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Related post: these lesions in the associatcul movt-uumts of the internal recti muHcles
is a proof that they should be regarded as actual paralyses. No case
can be regarded as belonging to this category in which the visual field
is not normal. Moreover, the power of convergence is \>y no means al-
ways interfered with in ataxy ; on the cr)ntrary, it may be markedly in-
creased. Still, the center (ov convergence is frequently involved in the
disease, but there is fre(pieiitly no direct relation between the degree of
the paralysis, measured by the Buy Grifulvin perimeter, and the maximum of con-
vergence. Sometimes the field-of-vision examination shows the oculo-
motorius to be intact, and here we attribute the cause of the variations
of the amplitude of convergence to a concomitant lesion of several cen-
ters presiding over dilTercnt iiioveiiients.
The Anatomy of Serpiginous Ulcer of the Cornea. — Verdese (ilnd.)
takes up the origin of hy|)opy(m in serpiginous ulcer of the cornea. In
this disease it has been proved that Bowman's mendjrane is infiltrated
with lymphoid cells, while in the membrane of Descemet no wandering
cells have ever been found. In view of this fact, it has been considered
that the probable cause of the presence of pus in the anterior chamber
is a prolapse of the posterior limiting membrane and the passage of the
pus-cells from the cornea through the rent into the aqueous humor. This
view Grifulvin V Verdese thinks must be modified,' as he considers the presence of
the hypopyum due directly to a rupture of the membrane of Descemet
which is not a real elastic membrane, as has been proved by its reaction
with coloring matters. According to Ranvier, the membrane of Descemet
is extremely fragile. In specimens examined by Verdese the membrane
at the point of rupture was found to be the seat of a finely granular
transformation, due probably to the compression exerted by the collec-
lionof lymphoid cells in its neighborhood. The leucocytes found in the an-
terior chamber are comparatively so few that they may be readily assumed
as coming entirely from the cornea through the rupture in the posterior
limiting membrane. Those lymphoid cells which have by their gravity
reached Fontana's spaces below here set up an irritation which causes
infiltration of the sheath of the vessels with numerous leucocytes. The
iris takes no part in this inflammatory process. The filament met with
so often in this form of corneal trouble which is attached to the pos-
terior surface of the cornea and floats in the aqueous humor, and Buy Grifulvin V which
has been regarded as pathognomonic of a serpiginous corneal ulcer,
must now be regarded as equally pathognomonic of a rupture of the
membrane of Descemet. The little abscess which causes the rupture
of the posterior limiting membrane and which infiltrates and separates
the deep bundles of corneal fibers becomes the origin of a new ulcera-
tive process which extends from behind toward the superficial parts.
The incision recommended by Saemisch in these cases, which splits the
entire ulcer, makes a communication between the deep and the super-
ficial ulcerative processes, and thus enables the disinfecting Grifulvin V 500 agents to
destroy the germs lodged in the tissues.
Astigmatism. — Bettremieux (ibid.) thinks that the blepharospasm
met with so frequently in astigmatic patients is due to the existence of
an instinctive closure of the lids in the interest of improved vision, and
that instinctive closure is at some period transformed into an involun-
tary and at times painful veritable blepharospasm. He admits also the
possibility that the contraction Buy Grifulvin Online of the lids may Grifulvin V Micr produce a dynamical
compensatory astigmatism which temporarily modifies the shape of the
eye. Mydriasis is an important symptom if not produced by a drug,
and provided it is not excessive but moderate, as in some cases of
myopia. Bettremieux thinks that mydriasis of one eye may be induced
by the irregular and spasmodic contractions of the ciliary muscle pro-
voked by astigmatism in the other eye.
Ophthalmoplegia Externa following Faucial Diphtheria. — Evetsky
(ibid.) reports several cases of this complication, one of them occurring
Aiijr. 11, 1888.]
MISCELLANY.
165
in his own practice, and gives a summary of the modern view:* on this
subject. It is f^enerally believed that the seat of the lesion of the
oculomotor nerves in ophthalmoplegia externa is to be found in their
nuclei. If we admit another locality it will be difficult to explain the
existence of an isolated paralysis of the external ocular muscles alone,
while the internal ocular muscles, the nerves of which run in the trunk
of the oculomotorius by the side of the other paralyzed branches, re-
main entirely intact. In addition to thii^ purely theoretical consideration
there are a large number of clinical observations in favor of the above
view, such as the complication of ophthalmoplegia with bulbar paralysis.
Still, many neuro-pathologists hold that the anatomical seat of diph-
theritic paralyses must be looked for in multiple neuritis, and hence
that they are not central but peripheral in origin.
Electric Ophthalmia. — Terrier {ibid., Jan.-Feb., 1888) regards the
ophthalmia produced by exposure to the electric light as a sort of ocular
sunstroke, in which the membranes of the eye react much more violently
than the skin. The ocular conjunctiva, which is exposed to the action
of the electric light, is much more actively congested than the parts
which are concealed by the lids. The action of the calorific rays in
the production of this congestion may be entirely neglected, but we are
not yet in a position to decide whether the active congestion is due to
the chemical or luminous rays.
Binocular Vision after the Operation for Strabismus. — Landolt
(ibid.) formulates his conclusions on this subject as follows : If the case

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Último acesso:segunda, 2 dezembro 2013, 00:46  (1759 dias 10 horas)