Recovery of sight after rupture of the globe.

Abstract

A farmer, aged 44, was admitted to hospital on September 2, 1952, after being kicked in the right eye by a cow. The left eye had been lost 10 years before from injury by a pick-axe in a quarry. The conjunctiva was seen to be lacerated above and the globe partly collapsed, but no further details could be made out on preliminary examination. Under general anaesthesia the wound was cleared of debris and blood-clot, revealing a rupture of the sclera in the ciliary region from 11.30 to 2.30 o'clock. The wound was closed by episcleral mattress suture and the conjunctiva repaired. The dressing was not changed until the third day, when the globe was found to be reformed, and the cornea clear, but only a uniform obscurity of blood within. Durino the next week a clearing showed behind the cornea and gradually enlarged as though the blood were being pressed uniformly backward, limiting the clear anterior segment with an even background. A fortnight after injury, the front half of the globe being clear, the rear impenetrably filled with blood, the patient was sent home. Four weeks after injury a dull red reflex could be seen. A month later the fundus could be glimpsed and vision with + 10 5 D. sph was just 6/60. Five months later the rather murky vitreous, with large white floaters, allowed a fair view of apparently undamaged fundus;'vision with + 11 5 D. sph. c + 3 D. cyl. axis 170 was 6/9 and with +4 addition J.1 with difficulty. ~~~~ ~~At the last examination in December, 1953, 15 months after the injury, corrected vision was 6/6 partly and J. 1 with ease. The eye looked curously featureless, the only ~~~interruptions in the media being where the clear anterior segment met the smooth face of the vitreous and a few thin, papery fronds, apparently anchored in the ciliary region. The vitreous, now clear, appeared less dense than usual, the fibrillae sparser and more tenuous. The fundus, clearly seen, showed little evidence of