4 BACTERIOLOGY OF THE EYE 



Amongst the peripheral catarrhal infiltrates and ulcers many diplo- 

 bacillary cases will be found, for which the zinc treatment far sur- 

 passes all others. 



. INTRA-OCULAR DISEASES. 



Fluids taken from the anterior chamber by puncture or with a fine 

 syringe can be similarly examined on a slide. In the case of purulent 

 processes the actual cause may be demonstrated at once ; but it should 

 be remembered that just as a sterile hypopyon can result from an 

 infection of the cornea, so it can result from the influence of a distant 

 focus deep in the eye. In many cases of perforating wounds I have 

 found the hypopyon sterile and the vitreous infected. In this con- 

 nexion it must be noted that the organism may have disappeared from 

 the anterior chamber, and still remain in the more nutrient vitreous. 



When the eye is available after an exenteration or enucleation, 

 material can be taken from several places, naturally with as little 

 damage as possible to the specimen. The surface of the globe at the 

 point of perforation should first be cauterized, to prevent any contami- 

 nation with germs which may be adhering to it. 



In iritis a diagnostic puncture of the living eye has lately been 

 recommended by Gourfein, 1 Morax and Chaillous, 2 and Zur Nedden. 3 

 For this purpose the cornea is punctured obliquely with a cannula 

 attached to a syringe, and the fluid which runs into the syringe is 

 examined. In the case of acute iritis a slide should be prepared and 

 stained in the method introduced by Giemsa to demonstrate the 

 Spirochceta. In dealing with chronic iritis the important question 

 arises, Is the case one of tuberculosis? and it is better to make 

 inoculations with the aqueous obtained. Gourfein and Morax have 

 thus inoculated tuberculosis in rabbits. Of course a negative result 

 in such a case is of little value, as the organisms can remain in the 

 iris, and not pass out into the aqueous. 



As in other exudations, the causal germs in an intra-ocular suppura- 

 tion may die out after a varying time, which depends on the particular 

 species of organism present (pathogenic B. subtilis dies rapidly ; other 

 pyogenic organisms resist longer), on their number and virulence, and 

 also on the method and site of their implantation (direct vitreous 

 infection, with a simultaneous wound of the lens, favours their spread 

 and persistence, while a pure infection of the aqueous, and many 

 hsBrnatogenous infections readily disappear). The resistance and 



1 Recueild'OpMh., 1904, p. 434. 2 Ann- ffOcul, 1901, cxxvi., p. 119. 



3 Vers. der Deutschen. Ophth. Ges., Heidel., 1906. 



