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.

    23/142 (page 7)
    In the ripe stage these lenses vary considerably in size and appearance. The diminution in size, especially in thickness, varies inversely with the degree of nuclear sclerosis, and therefore to a large extent with the age of the patient. A broad thin disc may result, with sharp edge; but more frequently the contraction is lateral as well as antero-posterior. The nucleus ranges from opaque white or cream-coloured, in a few rather young lenses with defective sclerosis, through the average smoky brown, to the larger dark hypersclerotic nucleus. The lenses with whitish nucleus may appear perfectly ripe clinically, while on extraction the equatorial rim of cortex may be found quite or nearly transparent; this thin transparent or translucent rim is, however, firm, and separates whole from the capsule. In other lenses the distinction between nucleus and cortex is not very evident; the loss of trans- parency seems uniform throughout, but very incomplete. The degree of opacity is much less marked in the ex- tracted lens than would be expected from the clinical appearance. There may be fine superficial radial slits or cracks on the anterior surface. In other cases the nucleus is covered by a separable thin layer of opaque cortex, either somewhat firm and consistent, or soft and moist, suggesting some admixture of the liquefying pro- cess but there is, as a rule, very little cortical matter behind the nucleus. The unripe shrinking cataracts seen through the pupil have a diffused greenish appearance, perhaps tinged with olive from nuclear sclerosis, at other times grayish. A few of the grayish opacities are quite deep ; there is a quantity of perfectly clear cortex through which a very distinct shadow is thrown by the iris, seen by looking * Very rarely there are thin glistening sectors of anterior cortex regularly arranged, as in the unripe swollen cataracts.