Pseudoglioma / by John B. Story.

  • Story, John B.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Pseudoglioma / by John B. Story. 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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    PSEUDOGLIOMA. The case which I have the honour to bring before the Pathological Section of the Academy of Medicine, is one of those extremely- interesting ones where difl&ciilty is frequently experienced in estab- lishing the differential diagnosis between a retinal glioma and a iibro-plastic or puroplastic inflammation in the interior of the eyeball. The opinions of authorities differ as to the extent of this difficulty, but all admit that it exists, from Virchow, who stated in 1864 that no sharp line of demarcation exists between glioma retinse and inflammatory growths in the same tissue, to Hirsch- berg, who admits that in some cases the diagnosis must remain, temporarily at least, uncertain. If the patient comes under observation while the media are still clear, the diagnosis is not exposed to the same difficulties as when the lens is opaque and the pupil occluded with an exudation which even in true cases of glioma may be of a simple inflammatory character. During this period the wide pupil, the metallic yellow- ish reflex from the fundus oculi, and the knobby hillocks rising from the probably detached retina point to the presence of glioma, which the occurence of iritis, with a contracted pupil, and synechia, and the appearance of a duller whitish reflection from the fundus, indicate the more probable existence of plastic or suppurative choroiditis. The tension, too, is of help, being generally above normal in glioma, and subnormal in the inflammatory affec- tion. None of these rules, however, can be regarded as absolutely invariable. Later on membranous opacities in the vitreous may be a source of confusion, in addition to the presence of cataract, opacity in the cornea, and changes in the anterior chamber, but these are generally late occurrences in the growth of a glioma, and the tension is generally sufficiently abnormal in such cases to enable • Read in the Pathological Section, November 30, 1883.