378 



pain in the brow and temple, which often is so severe at night as to 

 prevent sleep. 



Diagnosis. — The disease with which this is most likely to be con- 

 founded is iritis, as it is seldom the patient presents himself in the 

 earl v or amaurotic stage. The previous history of the case, but more 

 especially the fact that in postfebrile ophthalmia, muscae and dim- 

 ness of vision invariably precede vascularity of the eye, while in iritis, 

 redness, photophobia, &c. exist for several days before vision is dis- 

 turbed, will readily enable us to distinguish between the two diseases. 

 In its advanced stage, it strongly resembles what Tyrrell describes as 

 chronic choroiditis. In one of the first cases that came under my 

 care, I mistook the disease for amaurosis, the patient being sud- 

 denly struck blind, and the blindness continuing for some time with- 

 out the eye presenting any other signs of disease. 



Prognosis. — If the case presents itself before serious change of 

 structure has taken place, and appropriate treatment be at once re- 

 sorted to, the disease can readily be checked and the eye restored to 

 its healthy condition. Occasionally muscse continue for some time 

 after all other symptoms of disease have subsided, but tbey sooner or 

 later entirely disappear. As an evidence that the disease, if left to 

 itself, has a tendency to result in total loss of vision, I would state 

 that in a patient under the care of my colleague, Br. Wilkes, who 

 discontinued his attendance immediately after his first visit, and who 

 returned again seven months after, the eye was perfectly amaurotic r 

 and still continues so. No remedies had in the mean time been used. 



Statistics. — The youngest patient admitted was two years and a 

 half, the oldest forty-nine years of age. Thirteen of twenty-nine 

 patients were between the ages of ten and twenty years. Sixteen oc- 

 curred in males and thirteen in females. With the exception of six, 

 who Avere still suffering from the debility consequent upon the fever, 

 they were all apparently in good health. The right eye was affected 

 in fifteen, the left in eleven, and in three both eyes. The period after 

 the fever at which the ophthalmia made its appearance, varied from 

 several days to seven months. In several cases the muscse appeared 

 while the patients were still ill with the fever. The interval between 

 the amaurotic and inflammatory stages, varied from a few days to -two 

 weeks. In four cases the patients at the time of admission were able 

 to read small print with some difficulty, others had sufficient vision 

 to enable them to count their fingers, but the great majority had a 

 bare perception of light. In only three cases did the patients 

 escape a relapse of the fever; in one case there was a second re- 

 lapse. The cure occupied from ten days to seven weeks. Nearly 



