CXX BOWMAN LECTURE. 



occurred in three of lier children ; (these three are 

 Figs. 181a, 1816 and 181c, Appendix Via). 



Cases of family or hereditary congenital optic atrophy 

 have been described as if forming a group in some way 

 distinct from Leber's disease. I believe that most of 

 these are true Leber's disease setting in very early in 

 life or perhaps sometimes before birth. Certainly several 

 of those given in Appendix Via present the classical 

 symptoms; and I doubt whether we have at present 

 sufficient evidence to justify us in setting up any of these 

 family infantile cases as a distinct group. 



There does not seem to be any connection between 

 juvenile Leber's disease and the cases of progressive 

 failure of sight with slight macular and papillary changes, 

 and coincident mental degeneracy, in children, described 

 by F. B. Batten, Mayou, Sydney Stephen son and others.* 



As outlying cases the following may be mentioned: 



I have once seen double chronic stationary central 

 amblyopia with partial optic atrophy corning on in an 

 old man at about the age of 76, and ordinary acute 

 retrobulbar neuritis, first in one eye, and after a year's 

 interval in the other, in his daughter aged 2324 who had 

 symptoms suspiciously like early disseminated sclerosis 

 (P. 49, 62 and 52, 146). 



I also saw in 18811882 retrobulbar neuritis limited to 

 one eye and following an attack of diplopia due to paresis 

 of one of the rotators, in a man set. 50 years,t whose 

 daughter was under Mr. Holmes Spicer's care 20 years 

 later, set. 33 years, for retrobulbar neuritis of left eye, which 

 relapsed slightly 4 years later (1906), when she also had 

 threaten ings of disseminated sclerosis. 



Acute retrobulbar neuritis has also been seen in two 

 sisters in more than one instance. 



* T.O.S., xxiii, 1903, p. 386, and xxiv, 1904, p. 142, et se<j. 

 t Ibid., iv, p. 210, Case 17. 



