A STUDENT, aged 16, a somewhat anaemic but otherwise healthy girl. In February, 1913, I tested her refraction, and the left pupil was then normal. It was noticed by her mother to be enlarged in the following July. In May, 1914, I saw her again, and the condition has remained unchanged since then. In moderate light the left pupil is dilated to between two and three times the diameter of the right. It does not react to light either directly or consensually. It does contract well to convergence, though somewhat slowly. It also shows a marked contraction immediately after a voluntary closure of the lids. Vision is not affected either for distance or near. Right eye normal.
Section of Ophthalmology 51 few days ago, in which, despite a clear history of forceps injury, there appeared to be nothing previouslywrong except high astigmatism, and the fundus seemed to be normal. It is possible to get this degree of birth injury in ordinary delivery without forceps. Mr. ERNEST CLARKE (President) said that the optic nerve might be injured in ordinary delivery without forceps, considering the distorted condition in which the head was sometimes delivered, even when no instruments were used. Fundus Pictures. By ARTHUR GRIFFITH, F.R.C.S. (I) RIGHT eye, gumma of sclera. (II) Left eye, gummatous scleritis. (III) Rash on forearm. Patient, male, aged 49. History.-Twenty-five years' service in Army, ending in December, 1919. Right eye painful and red for three months. Left eye swollen for two months. Vision: Right ", N.I., H.M. + 075 sph.; Left ', with + 1 25 sph. =-. Right eye, gummatous ulcer of sclera. Rectus externus destroyed, and eye convergent. Patch of acute choroiditis downwards and outwards. Vitreous haze. Left eye, gummatous scleritis, temporal side of limbus. Wassermann reaction strongly positive. After three weeks' treatment, this patient regarded himself as sufficiently improved, and declined further treatment.
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