1996 DISEASES OF THE ORGANS OF SPECIAL SENSE 



by exposure to light, while the patient may complain of a shght 

 feeling of grit in the eye or of a burning sensation. 



On examination, a portion of the palpebral and of the ocular 

 conjunctiva is seen to be congested, while the secretion from the 

 Meibomian glands is noticed to be increased in amount and the 

 eyes to be watery. Treatment consists in bathing with warm 

 2 per cent, solution of boric acid, in giving the eye rest, and in 

 wearing neutral-tinted or yellowish-tinted glasses (Xanthophylline) , 

 which can be obtained in three strengths — light, medium, or strong. 



Conjunctivitis. 



This is extremely common in the tropics among natives and 

 Europeans, and may be clinically subdivided into — (i) Conjunc- 

 tivitis catarrhalis; (2) Conjunctivitis gonorrhoica; (3) Ophthalmia 

 neonatorum; (4) Conjunctivitis trachomatosa; (5) Epitheliosis 

 desquamativa; (6) Conjunctivitis phlyctenulosa; (7) Conjunctivitis 

 vernalis. Diphtheria is not common in the tropics, and diphtheritic 

 conjunctivitis is rare, while conjunctivitis nodosa is extremely rare, 

 but can be caused by caterpillar hairs, or plant hairs, becoming 

 embedded in the conjunctiva. 



Conjunctivitis Catarrhalis. 



This may be subdivided into the acute, the chronic, and the 

 follicular forms. 



The Acute Variety. — This is very common in the tropics, where 

 it may occur in epidemics. The most common cause is the Koch- 

 Weeks bacillus, which may induce a very severe form of inflam- 

 mation; while almost as frequently the Morax-Axenf eld bacillus 

 causes a milder though more prolonged attack, often called angular 

 conjunctivitis. Rarer causes are the pneumococcus and staphy- 

 lococcus. The small eye fly of Ceylon is suspected by Castellani and 

 Perry of being an agent in the spread of this disease in Colombo. 



The disease begins with photophobia, burning and itching in the 

 eyes, with a sensation of grit, all of which symptoms are more pro- 

 nounced in the morning than in the evening, when the eyelids are 

 often glued together by the dried conjunctival secretion. 



On examination, the palpebral and ocular conjunctivse are seen 

 to be red and congested, and sometimes to be marked by red spots 

 indicative of small haemorrhages, while the conjunctival secretion 

 is increased in amount and may have particles of mucus swimming 

 in it, or it may be largely composed of mucus, or in severe cases it 

 may be purulent. Usually both eyes are attacked. The disease 

 may disappear in eight to fourteen days if untreated, but more 

 usually it becomes chronic. The complications most commonly 

 observed are corneal ulcer and iritis. 



The best treatment in severe cases is to evert the eyelids, and to 

 lightly mop the inflamed conjunctiva with 2 per cent, solution of 

 silver nitrate, followed by a weak solution of ^alt, or by instilhng a 



