Case of successful removal of piece of steel from the vitreous chamber / by Charles A. Oliver.

  • Oliver, Charles A. (Charles Augustus), 1853-1911.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: Case of successful removal of piece of steel from the vitreous chamber / by Charles A. Oliver. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    to a six by seven millimeter's oval, with its long axis at ninety degrees. The iris was slightly inflamed, and there was a rather deep hypopyon. The crystalline lens was apparently uninjured, though there were a few faint, just commencing, cortical striae in the lower outer equa- torial region, as in the other eye. The vitreous chamber was partly filled with blood and pigment-debris, not permitting any view of the fundus. Vision was reduced to the ability to see to count fingers at two meters' distance in a field which was markedly indentated to the upper nasal side. The patient consenting to an immediate attempt for removal of the foreign body, he was etherized. Based upon the clinical conditions seen—particularly the recent- ness of the injury, the position and the direction of the sdleral cut, the relative positions of the lips of the wound, and the diminution of the visual field in the upper nasal side; in association with the assertions of the patient as to the angle of the receipt of the blow, and the presence of a foreign body in the eyeball as determined by the skiagraphs, I determined to introduce an electro-magnet through the scleral wound and make search for the supposed foreign body in the lower outer part of the vitreous chamber. Employing a long, thin, curved electro-magnet of sufficient strength to lift a heavy bunch of keys in the manner indicated, I was immediately rewarded, without penetrating to any depth, with the im- pact of the foreign mass on the tip of the instrument. Finding that the chip of metal remained against the inner edge of the wound, I substituted a very broad and quite flat electro-magnet and carried it slightly into the eye at right angles to the length of the wound. I thus produced a broad, gaping rent, through which the piece of metal was delivered >»'ithout the loss of a drop of vitreous humor. The mass, which was steel, was eight millimeters long, five milli- meters broad at its widest portion, and one millimeter through its thickest part. It weighed one-seventh of a gramme. The evening of the day of operation I telephoned to Dr. Sweet, asking him to let me know in what part of the eyeball he had located the piece of metal. He replied down and out, thus agreeing with my clinical findings, and proving that his method had independently given the localization of the mass. In two days' time the wound was healed, and the vitreous opaci- V