the pupil. In dogs the cataract is usually associated
with fewer complications, and the resulting imperfect vision is not a
source of danger to man. Extraction of the opaque lens may in this
case appeal so strongly to the sense of comfort of the owner that the
operation may become permissible or desirable.
In man the operation may have to be delayed for a considerable
time because of the unripeness of the cataract. The center of the lens
may be firm and opaque while the outer layers are so soft that they
would be likely to be retained in the capsule and would not only
produce persistent opacity, but would be a continual threat of
destruction of the eye by active inflammation. The ripeness is
ascertained by careful scrutiny of the shadow of the iris during
illumination of the interior of the eye. If ripe, the dark shadow of the
iris approximates closely to the margin of the iris itself, whereas if
the outer portion is unripe there is a clear zone of greater or less
depth between the margin of the iris and the shadow reflected by the
opaque portion of the lens.
In the lower animals the question is less important as we do not
aim at securing perfect vision, and the danger of inflammation is
therefore the main consideration. Escaping this, the aqueous humor
may be expected to dissolve and remove the greater part of the still
adherent lens substance, and the unsightliness of the dense white
cataract is largely done away with.
Discission. Tearing of the capsule so as to admit the aqueous
humor to the lens may be admissible in the young with soft
cataract. The liquid causes gradual swelling up, solution and
absorption of the lens so that in the course of a week or two the
whole may be removed. It is not, however, unattended by danger, as
the rapid swelling of the lens will sometimes determine an
inflammation which will lead to complete destruction of the eye. The
eye is first thoroughly washed with aseptic cotton and a sublimate
solution (1 ∶ 1000), and is then rendered anæsthetic by cocaine (5 to
10 per cent. solution) or in the large animals general anæsthesia is
produced by ether or chloroform. The eyelids are held apart by the
lid speculum, the nictitans held if necessary by forceps, and the bulb
steadied by seizing it with hooked forceps. A cataract needle is
passed through the cornea close to its border, and carried through
the pupil, previously dilated with atropia, so as to tear an opening in
the anterior capsule about two-thirds the diameter of the lens. If the
toughness of the capsule threatens to endanger the ciliary body by
dragging upon it, two needles or fine hooks may be introduced
through opposite borders of the cornea (inner and outer) and the
capsule may be torn without throwing any strain on surrounding
parts. The pupil must thereafter be kept dilated by atropia to obviate
adhesion of the iris to the wound and the eye must be kept in
comparative darkness and aseptic. If active inflammation sets in,
cold, astringent or iced dressings may be called for, while if the
swelling of the lens is threatening it should be at once extracted. If
the eye becomes unduly tense, puncture of the cornea is indicated,
and the relief of tension will sometimes start a tardy solution into
renewed activity.
Linear extraction of the lens. The animal and the eye having
been prepared anæsthetically antiseptically, and midriatically as for
discission, the lids are fixed with a speculum, the nictitans and the
bulb with forceps, a Gräfe cataract knife is introduced through the
inner side of the cornea, close to its margin and with its point parallel
to the front of the iris. The handle is then raised and the cornea
detached from the sclera by a series of gentle sawing motions until it
has reached a point parallel to the outer margin of the cornea. If the
pupil is insufficiently dilated, the iris should now be seized by forceps
drawn out through the corneal wound and snipped off by scissors
curved on the flat. Then the cystotome (hooked knife) is introduced
with its back turned downward and carried to the further side of the
capsule and close to the iris, its cutting point is turned backward and
inserted in the capsule, and drawn across from side to side to make
an orifice large enough for the escape of the lens. It is then given a
quarter revolution so as to turn the point of the knife downward and
is withdrawn from the wound back first. The lower part of the sclera
and cornea is now gently pressed with a lens spoon so as to dislodge
the lens from the capsule and deliver it through the corneal wound.
Counter pressure may be made on the sclera at the upper part of the
eye ball. The cornea is now gently stroked with cotton dipped in
sublimate solution to pass all blood from the anterior chamber, and
render the parts antiseptic. The iris is carefully replaced inside the
cornea and any obstinately protruding parts must be excised. The eye
is now covered with cotton steeped in a sublimate solution (1 ∶ 1000)
and bandaged without undue pressure, and the animal tied to two
sides of the stall so that it is impossible to rub the eye.
It is well to dress the eye on the second day, and if adhesion of the
wound is complete it may be left without bandage at the end of a
week or a fortnight.
Success depends mainly on the avoidance of infection. Therefore
every indication of local or general infection should forbid the
operation. Any existing infectious disease or any local eczema,
conjunctivitis or disease of the lachrymal apparatus should be cured
and the region thoroughly disinfected before proceeding. The head
should have a good soapy wash, followed by a sponging with
sublimate solution (1 ∶ 1000), the conjunctiva carefully washed out
with the same and a bandage damp with it applied over the eye. This
bandage is only removed on the operating table. Cloths dampened
with the solution are laid on the face around the eye, the eye is
cocainized with a 5 per cent. solution applied at intervals of one
minute and when quite insensible the operation is commenced. The
greatest care must be taken to render the hands of operator and
assistants and all instruments thoroughly aseptic. The instruments
are taken from a 4 per cent. solution of carbolic acid and placed in
water (which has just been boiled) until needed, and to wipe the eye
or make any application, sterilized cotton only is used and never
touched to the eye more than once. A sublimate bandage is placed
over the eye and worn for ten days or a fortnight. Then if the corneal
incision is healed and pale it may be left off. The pupil should be kept
dilated by a few drops of atropia daily for this length of time.
Any occurrence of iritis or choroiditis usually indicates infection
and must be treated on general principles, but with especial
reference to disinfection, and if this cannot be secured the eye will be
almost inevitably lost.
In case of renewed opacity through thickening of the capsule an
aperture must be torn in that membrane by the same method as in
discission. This is commonly known as needling. It must be
conducted under the same antiseptic precautions as in extraction.
Suction. This is only applicable to a lens which has become fluid as
well as opaque. It consists in withdrawing the liquid lens through a
hollow needle.
DISLOCATION OF THE LENS.

Congenital; acquired; traumatic, softening of suspensory ligament: hinge


motion, lens drops behind iris, protrudes through pupil, cataract. Apparent
increased depth of anterior chamber, tremulous iris, projecting edge of lens like
black ring. Treatment: extraction.

Dislocation of the lens may be congenital, or acquired. In the latter


case it is explained by a traumatism or a liquefaction of the vitreous
and coincident softening of the suspensory ligament. In either case,
if the ligament is torn through in more than one-half its
circumference, the lens will hang by the remainder and move on it as
on a hinge so as to change its location in the different positions of the
head. This is especially so where the vitreous has become abnormally
fluid as there is then no resistance to the free backward movement of
the lens. The writer has seen the eye of a cow affected in this way, so
that the cataractous lens advances to the pupil and recedes from it as
the eye is moved. In other cases the dislocated lens, being attached
below only, drops down and virtually disappears behind the lower
part of the iris. In still other cases it becomes wedged into the pupil,
or protrudes into the anterior chamber and lies in front of the pupil
and iris. The semi-detached lens sooner or later becomes opaque. A
cataract with contraction of the newly formed tissue on the capsule
and undue tension on the suspensory ligament may, however,
precede the dislocation which is then precipitated by some shock, as
a blow, fall, sneeze, cough or emesis.
The condition leads to an apparent increase in the depth of the
anterior chamber, and tremulous movement of the iris, and if
illuminated the impacted condition of the lens or its changes of
position can be detected. If its edge is exposed it appears as a black
ring.
Treatment is useless, unless it be extraction of the lens, or
iridectomy in suitable cases.
PERSISTENT ARTERIA HYALOIDEA.

In the embryo this artery occupies the central canal of the vitreous
and extends from the optic papilla to the posterior pole of the lens.
At times it persists after birth and even to mature life and is then
detected as a gray or dark thread on ophthalmoscopic examination.
Berlin records a case in an old horse and others in young cats, and
Möller other cases in dogs. Treatment is manifestly hopeless.
OPACITY OF THE VITREOUS.

From inflammation of the ciliary body, choroid or retina. Pupil copperas green
with white points, lines or patches, move in opposite direction from the eye,
liquefied vitreous, crystals of cholesterine, scintillance, opacity. Treatment.

Opacities visible with the ophthalmoscope usually come from


effusion of blood into the vitreous, or inflammation of the retina,
choroid, or ciliary body. Blood thrown into the vitreous will usually
leave some permanent turbidity. In choroiditis or retinitis the
ophthalmoscope may reveal the changes in these structures. A
turbidity appearing in the anterior portion of the vitreous, without
any apparent cause, is probably due to cyclitis which cannot be seen
with the ophthalmoscope, but may cause special tenderness around
the sclero-corneal zone. It is common in recurrent ophthalmia of the
horse and in irido-choroiditis in animals generally, and may be a
distinct feature of glaucoma. The general reflection of the pupil is
copperas green, but gray or white points, lines, bars or patches may
often be recognized. These being back of the lens and axis of the eye,
move in the opposite direction from the line of vision, thus if the eye
looks upward they descend, if it looks downward they ascend, if it
turns to the right, they turn to the left and vice versa. Tested by a
burning candle the three reflections remain clear and distinct unless
lens or cornea are affected.
Not infrequently the vitreous is found abnormally fluid, and
among its solid particles in affected horses have been found crystals
of cholesterin (Jacobi) and tyrosin (Möller). In the illuminated
vitreous such crystals may be seen to reflect the light like a shower of
sparks (synchysis scintillans). Opacity of the vitreous has been seen
in cases of amaurosis in horses (Hertwig) and glaucoma in lambs
(Prinz).
Treatment is rarely satisfactory, though in some recent cases, and
in the absence of any other irremovable lesion, reabsorption of a
slight exudate may take place, in connection with the use of mild
saline laxatives and diuretics.
RETINITIS.

With choroiditis and cyclitis, albuminuria, nephritis, mellituria, leukæmia,


petechial fever, contagious pneumonia. Photophobia, contracted pupil, redness
around optic disc, enlarged retinal vessels, white and gray spots and radiating
lines, exudates, clots, fatty degeneration. Treatment: correct primary disease.

Retinitis is usually an accompaniment of choroiditis and cyclitis,


but it also occurs as a complication in a number of constitutional
maladies, such as albuminuria, nephritis, mellituria, leukæmia,
petechial fever, contagious pneumonia, etc. Fröhner records a case in
a leukæmic horse, Peters in one suffering from petechial fever,
Schindelka in cases of contagious pneumonia in the horse, and
Eversbusch in recurrent ophthalmia of the horse, and under other
conditions in dogs.
The attack is accompanied at the outset with much photophobia
and contraction of the pupil. When this is dilated and the fundus of
the eye examined with the ophthalmoscope, the retina is seen to be
reddened for some distance around the optic disc and the blood-
vessels are materially enlarged. Later, white or gray spots and lines
are seen in and around the disc, tending to assume a radiating
direction, and the retina at large, on careful examination may have a
distinctly striped appearance. Brownish, reddish or light colored
exudates and hæmorrhages may be made out in certain cases
between retina and hyaloid, or between the retina and choroid. Fatty
degeneration of the fibrous tissue is common.
Treatment must be first that for the primary disease of which the
retinitis is a complication, and the result will depend on how
amenable that affection is to therapeutic measures. In advanced
albuminuria or mellituria, the retinitis, which is usually double, is
hopeless, while in contagious pneumonia, petechial fever, leukæmia
and other less fatal affections, retinitis in its initial stages may
recover. In cases of advanced disease with serious structural changes
in the retina, recovery cannot be looked for.
DETACHMENT OF THE RETINA.

This may occur in any case of retinitis or choroiditis. It is


especially common in recurrent ophthalmia in horses. It may also
occur through the dragging by contracting inflammatory products in
organization. Spontaneous recoveries have taken place through
reabsorption, and attempts have been made by the injection of iodide
lotion to hasten this, or more safely by rest and diaphoresis.
Puncture and aspiration have also been tried with most varied
results. As a rule in the lower animals the treatment of the
inflammation, with rest, a pressure bandage, and pilocarpin will be
indicated.
RETINAL HEMORRHAGE.

This occurs in inflammations of the retina or choroid, also in


degenerations of the vascular walls and as a result of traumas, or
poisons. Schindelka quotes a case in a dog from ptomaines,
Eversbusch, one from scurvy in the dog, Appenroth, one in a calf
from a blow with a cow’s horn, and others in cats and horses from
traumas. It is present to a slight extent in all inflammations of the
retina. With the ophthalmoscope the recent lesion appears as a
bluish red blotch on a bright red ground, and the older lesion of a
brownish red. Rest and a pressure bandage may be employed after
subsidence of the inflammation.
TUMORS OF THE RETINA.

Eversbusch found subretinal cysts in a 24 year old horse, Merkel


and others have found similar bodies in old dogs and cattle.
Sarcomata and melanosarcoma are found on the surface of the
choroid in gray horses, implicating the retina. The only remedy is
enucleation of the bulb.
INFLAMMATION OF THE OPTIC NERVE.
PAPILLITIS.

Choked disc. Neuro-retinitis. Papillo-retinitis. Nerve swelling blocks veins.


Causes: lead, tumors in brain bilateral, in orbit unilateral, influenza, petechial
fever. Symptoms: redness of optic disc, retinal arteries contracted, veins gorged,
papilla swollen (woolly), vitreous opacity. Treatment.

This is also known as choked disc from the obstruction of the


return of blood by the veins of the retina which pass out at the
cribriform lamina. The swelling of the nerve ending and papilla
compress the veins, causing stagnation and venous congestion in the
retina. When the retina is thus involved the term neuro-retinitis or
papillo-retinitis is often applied.
Causes. The condition has been traced to lead poisoning, brain or
orbital tumors, and various infectious diseases. Except in orbital
tumor the disease is usually bilateral. In horses Schindelka has seen
the condition in influenza and Peters in petechial fever, heart failure
and dyspnœa. In a necropsy on a horse the writer found complete
cataract, atrophy of the bulb to less than two-thirds the size of its
fellow, thickening and furrowing of the sclera, the presence of an
extensive old blood clot in the seat of the vitreous, cupping of the
disc, retro-ocular neuritis with exudate inside the sheath, and a
considerable reddish brown tumor of the choroid plexus on the same
side. The trouble was attributed to the blow of a rope on the eye a
considerable time before. The blood in the vitreous retained its dark
hue and showed no evidence of microbian invasion.
Symptoms. To the phenomena of retinitis there is added violent
injection of the capillary plexus of the papilla. The arteries of the
retina are contracted while the veins are dilated and tortuous. The
papilla is swollen and is said to have a woolly appearance. The
vitreous may be opaque by reason of exudation or blood
extravasation into its substance. Retro-ocular neuritis is usually
present, and brain tumor in certain cases. Möller calls attention to
the fact that with atrophy of the bulb the elliptical outline of the
papilla gradually lessens and it becomes more nearly round. In dogs,
too, the form of the papilla is also changed and the same author has
found it distinctly triangular. The pupil may be at first strongly
contracted and later freely dilated.
Treatment is usually of little avail and does not differ materially
from that adopted in retinitis. In tumor of the orbit pressing on the
optic nerve it may sometimes be reached through the temporal fossa,
but usually in all such cases enucleation of the eyeball is demanded.
RETRO-BULBAR OPTIC NEURITIS.

Definition. Neurites descendens and ascendens. Extension to bulb, other eye, or


brain. Causes: traumas, meningitis, infectious diseases, toxins, lead, tobacco, etc.
Symptoms: partial blindness: congestion of papilla, exudates in adjacent retina.
Treatment: eliminate poisons, lead, toxins, correct precedent disease, saline
laxatives, diuretics, potassium iodide, cupping, local bleeding, counter-irritants.
Hygiene.

This is inflammation of the optic nerve commencing behind the


eyeball and only involving the papilla secondarily. Extension to the
papilla has been called neuritis descendens in contradistinction to
neuritis ascendens in which the inflammation extends along the
nerve toward the brain. There is always a tendency to extension, it
may be to the papilla and retina, it may be to the chiasma and
opposite eye, and it may be inward toward the ganglia and choroid
plexus.
Causes. Apart from traumatic causes, retro-bulbar neuritis in the
domestic animals has been mainly seen in connection with
constitutional or infectious diseases; in the horse with petechial fever
(Peters), contagious pneumonia (Schindelka), meningitis (Peters,
Straub) and parotitis (Möller). It has also followed meningitis in
cattle (Nebelen). In man it has been traced to lead, tobacco, alcohol
and other poisons.
Symptoms. At first the patient may seem partially blind without
apparent cause. Later ophthalmoscopic examination reveals
congestion and swelling of the papilla, and congestion (especially
venous and capillary) of the retinal vessels. The discolorations in
streaks and spots, from exudates and degenerations follow as noticed
under papillitis. It is difficult to distinguish between this and
papillitis during life.
Treatment should be first directed toward the elimination of any
poisons, such as lead or tobacco, which may act as a causative factor.
Saline laxatives and in chronic cases potassium iodide would be
indicated. Every attention should be given to the maintenance of
good general health, and in acute attacks, local bleeding and counter-
irritation may be resorted to.
ATROPHY. PARALYSIS OF THE OPTIC NERVE.
AMBLYOPIA. AMAUROSIS.

Definition. Horses, dogs, cattle, sheep. Amblyopia, Amaurosis. Causes: retinal


paresis from brilliant light, of cerebral ganglia, snow blindness, poisons, lead,
opium, atropine, lolium, tobacco, carbon bisulphide, cryptogams, mushrooms,
“loco” plants, carbon monoxide, illuminating gas, quinine, heat apoplexy, cerebral
concussion, brain parasites, exudates, pressure, degeneration, gastric or intestinal
disorder, hæmorrhage, anæmia, diarrhœa, diuresis, excessive milk secretion,
gestation, embolism. Symptoms: constant excessive dilatation of pupil, no
response to light, brilliant reflection from retina and choroid, blue or yellow, (glass
eyes); bilateral, cerebral, tract or chiasma; unilateral, bulbar or nervous; face
without expression, ears alert, head to one side, nose elevated, nostrils dilated, ox
and dog smell ground, slow pace, high stepping, does not dodge a feint to strike.
Lesions: inflammatory exudate and retinal atrophy, congested, “woolly” papilla,
retro-bulbar congestion or atrophy of nerve, thickening of neurilemma, tumors of
orbit or foramen optica, cœnurus, cysts, abscesses, cholesteatomata, psammomata,
hydrocephalus, meningitis, pineal hypertrophy, cranial fractures or tumors,
embolisms or aneurisms, hypertrophy of dura, apoplexy. Treatment: remove
causes, laxatives, diuretics, for lead, sulphuric acid and potassium iodide,
darkness, extract cœnurus, elevate depressed fractures, ice, cold snow, to head,
blisters, setons, electricity, strychnia, remove tumors.

Blindness without adequate, corresponding, visible changes in the


structure of the eye, has long been recognized in the lower animals,
having been observed in horses, dogs, cattle and sheep. When partial
it is known as amblyopia, and when complete as amaurosis or
blindness. The term amaurosis is, however, being gradually
eliminated from ophthalmological nomenclature in favor of that of
atrophy.
Causes. These may be factors which act directly on the retina, as
the intense light of the sun, of an electric, lime or magnesium light,
of the reflection from snow, ice, water, sand, or white dust. These
exhaust the power of vision by over-stimulating it, but whether the
blindness is due to fatigue of the retina or of the cerebral ganglia
which preside over sight, it is difficult to decide. This form is much
more likely to occur in horses which spend most of their time in
darkness, as in unlighted stables or mines, when they are suddenly
brought into the sunlight. Snow blindness, however, from prolonged
exposure, is common in animals as in man, and the case of the
staghound reported by Johan, is by no means an isolated one.
Much more common are factors which act primarily on the nerve
centres. Poisoning with lead, poppy, belladonna (sheep and goats,
Gerlach), lolium temulentum (Klüver), tobacco, carbon bisulphide,
cryptogams (musty fodder), mushrooms, astragalus mollissimus,
etc., abolishes vision more or less perfectly. Common illuminating
gas and carbon monoxide have shown this effect on dogs and
chickens. Quinia subcutem has induced the condition in dogs
(Becker and Eversbusch). More or less complete amaurosis is noticed
in connection with heat apoplexy in horses and fat cattle.
Cerebral concussion from blows on the head, knocking the head
against a post or wall, or from violent falls induce blindness which is
to be attributed rather to lesion of the brain. The same remark
applies to cases that appear during the progress of brain disease,
parasitic or otherwise, to those that occur in connection with
overloading of the stomach or intestines, and from gestation (Riss).
In cases appearing after severe depletion, like profuse
hæmorrhage, diarrhœa, or diuresis, or excessive secretion of milk
(bitch), the anæmia of both eye and brain may be taken into account.
When amaurosis develops during some inflammatory or infectious
disease, as in parturition fever in cows, the immediate cause may
sometimes be found in embolism of the retinal, or cerebral arteries.
Symptoms. The most striking feature of amaurosis is the constant
excessive dilatation of the pupil. This is the same in light and
darkness, and in fully developed cases the animal may be taken from
perfect darkness to the full glare of sunlight or electric light without
the slightest contraction of the pupil. The pupillary reflex to light is
entirely lost. In the slighter cases (amblyopia) there remains some
slight response of the iris to light but always far short of the normal.
The widely dilated pupil admits a flood of light, and in the absence of
cataract, lights up the chamber of the vitreous to an unusual degree.
The blue or yellowish reflection of the tapetum is very striking, and
led to the obsolete names of gutta serena and glass eyes. Sometimes
the disease is unilateral and at others bilateral. In case it is unilateral
there is a strong presumption that the causative lesion is in the
affected eye or in the optic nerve in front of the chiasma. In the
bilateral cases it is more likely to depend on disease of the brain or
some more distant organ.
Certain important indications are to be drawn from the expression
of the face, the position of the head and ears and the mode of
locomotion. In all blind animals the face is without expression. The
dilated pupils give no suggestion of mind looking through them, they
have on the contrary an uniform stony stare. There is no sense of fire
or life, but the face is like a dull sculptured mass. The immobile face
finds a sharp contrast in the alertness of the ears, which may be
carried one forward and another back, but fixed and yet ready to turn
to catch every sound. In the horse the head is usually carried a little
to one side for the same reason, and with the nose elevated (star-
gazer) and nostrils dilated. The ox inclines to carry the head low,
while the dog keeps his nose near the ground to guide himself by the
sense of smell. All blind animals are disposed to move slowly and
carefully, and the horse acquires a habit of high stepping to avoid
stumbling.
A common and important test where both eyes are equally affected
and cannot be contrasted with each other, is to strike the lower part
of the face with the hand and immediately threaten to repeat the
blow. If the animal can see, it will seek to jerk the head out of the way
as soon as the hand is raised for the second blow, while if blind there
will be no such movement provided the motion of the hand has not
been such as to induce a current of air on the face.
Lesions. Blindness, or the general symptoms of amblyopia or
amaurosis, may attend on the atrophy of the retinal fibres in
connection with inflammatory exudation or blood extravasation on,
in, or beneath, the retina. In other cases the lesion is in the papilla
which is inflamed and swollen with the woolly aspect characteristic
of choked disc. In others there is congestion of the optic nerve
behind the bulb, with exudation into its substance or beneath its
sheath, or the nerve has already undergone extensive atrophy with
thickening of its neurilemma. In other cases there is atrophy of the
arteria centralis retinæ, or tumors of the orbit or optic foramen
pressing upon the nerve. Cases of this kind are reported in the larger
animals by Leblanc and Tscheulin, and in dogs and ducks by Hilbert.
Much more frequently the determining lesions are situated in the
brain or its meninges. In sheep it is very common from the
development of cœnurus cerebralis over the optic lobes. Kühnert
found a cyst with delicate walls in the brain of a horse affected in this
way. Amaurosis is occasionally seen in connection with the cerebral
abscesses which form in complicated cases of strangles or in pyæmia,
also in cases of cholesteatoma of the choroid plexus. Other
conditions of its occurrence are hydrocephalus, meningitis,
hypertrophy of the pineal gland, fracture of the cranium, tumors of
the cranium or dura mater, embolism or aneurism of the cerebral
arteries, hypertrophy and induration of the dura mater (ox, Leblanc),
or sanguineous apoplexy. In a certain number of cases there may be
no lesion of brain or eye, or only a congestion of the former in
connection with lead poisoning, rye grass poisoning or other gastric
disorder, or of gestation.
Treatment. Success will depend on the sympathetic nature of the
condition or on the transient and removable character of its
causative factor. When the condition is but a symptom of overloaded
stomach or a transient poisoning by vegetable or mineral agents a
direct recovery may be expected to follow their disuse and
elimination from the system. This may be hastened by the exhibition
of laxatives and diuretics, and in the case of lead by sulphuric acid
followed by iodide of potassium. In cases of snow blindness it is only
necessary as a rule to place the animal in the shade until the over-
stimulation shall have subsided. In all these cases the attack has
come on abruptly and without any local symptom of ocular
hyperæmia and this with the preservation of the general senses can
always be looked on as a favorable indication.
In cases that come on slowly and which are accompanied by
symptoms of vascular disturbance or structural changes in the eye,
or brain, treatment is likely to be less successful. Nevertheless
cœnurus may be removed by surgical means, depressed fractures
may be elevated, and acute cerebral and meningeal congestions may
be met by appropriate measures. If the cerebral congestion is acute,
free bleeding from the jugular with a strong purgative and the

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