INFLAMMATION OF THE SCLEROTIC COAT. 361 



abscess. It is then dried with corrosive sublimate or iodoform- 

 gauze and washed out with a solution of corrosive sublimate and 

 dusted with iodoform or calomel until it dries up. 



(4) Ulcerationof the Sclerotic Membrane. In this condition 

 we find a loss of substance in the cornea which varies in size and 

 depth, showing a grayish-white or grayish-yellow ground, and, as 

 a rule, has short, abrupt borders with a bluish-gray, gray, or 

 grayish-yellow opacity in the immediate neighborhood of the ulcer- 

 ation. When the ulceration of the sclerotic membrane begins to 

 heal it is indicated by a lessening of the infiltration in the imme- 

 diate neighborhood of the ulcer, the dull circle surrounding it 

 becomes clearer, the color shiny, and the pericorneal injection 

 less. The dread of light begins to disappear. In rare instances 

 the bloodvessel will shoot from the edge of the cornea toward the 

 ulcer, and an epithelial covering is now formed over the pit-like 

 ulcer, which resembles very much the normal tissue of the sclerotic 

 membrane, but it is not as transparent* in color as it was before. 

 If the ulceration has not been very deep, we see the dulness grad- 

 ually disappearing, leaving only a very thin white veil ; or, if the 

 ulceration is deep, we have as a result a distinct white spot which 

 remains permanent (cicatrix of the sclerotic membrane, macular 

 cornea). This cicatrix of the membrane may become clearer in 

 the course of time, but, as a rule, it never disappears entirely. 

 When the ulcer does not take a favorable termination we find the 

 inflammation increases, the ulceration becomes deeper, and we 

 have a perforation of the membrane in a few days. The contents 

 of the anterior chamber escape through the opening, and in rare 

 instances the iris and the lens push forward and may also escape 

 if the opening is large enough. After perforation occurs the ulcer 

 begins to heal, and we have an adhesion of the iris and lens to the 

 posterior wall of the sclerotic membrane. In other cases where 

 the opening of the ulcer is very narrow the anterior chamber fills 

 up again, is forced forward, forming a clear bladder-like body, 

 forming dropsy of the sclerotic membrane, or keratocele. If the 

 ulceration is large, the whole ground of the ulcer becomes embossed 

 — that is, it stands out from the surrounding membrane in a pecu- 

 liarly distended manner. As a consequence of rupture we may 

 have a series of ulcers of the membrane. The opening may close 

 up quickly, the fluid of the anterior chamber may collect, and the 



