106 BACTERIOLOGY OF THE EYE 



it would be very difficult to do so and exclude an insidious ectogenous 

 infection. 



In the literature many accounts of such non-bacterial inflammations of wounds 

 are found : Vignes (Ann. d'OcuL, 1896, cxvi., p. 376) and Kockliffe and Nettleship 

 (T. O. S., xvi., p. 352) describe such cases. See also Wagenniann (A. f. 0., 1896). 

 Similar changes are ascribed to diabetes. 



Dolganow (A. f. A., 1896, xxxii., p. 262) reported having experimentally demon- 

 strated that the toxin of Staph. aureus, circulating in the blood after repeated 

 injections, could cause an infiltration of the optic nerve and choroid. This, how- 

 ever, has not yet been confirmed. Certainly a slight infiltration of the choroid 

 can occur in the human eye without anj T demonstrable metastatic deposition of 

 organisms (Goh, A. f. 0., xliii., 1, p. 147, and preparations by Yamaguchi). 



The effects on the eye produced by the toxins of the pyogenic 

 organisms circulating in the blood, tend towards haemorrhagic changes 

 in the retina, and this is what is invariably found clinically. 



In the case of insidious wound infection, especially in iridocyclitis 

 traumatica, the possibility of the introduction from without of an 

 organism of long latency must be very carefully considered. The 

 causal agent in this condition is almost unknown; it is related to 

 that of sympathetic ophthalmia, and in this respect somewhat resembles 

 the organisms of the tubercle group, which have a latent period of some 

 weeks after their inoculation, and the power of healing into the 

 tissues, to cause recurrences later, which power is only very slightly 

 possessed by the true pyogenic organisms. 



The healing in of living pyogenic organisms into the eye, to cause 

 renewed inflammation later on, has never been demonstrated. These 

 organisms, it should be observed, can be demonstrated in the eyeball, 

 even after panophthalmitis and perforation, for a longer time than 

 that given by Deutschmann in his review of sympathetic ophthalmia. 

 In Schmidt -Rimpler's case it was four weeks, in Schirmer's 1 

 three weeks, and in Axenfeld's 2 case five weeks. 



Regarding- sympathetic inflammation after wounds, both in 

 the ' exciting- ' and the sympathizing- ' eye, cf. section on 

 Endogenous Infection.' 



In the experimental records concerning traumatic infection of the cornea or of 

 the interior of the eye with Aureus (or a traumatic tuberculosis 3 ), the question 

 whether such should be treated by iodoform injections (Ostwald, Haab 4 ), by sub- 



1 A.f. 0., 1892, xxxviii. 4, p. 95. 



2 Ibid., 1894, xl. 1, p. 47. 



3 Traumatic tuberculosis of the eye in man is exceedingly rare (Schirmer). 



4 Concerning the literature of intra-ocular disinfection, especially with iodoform, see the 

 detailed paper on the subject l>y Krauss (Zcit.f. A., 1904, xii. 97). Romer states the view 

 that iodoform treatment has a special effect on a staphyloooccal infection, but not on 

 Sabtilis. 



