The practical details of cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1903
Catalogue details

Licence: In copyright

Credit: The practical details of cataract extraction / by H. Herbert. Source: Wellcome Collection.

    21/142 (page 5)
    The measurements of such lenses given in the table at the end of this chapter show that this shallowing may represent, in part at least, actual increase in volume of the lens above normal. Other possible additional ex- planations are displacement forwards of the lens, and alteration of its shape, corresponding with the change in its consistence. If left, the fluid tends to gradually diminish in quantity, and may ultimately entirely dis- appear, leaving only the nucleus in a shrunken capsule. Here again, with undilated pupil, a mistake may readily be made as to the nature of the cataract, the nucleus acquiring a greenish or grayish tint from the conditions under which it is seen. Both it and the iris are, however, frequently more or less tremulous; and if the pupil be dilated, the upper edge of the nucleus may perhaps be seen, and the patient may then acquire fair vision. Apart from obviously displaced lenses, the majority of tremulous cataractous lenses seen in Bombay are of this class. The tremor is sometimes more noticeable with the patient lying on his back than in the erect attitude. It indicates a stretched and weakened zonule, owing to the retraction of the nearly empty capsule, and is not found in the over-ripe discoid or shrinking cataract. Twice I have found that the nucleus had disappeared, and not the fluid ; the latter had acquired a slightly creamy tint. Working backwards from the typical Morgagnian cataract, there are lenses with only the superficial cortex quite fluid. The deeper soft lens-matter may have only sufficient consistence to limit the movement of the nucleus, or, in slightly less advanced cases, may come away partly in small flakes, the rest remaining adherent to the nucleus. Then there are ripe cataracts, with the whole of the cortex opaque, soft, whitish, without definite structural markings within the undilated pupil, but on extraction breaking up in its equatorial portions into more or less