60 DR. FRANZ ON THE CURE OF CONGENITAL BLINDNESS, 



testimony both of the parents and of the nurse, whom 1 have closely questioned on 

 this subject. The latter, who can distinctly remember all the circumstances of the 

 case, told me that when the child was a few months old, she held a light before its 

 eyes, of which it took no notice. I ascertained also from her that the eye-balls had 

 not that restless motion which is generally observed in those who are born blind, but 

 that both eyes were always turned inwards, and that but rarely either the one or the 

 other was moved from the internal canthus. 



It was also stated to me, that towards the end of the second year the operation of 

 keratonyxis was performed on the right eye, upon which a severe iritis ensued, termi- 

 nating in atrophy of the eye-ball. Within the next four years two similar operations 

 were performed on the left eye, which did not indeed destroy the organ, but at the 

 same time did not remove the opacity in the pupil. The colour of the opacity be- 

 came in time, however, of a clearer white ; and the patient acquired a certain sensa- 

 tion of light, which he did not seem to have had before the operation. Both eyes for 

 a long time retained a disposition to inflammation, and suffered repeatedly from con- 

 junctivitis, whence the vessels of the conjunctiva were increased in number and size 

 to such an extent, that it was necessary they should be several times excised. 



At the end of June 1840, the patient, being then seventeen years of age, was 

 brought to me by my friend Dr. Swaine, for the purpose of consulting me with re- 

 gard to the congenital double strabismus, and at the same time to hear my opinion 

 on the more severe ophthalmic affection, which up to this period had been considered 

 incurable ; the patient himself regarded his case as hopeless. The following are the 

 particulars elicited on an attentive and careful examination : — On the right side, the 

 eyelids and parts adjacent appeared contracted ; they were less in size, and the eye 

 itself was situated deeper in the orbit than the left. At each act of winking spasms 

 of the eyelids were induced, and, when the left eye was turned outwards, the spas- 

 modic twitchings extended over that half of the face. Both eyes were so much in- 

 verted, that nearly one half of the cornea was hidden by the inner canthus. The 

 left eye he could move voluntarily outwards or in any direction with certainty, but 

 not without exertion ; it returned immediately inwards, when the influence of the 

 will had ceased. The motion of the right eye upwards and downwards the patient 

 had under his control, but not so the movement towards the external canthus, in 

 effecting which he only succeeded after many attempts. The left eye-ball was of the 

 natural size and elasticity ; the right, on the other hand, was at least a third smaller, 

 and felt soft, and like dough ; it was also, in the neighbourhood of the rectus in- 

 ternus, flat, or rather pressed inwards. The cornea was less convex, somewhat 

 smaller, but not in proportion to the diminished size of the globe itself; it was 

 clear, and free from opacity, except in the centre, where the keratonyxis had left an 

 opake spot. The fibrous structure of the iris was irregular; its colour, which was 

 brown, rather lighter than that of the left eye. Different degrees of light produced 

 no effect on the motion of the iris ; but when the eye was moved in a horizontal di- 



