Excision of the eyeball in cases of melanosis, medullary carcinoma, and carcinoma : with remarks / by J. Argyll Robertson.

  • Robertson, J. Argyll.
Date:
1844
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Licence: Public Domain Mark

Credit: Excision of the eyeball in cases of melanosis, medullary carcinoma, and carcinoma : with remarks / by J. Argyll Robertson. Source: Wellcome Collection.

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    loss of appetite and sleep. The pain lie described as occasionally of a burning, at other times of an excruciating lancinating char- acter, extending to the temple and forehead, and sometimes to the occiput. On the 18th January 1825, I removed the con- tents of the orbit. On introducing my finger after the excision of the eyeball, to ascertain the condition of the parts, 1 tound that the o-reater part of the orbital plate of the frontal bone had been absorbed, so that the finger lay in contact with the mem- branes of the brain,—a state showing the necessity oi extreme caution in the use of the knife in cases of long standing and accompanied by much enlargement of the contents of the orbit. That the bone had not participated in the mahgnant disease, but that it had been removed by simple absorption, is sufficiently demonstrated by the favourable result of the case, and by all the parts removed exterior to the sclerotic being free from the disease. This patient made a rapid recovery, without a single untoward symptom. In 1836, eleven years after the operation, he was in o-ood health, since which time I have not heard of him. On making a section of the eyeball the following appearances pre- sented themselves (Fig. 15):— .... The whole of the eyeball was filled by a soft mass lying withm the choroid; it was of an opaque white colour, and when sub- mitted to the microscope presented all the characters of the carcinoma fasciculatum. There was no trace of the lens; the cornea was ulcerated at its centre, through which ulcer the tumour slightly protruded. In all the other cases, as I have stated, the disease returned in the orbit, and in all presented the same appearances ; the socket becoming filled by a soft medullary mass, accompanied by fetid discharge and more or less bleeding. Ehzabeth Williarnson died three months after the operation; Jane Macpherson hved five months ; Peter Johnston, eleven months; and John Richardson, eight months. SCIRIMIUS. Scin-hvs is described by most authors on ophthalmology as in many instances originating in the eyeball itself, commencing with severe pain in the eye and head, followed by dimness of sight, and at last total blindness, the eyeball becoming indu- rated and misshapen, the sclerotic of a dirty, yellow colour and irregularly prominent, and the superficial vessels enlarged and varicose. That the disease subsequently extends to the sur- rounchng parts, the conjunctiva ulcerates, and the ulceration passes from one tissue to another. That on making a section of the eyeball after its removal, the sclerotic is found thickened, cartilaginous, and intersected with Avhite bands, and the place of tlie vitreous humour occupied by a mass of a somewhat less firm consistence, and divided by similar membranous septa.