84 MICROSCOPY OF THE LIVING EYE 



due to local disease in other parts of the eye — and it is reasonable to 

 assume that probably none will be found for some time yet to come. 

 No matter what advantages have accrued in the past and will accrue 

 in the future from rational research, certain apprehensive elderly 

 patients will always criticise, some will even feel resentment towards 

 any profession which, concerned with healing, cannot confer somatic 

 immortality. The more vigorous has been the patient's vitality, 

 or the greater his attainments in life, often as not the higher his 

 social status, then the more independently and indomitably will 

 he be likely to resent accepting defeat in decline, and so will turn 

 to any " treatment " that is accompanied by some plausible ritual 

 — be it bathing the eyes with lemon- juice, gazing at coloured 

 fetiches or what not — hopefully offered as warding off the dreaded 

 condition of " cataract." This is digression : it is only to urge 

 avoidance of the misguided use of the word " cataract " (14) in 

 relation to minute lens-changes, which, often practically invisible 

 by retroillumination, would commonly enough not materially 

 alter for, it may be, twenty or thirty years, even when nothing 

 at all is done ; yet which, to the mind of an apprehensive and 

 impressionable patient submitting himself to some faith cure, 

 may afford a wonderful example of a skilled remedy for a 

 condition which did not materially exist. 



Of much more clinical significance may be the discrimination of 

 lens-changes which are secondary to such other eye-affections as 

 cyclitis, choroiditis, etc., and also the study of the effects of 

 perforating and concussion-injury to the lens. 



One interesting class of concussion-injury may be mentioned. 

 Fig. 50, B, shows the ophthalmoscopic appearance of a zone-like 

 opacity in the anterior lens-cortex caused by a previous concussion- 

 injury. In Fig. 50, A, its level is defined in the slit-beam between 

 the capsular and the adult nuclear face. The mjury in this case 

 was sustained seven years previously in the immediate subcapsular 

 region ; the persisting opacity which resulted has relatively 

 migrated gradually away from the subcapsular region with the 

 combined growth of new lens-matter beneath the capsule and the 

 gradual shrinkage of the older lens-matter nearer the centre. 

 This is a gross and obvious case ; but it sometimes happens that 



