General suppurative inflammation of eye. Experimental cases. From
traumas. Diagnosis; foul wound, violent eye inflammation, yellow
purulent appearance, high fever, involves second eye. Treatment:
antiseptic, enucleation.
This term has been applied to a general purulent inflammation of the eye
resulting from infection with pus germs entering from without through
traumatic injuries, or by reason of inflamed tissues, or on the other
hand, reaching the eye as a general infection through the blood. It may
begin therefore, as conjunctivitis, scleritis, or keratitis, and
gradually extend to active infection of the iris, choroid, and ciliary
body.
Möller produced an experimental case in a foal by the injection of the
staphylococcus pyogenes aureus into the anterior chamber. In 24 hours
there was violent inflammation: the eyelids were closed, the conjunctiva
dark red, and a mass of glairy pus under the eyelid. The cornea was
cloudy throughout, though still dimly transparent so that the
accumulating pus in the anterior chamber could be seen. The iris was
strongly dilated and the eyeball abnormally tense. The second day the
bulb was visibly enlarged, the eyelids greatly swollen, the conjunctiva
infiltrated so as to cause chemosis, and the cornea completely opaque.
The infiltration of the orbit caused the eyeball to protrude from its
sheath. A high fever set in and on the fifth day the foal died.
Cases in the lower animals are usually the result of direct infection
through some traumatic lesion of the eye.
The special feature of the disease is the rapid and abundant production
in all parts of the eye of pus cells until the whole organ has become a
bag of pus.
The chief diagnostic symptoms are the presence of a foul wound, the
rapid advance of the phlegmonous inflammation of the conjunctiva and
lids, the yellowish opacity of the cornea, and, if visible, of the
aqueous humor, the prominence of the entire eyeball, the high attendant
fever and the early destruction of the eye. In the domestic animals the
sympathetic irritation of the second eye has not been observed so
commonly as in man. If the patient survives, the pus makes its way
slowly to the surface, and escapes, and the cavity granulates and heals
with contraction of the eye into a small nodular mass.
The _treatment_ of the condition is essentially antiseptic and should be
made preventive if possible, as there is little hope of saving the eye
if the suppurative inflammation has been already established. The wound
should be treated at the earliest moment with antiseptic lotions,
sublimate solution (1 ∶ 5000) or potassium permanganate solution (1 ∶
100) or pyoktannin (1 ∶ 1000), or creolin (1 ∶ 100). When inflammation
has actually set in, these should be used still more assiduously by
frequent injection under the lids, or by inserting antiseptic cotton
between these and the bulb.
=Enucleation.= When the eye has become a virtual abscess the quickest
and most perfect relief is secured by the complete extirpation of the
eyeball. The patient is narcotized by ether or chloroform, and a thread
or hook being passed through the cornea, the globe is quickly dissected
out by curved scissors. Bleeding may be checked by pressure with cotton
wool steeped in tincture of the muriate of iron, and later the wound may
be dressed with stupes wet with a mixture in equal parts of standard
solution of sulphurous acid, glycerine and water.