Congenital cataract, with imperfect development of the lenses / by William Walker.

  • Walker, William (Surgeon)
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Congenital cataract, with imperfect development of the lenses / by William Walker. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    lay in close contact with the posterior surface of the iris, while their inner and lower edges, which were quite free and sharp, were turned backwards away from the iris. They moved backwards and forwards a little when the globe was moved like a flap or valve. An operation for the removal of the lens, which was performed on the left eye of this patient at two different times, proved quite unsuccessful. This however, I will again refer to in the sequel. On a review of the foregoing cases, several points present them- selves for consideration. In the first place, Was the disease congenital ? We have no dis- tinct evidence that it was ; but I believe that it did exist from in- fancy, for in both vision was veiy imperfect from a very early age: in the first, the imperfection was discovered when he was only ten years old, or at that time when the eyes were more particularly oc- cupied in the contemplation of minute objects, in the course of his education ; in the second case, vision was very imperfect from in- fancy; and the opacity in both was so slight and so difficult of letection, that it might easily have existed from birth, without at- tention being directed to it, both patients being able to go about with comparative ease; and it is, I think, very rarely that we see the lenses becoming opaque in early life, unless they have been so congenitally. In the second place. How was it that the lenses did not occupy their natural position, and fill up the whole of the space behind the pupil ? This, I confess, is a difficult question, and can only be an- swered on the supposition, that from some cause or other, with which we are unacquainted, they had been arrested in their development, —at least I can give no other explanation of it. One peculiarity, which was better seen in the second case than in the first, was, that the lenses in both eyes did not seem to be con- tained in any capsule ; they presented exactly the appearance which the lens does when it is removed altogether from the eye, and the most careful examiiiation failed in detecting any appearance of cap- sule. Had the capsule been present, we would have had it almost certainly opaque at one point or other, probably throughout; for in congenital cataract, both lens and capsule are usually opaque. No opacity, however, existed. In the third place, Were the lenses, at their upper and outer edges, adherent to the ciliary processes or not 1 This question cannot easily be answered, as the pupils could not in either case be dilated so fully as to bring the whole body of the lens into view. That they were adherent to some part or other behind the iris, and that part pretty near the junction of that membrane with the ciliary body, was proved by the first operation which I performed on the left eye of the second patient, in which I introduced a needle through the sclerotic in the usual way, brought it in front of the lens, and then tried to depress it. This I utterly failed in accomplishing; the lens could not be moved from its situation ; it could be pushed backwards, exactly like a valve, but it could not be made to descend.