INFECTIONS OF THE OCCULAR REGION 383 



In a gonorrhoeal ophthalmia the secretion is much more abundant and there is 

 an absence of contaminating organisms, the reverse of infection with the confusing 

 M . catarrhalis. As a matter of fact, large numbers of M . catarrhalis may be present 

 in the conjunctival secretion with only slight irritation being observable. 



Wherry has reported two cases of ulcerative conjunctivitis with lymphadenitis 

 of cervical glands, fever and marked prostration, due to infection with B. tularense, 

 occurring in persons who had handled rabbits which had died of this plague-like 

 infection. The organism was first noted by McCoy in squirrels in California. The 

 symptoms and lesions in these animals are those of plague. Guinea-pigs succumb 

 after the cutaneous inoculation of material and show lesions markedly resembling 

 plague. The organism, however, will only grow on coagulated egg yolk, thus 

 differentiating it from B. pestis. McCoy has noted that the infection in squirrels 

 may be transmitted by fleas (Ceratophyllus acutus). 



In keratomycosis the cause has been ascribed to Aspergillus fumigatus. 



Certain fungi of the genus Microsporum have been thought to be 

 the cause of trachoma, as have also certain bacillary forms. One 

 should be very conservative about reporting fungi in smears or cul- 

 tures of external surfaces. 



The larval stage of Tania solium (Cysticercus celluloses) has a predilection for 

 eye as well as brain. It is usually situated beneath the retina. 



The question as to the nature of the so-called ophthalmic flukes is taken up under 

 trematodes. Echinococcus cysts have been reported in the orbit. 



The adult Filaria loa tends at times to appear under the conjunctiva or in the 

 subcutaneous tissue of the eye-lids. 



Fly larvae have been reported from the conjunctival sacs hi the helpless sick, 

 species of larval sarcophagids having been reported as invading the conjunctival 

 region in purulent ophthalmias. 



Demodex may cause an obstinate blepharitis. 



Prowazek has thought that certain fine dots within the cytoplasm of epithelial 

 cells, which stain best by Giemsa's method and which he considered protozoal in 

 nature, were the cause of trachoma. See Koch-Weeks bacillus and trachoma 

 bodies. 



