1994 DISEASES OF THE ORGANS OF SPECIAL SENSE 



sent or more prolonged expert treatment. A model hospital of 

 this nature can be found in the Victoria Eye Memorial in Colombo, 

 Ceylon. The prevalence and importance of eye disease in the 

 tropics cannot be too strongly insisted upon. The cases of oph- 

 thalmia are so frequent that it has been stated that in no region of 

 the world is conjunctivitis so common, which may be due to the 

 high temperature which favours the growth of micro-organisms; 

 to the overcrowded and filthy native dwellings, which favour their 

 dissemination; to the dirty habits of the lower-class natives; and 

 to the presence of large numbers of flies at certain seasons, which 

 also materially assist in the spread of infection from the diseased 

 to the healthy. Moreover, these factors are reinforced by the 

 irritation caused by the glare of the sun, and by the dust. Blind- 

 ness is also very prevalent in the tropics. Denham, in his report 

 on the census in Ceylon in 1911, states that, in a population of 

 4,106,350 persons, there Were 3,957 blind persons, which figures, 

 when analyzed, showed that there were 11 blind men and 8 blind 

 women in every 10,000 men and women in Ceylon. In India, in 

 1901, there were 12 blind men and 12 blind women per 10,000 of each 

 sex; while in England, in 1901, there Were 8 blind men and 7 blind 

 women per 10,000 of each sex. 



Dr. Andreas Nell, in his statistics of the Victoria Eye Memorial Hospital in 

 Colombo, Ceylon, for the years 1906-1918, shows that the causes of blindness 

 in Ceylon may be classified as follows : — 



Congenital Causes. — These included malformations of the eyeball, and syphilis 

 acting upon the optic nerve, retina, and choroid . 



Local Eye Diseases. — Ophthalmia neonatorum, Purulent ophthalmia in 

 adults, Catarrhal ophthalmia, Granular ophthalmia, Ulceration of the cornea. 

 Severe paralysis of the ocular muscles, and Glaucoma. 



Traumatisms. — Injuries from sticks, thorns, and edges of leaves in the jungle, 

 from spikes in the paddy ear, from the tips of the blades of water-grasses. 

 Some of these injuries are at first trifling, but may become septic, and so cause 

 blindness. 



Constitutional Diseases. — These include syphilis, malignant tumours, leprosy, 

 tuberculosis, and enteric fever, but malarial cachexia was not met with as a 

 cause of blindness, nor was ankylostomiasis. 



Drugs. — Alcohol (most common) ; tobacco (rare) ; quinine and opium (very 

 rare) . 



There can be no doubt that blindness arises from neglect of the 

 trivial cases of eye disease, and from septic infection, and that, 

 as medical aid becomes more readily available and hygiene is im- , 

 proved, this serious affliction will diminish in the tropics. 



For the purposes of the few remarks which we propose to make 

 it will be convenient to divide the subject into: A. Eye Diseases 

 Proper; and B. Eye Comphcations of Tropical Diseases. r 



A. EYE DISEASES PROPER. 



(Edema of the Eyelids. 



Under this term Chalmers and Marshall mention the acute swell- 

 ing of the eyelids in Europeans and natives in Khartoum. The 



