Tubercular iritis / by W. B. Inglis Pollock.

  • Pollock, W. B. Inglis.
Date:
[1904]
Catalogue details

Licence: In copyright

Credit: Tubercular iritis / by W. B. Inglis Pollock. Source: Wellcome Collection.

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

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    Tension was decreased, and slightest pressure on the globes caused pain. Tlie right remained unchanged, but left became softer and more painful and inflamed, so on 27th July the left eye was enucleated. She was dismissed on 11th September with V.A., right = fingers at 3| feet, and tension minus also. The left ej^eball was placed in Mliller's fluid and preserved in 70 per cent alcohol, then embedded in celloidin for cutting into sections. Naked-eye examination.—The anterior chamber is shallow; the vitreous shrunken to two-thirds; the retina in position; and a number of tubercles the size of pinheads visible in the choroid. A slightly larger one, lying at the inferior part, I returned to Professor Greef for the museum. Microscopic examination.—There are numerous broad peripheral adhesions of the iris to the cornea, but internally and superiorly the angle of the anterior chamber is free. At almost all parts the iris is attached to the anterior surface of the lens at the pupillary margin (posterior synechise). A fine connective tissue membrane lies across the pupil, representing an exudation of some considerable age, which has been replaced by fibrous tissue. That its origin is not very old is shown by the presence of oval cells which are passing into spindle cells, and by the absence of shrinking. At the centre of the lens it is thicker, but for the most part it is little more than a single layer of cells. There is considerable bulging of the iris forwards near its peripheral attachment, a condition termed clinically iris bombe. All these show that increased tension has caused the destruction of the eyeball, and led to the atrophy of the ciliary body to be described. The nodules projecting on the surface of the iris are composed of epithelioid and round cells, the latter in pre- dommance. They have no capsule nor vessels in the interior. Giant cells and tubercle bacilli were not found. Other nodes lie deep in the stroma of the iris, and a number are present near the; periphery of the anterior chamber in the ligamentum pectinatum or the iris. Most of them lie about one to two milhmetres from the pupillary margin. No caseation was noted. The remaining changes in the iris are mainly those ot atrophy. The delicate reticulated stroma of branching cells has been almost entirely lost, especially in the ciliary zone, and is replaced by a tissue rich in round- and spindle- shaped elements. The posterior pigment layer is in position. Ismail haemorrhages are seen at one or two places (Fig. 1, p. 4). In the ciliary body are also seen the same circumscribed A 2