1901 Journal of the American Medical Association (JAMA)  
loss in two other cases, in neither of which did it lead to any notable modification of the result. There was hemorrhage into the anterior chamber three times, twice from injury, once without obvious reason. In the traumatic cases both recovered without permanent injury; in the third case the hemorrhage was profuse, quite filling the anterior chamber and the patient recovered with V. = 6/LX. The nasal end of the wound became infected in one case, but prompt treatment arrested the progress of
more » ... the progress of the ulcer, but deft the periphery of the iris adherent to the wound at that point causing a slightly ovoid pupil. Secondary operations were performed in 14 cases. An exceptionally favorable result was obtained in one patient. Both eyes were operated upon at different sittings resulting in both in central, round, freely acting pupils and V. = 6/V in each eye. He enjoys binocular vision both for distance and in reading. But one loss is to be recorded. The patient left the hospital with V. = 6/ VII L/2, but returned in iwo years with vision sunk to 6/XV due to a gray capsule, following "a cold" in his eye. A capsulotomy was performed followed by no reaction and V. rose to 6/VI. He received his discharge from the hospital on the fifth day with the eye white. He returned the following day with the eye flushed and painful. There was a gray point at the site of the corneal puncture which was rapidly followed by purulent panophthalmitis and loss of the eye. The visual results were as follows : V. = 6/V in 5 eases ; 6/VI in eight cases; 6/VII y2 in 5 cases; 6/IX in seven cases; 6/XH in seven cases; 6/XV in 2 cases; 6/XX in 1 case; 6/LX in 1 case; good in 2 cases; no record in 2 cases; total, 40 cases. The acuity of vision in many of the cases was recorded at the time of their discharge from the hospital. It is probable that later study would have shown better vision. In some instances when V. = 6/XII secondary operations were not attempted since that vision was sufficient for gross pursuits and further risk was not deemed advisable.! others, have introduced into the management of partial lens opacities considerations which make the old and easy classification of incipient and ripe cataracts unsatisfactory to the observer, and unjust or cruel to the patient. A few clinical truths seem to have been firmly established. We know that the situation of early opacities is of prognostic importance; that senility is neither the only nor the most important factor in etiology of so\x=req-\ called primary senile cataract; that the uveal tract, especially the choroid, should be minutely studied; that "spontaneous cures" now and then occur from absorption, with or without capsule puncture, or from luxation; that hygienic, optical and medicinal care are of importance, and seem to retard progress of lens-clouding:[ill] that ripening operations are unreliable, and probably entirely unnecessary; that if the opacity interferes \ s=d\I wish to acknowledge the efficient aid of Dr. E. S. Saylor in collating the histories, and in preparing the accompanying table of cases.
doi:10.1001/jama.1901.62470490015001d fatcat:vwf6izze5bek7jgcinqdbkh7pu