Subjective symptoms in eye diseases / by George A. Berry.

  • Berry, George A. (George Andreas), 1853-
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Subjective symptoms in eye diseases / by George A. Berry. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    19/28 (page 17)
    ■ ) recently referred to hy Man timer/ Since then two more have been added to the list of temporal hemianopsias.^ Optic Atrophy.—Except where there is marked diminution in the size of the vessels of the retina, it would be rash to come to any conclusion as to the existence of optic atrophy from the mere ophthalmoscopic appearance of the papilla, as the physiological limits of colour and excavation are extremelv wide. Alon^' with a low degree of central visual acuity, an excessive paleness of the nerve is certainly suspicious; but there are many circumstances under which those two conditions exist, either mutually dependent or not, unconnected altogether with atrophy,—for instance, all those which i^ive rise to a central ne^'ative scotoma. For a safe diauiiostic as well as prognostic criterion we are thrown back upon the deter- mination of the state of the field of vision. Our knowledge on this subject was first clearly formulated by V. Gra3fe,^ and, indeed, so thoroughly was this subject investigated by him, that, with the exception of the slight refinement which has been introduced by the examination of the peripheral colour vision, little or no advance has since been made. One of the most important points which resulted from his observations was, that however much the central vision might be diminished, no fear of progressive atrophy, and therefore eventual total blindness, need be entertained if the boundaries of the field of vision remain normal. In progressive atrophy there is invariahly a limitation of the field. The limi- tation often takes place all round (concentric limitation), but in other cases the field in one direction is more restricted than in the rest. The restriction which is taking place can frequently be most easily demonstrated for colours. This is, very probably, simply because, if the examination be made in ordinary daylight, the ' Loc. cit. 2 Treitel, Grsefe's Archiv, vol. xxv. ; Gowers, in a coininiinication to a recent meeting of the Oplitlialmological Society. ^ Klinische Monatshl. f. Autjenh.^ I860, and Archiv, vol. ii.