162 OLIVER — BLINDNESS FROM MALFORMATION OF SKULL. [April 5, 



bone fails to exhibit any of the sinuses that are seen in adult life. 

 The optic foramina are large in size and triangular in shape, having 

 been obtained by the confluence of the presphenoidal and orbito- 

 sphenoidal centres. The superciliary ridges and frontal sinuses 

 are not yet present. The lacrymal bones consist of simple delicate 

 sheets. As a rule, the nerve foramina occupy sutural points or 

 positions of ossific centres. 



Both the primary and the secondary foramina, particularly the 

 latter, are disturbed by distortion-processes taking place during 

 their passage through many complicated bony tunnels before they 

 escape through the dural sheath, as is primarily done by the former 

 types. 



Minor arrests and perversions of development in the bones of the 

 upper face are so frequent that they constitute the daily findings of 

 the scientific ophthalmologist and trained optician. Orbital de- 

 formities, more especially those of the rim of the orbit, are very 

 common, and although they have decided effects upon refractive 

 error and exterior-ocular muscle-equilibrium, they fail to exert but 

 little, if any, damage upon combined visual functioning when the 

 resultant functional faults are either orthopedically or radically 

 corrected. More pronounced osseous deformation, the result of 

 disturbances of development of the bones of the face, show coarser 

 signs of fault in the eyeballs and their adnexa ; exhibiting, for 

 example, monolateral and bilateral stenoses of the nasolachrymal 

 ducts. In the grosser forms of congenital malformation leading to 

 antenatal or, later, postnatal blindness (the subject-matter of this 

 communication), it is probable that the primary changes have taken 

 place in the notochordal and trabecular regions during the chondral 

 stages of development of the brain-case. In these types, both 

 irregular ossification with consequent cranial contraction in one 

 situation and undue expansion in another, and undue sutural closure 

 from inflammation of the osteophytic membranes with resultant 

 thickenings and ridge-like eminences along the osseous junctures, 

 especially in the basilar series of bones at their asteriorial, inional 

 and lambdal points of junction, may appear. 



The normal morphology of the skull is expressed in three stages. 

 The brain vesicles are at first enclosed in a thin delicate sac, a part 

 of which gradually hardens into a fibrous membrane, while the rest 

 persists to form the dura mater of postnatal life. The second stage 

 is represented by a partial conversion of the metamorphic tissues into 



