By J. L. C. Martin-Doyle (Auth.)
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Extra resources for A Synopsis of Ophthalmology
T h i s is a disease o f middle-aged or elderly people, and in a surprising number o f cases there is a history o f contact w i t h chicken-pox. One o r m o r e branches o f the ophthalmic division o f the fifth n e r v e are affected. T h e disease is unilateral and is accompanied b y malaise, fever, and much pain. T h e pain follows t h e course of the nerve so t y p i c a l l y t h a t i t is often possible t o diagnose herpes ophthalmicus before the skin eruption appears. Shortly after the onset o f the pain skin vesicles appear as in herpes zoster in other parts o f the b o d y .
P A T H O L O G Y . — T h e lesion is v e r y frequently a p r i m a r y one and is due t o local inoculation w i t h the tubercle bacillus. T y p i c a l giant-cell systems are seen, and sometimes tubercle bacilli can be isolated from the scrapings. T R E A T M E N T must be drastic : ( 1 ) E x c i s e where possible ; ( 2 ) F a i l i n g this, curette and cauterize ; ( 3 ) T r e a t m e n t w i t h isoniazid, P . A . S . , or other antituberculous antibiotic is essential. SYPHILIS OF T H E CONJUNCTIVA R a r e .
P u p i l constrictors are miotics and those which paralyse accommodation are cycloplegics. , pupil dilators cause some degree o f paralysis of accommodation and the constrictors increase accommodation. These drugs act in different w a y s and are classified according t o their action. 1. P a r a s y m p a t h o l y t i c D r u g s . — T h e s e block the action o f acetylcholine, thereby causing pupil dilatation b y m a k i n g it impossible for the sphincter muscle t o contract. T h e characteristic e x a m p l e o f this drug is atropine which is a v e r y powerful dilator, slow in action but lasting a long t i m e and causing complete paralysis o f accommodation.