This disease is known by many as =vernal catarrh= or =spring catarrh=
of the conjunctiva. It is a chronic inflammation which sets up changes
in the conjunctiva and tarsus. This disease may be confused with
trachoma unless one observes closely. There are broad flat papillæ on
the conjunctiva. These papillæ may readily be taken for granulations.
They are larger than the granules in trachoma. They somewhat resemble
the arrangement of cobble stones. The conjunctiva has a bluish-white
filmy appearance called by some, milky shimmer.
The disease was thought at first to appear only in the spring,
hence the name vernal. Many cases continue through the year with
exacerbations in the spring. It occurs more often in boys. Both eyes
are attacked. It may heal and leave no trace. It may last from four to
twenty years.
=Causes.=—Almost all works on the eye say the cause is not known. De
Schweinitz says, “Definite information in regard to the cause of this
disease is lacking.” There may be a micro-organism which has not been
discovered.
I wish to call the attention of the osteopathic profession to the great
fact that there are numbers of diseases of the eye as well as of other
parts of the body about which the medical profession are entirely
“at sea.” This gives valuable ground for scientific research by our
profession.
My experience with this disease is not sufficient for me to speak with
any positiveness or finality as to its cause. The altered trophic
parts and the very chronic condition existing leads me to the firm
belief that we will ultimately find the cause as a mechanical lesion
affecting the trigeminal or sympathetic (or both) nerve connections.
Glare of light and local irritants act only as secondary causes. Nasal
disease may be associated and act as a cause.
=Symptoms.=—There is photophobia, some mucus, slight pericorneal
injection, redness of the conjunctiva of both the bulb and lids; that
of the lids is thickened and of dull pale color due to sub-epithelial
hyaline thickening. The fact that there is no pannus, and flat
granulations and recurrence with spring, marks it from trachoma.
=Prognosis.=—Under medical treatment it is unfavorable; may last twenty
years. Slight opacity of the cornea may develop.
=Treatment.=—The eyes should be protected with dark glasses. Cold
compresses give some relief. Boric acid is good as a wash. Yellow oxide
of mercury ointment may be of service as an antiseptic and alternative.
If nasal disease exists, it, of course, should be treated according to
indications. Fundamentally the lesions in the spine in the cervical
and upper dorsal regions should be specifically corrected. When enough
cases of vernal catarrh have been observed and treated osteopathically
much light and benefit will be brought to bear upon this obscure and
intractable disease of the conjunctiva.