PREVENTION, SYMPTOMS AND TREATMENT I49 



tracted pupils are commonly present in keratitis. Abscess in the 

 substance of the cornea, ulceration, and escape of pus in the anterior 

 chamber (hypopyon) may follow, or, with necrosis of the cornea, 

 extensive ulceration or wounds, the cornea gives way and a pro- 

 trusion occurs from the surface of the eyeball. This is of an ir- 

 regular, bluish-white color, often containing tortuous veins, and is 

 composed of the remains of the cornea, new-made connective 

 tissue and iris, and is known as anterior staphyloma. It may be 

 partial, protruding from the margin; or total, involving the whole 

 cornea. Examination of the eye by throwing a beam of light upon 

 it through a lens in a darkened place (oblique illumination) will 

 aid in determining haziness of the cornea, loss of substance (ulcer), 

 abscess, etc. 



Treatment. — In acute keratitis treatment should be begun with 

 a smart purge (H., calomel, 3i; aloes, 3vi; D., 2 to 3 compound 

 cathartic pills), and quinine in liberal doses (H. & C, 3ss; D., gr. 

 iii) thrice daily. 



Attention to hygiene is of much importance where debility is 

 the predisposing factor. The irritation may be relieved by bandag- 

 ing a gauze compress over the eye, soaked in a solution containing 

 extract of opium, gr. 20, and boric acid, 3iss, in water to make viii. 

 The patient should be kept in darkness if photophobia is marked. 



The most important drug is atropine (gr. i-iv to §i) which 

 may be added to a 2 per cent boric acid solution and dropped in the 

 eye four times daily. The stronger solution should be used with 

 much photophobia and lachrimation. Not over one minim at an 

 instillation in the case of the small animals. One or two grains of 

 holocaine hydrochlorate may be added to the atropine solution to 

 advantage in allaying irritation, or may be used without the atropine 

 in boric acid solution, if atropine does not agree. At night oint- 

 ment of yellow oxide of mercury (gr. viii to gi) should be rubbed 

 on the inner surface of the eyelids. In case of spreading ulcer of 

 the cornea, the above treatment should be followed, and the care- 



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