KERATITIS 531 



eyelids, ear, or adjacent parts, may be attended by it. Direct 

 injury to the cornea may be a cause. 



Symptoms.— The cornea becomes turbid, gray or yellow. 

 The normal transparency is lost. The turbidity may not 

 extend over the entire cornea. Very often a dulness of the 

 cornea is all that is noticed during the early stages of the 

 disease. 



When the cornea is closely examined there will be found 

 small elevations over the epithelial layer, and a network of 

 fine bloodvessels radiating more or less evenly from the 

 periphery to the center. The bloodvessels are often so small 

 that a reading glass is necessary in order to see them. They 

 run parallel to each other and usually do not anastomose 

 but terminate in a small loop forming a zone entirely around 

 the corneal limbus. These new formed vessels become quite 

 extensive and involve the entire cornea. Lacrimation, 

 photophobia, pain, and congestion of the sclera are present. 

 When examined with an ophthalmoscope there will be evi- 

 dence of iritis and choroiditis. 



Course.— The course is usually several days to a few weeks. 

 Abscess or ulceration of the cornea is a rare sequel. 



Prognosis.— Owing to the changes that have taken place 

 in the cornea, it requires quite a long time to bring about 

 healing. The tendency to recur makes the prognosis rather 

 unfavorable. Permanent turbidity of the cornea may result 

 with partial or complete loss of sight. 



Treatment.— During the early stages of the disease the 

 patient should be protected from strong light and everything 

 possible done to prevent irritation of the cornea. 



Constriction of the vessels and reduction of the irritation 

 are best brought about by applying to the cornea three or 

 four times daily codrenin solution (4 per cent.). This is 

 continued for two or three days. When there is evidence 

 of iritis or choroiditis atropin solution (| per cent.) is of value 

 to prevent adhesions (posterior synechia). 



If pus is present a mild, non-irritating antiseptic should be 

 used. Recommended are boric acid (2 per cent.), biniodid 

 of mercury (1-10,000). Codrenin solution may be added to 

 the above to constrict the bloodvessels and control the pain. 



