664 DISEASES OF THE EYES. 



On examination the eye appears extremely sensitive; in fact, it 

 can scarcely be touched unless cocaine solution is previously applied. 



The parasites, two or three as a rule, but in exceptional cases 

 from five to seven in number, are seen rolled up within the anterior 

 chamber of the eye. A week after the beginning of the attack, how- 

 ever, they begin to move about, and are then found close behind the 

 cornea, upon the lens, or suspended in the aqueous humour. 



The irritation produced sets up inflammation of Descemet's mem- 

 brane and the cornea, together with iritis, and, secondly, keratitis 

 and changes in the lens. 



Unless treatment is adopted verminous ophthalmia inevitably 

 ends in cataract. 



Diagnosis. Diagnosis is always uncertain on account of the diffi- 

 culty of examination. When the cornea is very opaque examination 

 necessarily gives a negative result. 



The prognosis is grave. 



Treatment. Eye lotions containing tincture of aloes, creolin, 

 corrosive sublimate, etc., have been suggested, but are practically 

 useless, because they can have no action on a parasite enclosed 

 within the globe of the eye. The most logical treatment consists in 

 aseptic puncture of the anterior chamber of the eye towards its lower 

 border with a cataract needle. 



The escaping liquid carries with it the parasites, and recovery is 

 then only a matter of time, provided the wound does not become 

 inflamed. The great danger consists in inflammation and suppura- 

 tion of the eye. This, however, can be avoided by antisepsis and by 

 applying a surgical wool dressing, which can be left in place for a 

 few days. 



