Ophthalmoplegia externa complicating a case of Graves' disease / by Francis Warner.

  • Warner, Francis, 1847-1926.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Ophthalmoplegia externa complicating a case of Graves' disease / by Francis Warner. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    gastric crises, and rises of temperature became infrequent and very transitory. In August she was ordered as follows : Liq. Hydrarg. Perchlor., 533; Potass. Iodic!., gr. v; Tr. Card, co., 3j; AquoB ad 5j> ter d. s. Slight mercurialism followed. The iodide was increased to gr. XV, and this was continued till the end of August, when she was ordered a simple tonic. There appeared to be no evidence of the presence of syphilis. Menstruation returned in September, and has continued regular since; it had been absent for eleven months. The goitre entirely disappeared, the circumference of the neck falling from fourteen to twelve inches and a half. In January, 1882, Mr. Tweedy kindly examined the patient and reported :— Pupils fairly active and in a state of medium dilatation, both eyeballs prominent, especially the left, the right the better sighted. On the left cornea at its lowest part is a linear horizontal scar corresponding to the palpebral fissure; the pupillary edge of the iris is jagged at the inner part, especially above. Just opposite the upper and inner edge is a clot of uvea on the anterior capsule of the lens, the remains of old iritis. Optic discs and fundi normal. Yery little move- ment of the globes, rather more in the vertical direction than in the horizontal; the left eye moves a little more than the right. In this case the immobility of the eyes was never absolute in any direction, and the limitation of the range of movements was not equal in all directions. Eeasons for thinking the paralysis of the ocular muscles central and not local in certain nerves are as follows : the average symmetry of the lesion, paralysis of the third, fourth, and sixth pairs of nerves would not account for the greater limitation of the movements in horizontal as compared with the vertical planes.