WITH PHYSIOLOGICAL OBSERVATIONS. 
67 
fingers of an assistant, the ball of the eye by a pair of forceps, and the tendon of the 
muscle divided by a pair of curved scissors. The rectus internus of the right eye was, 
like the organ itself, atrophied. The conjunctiva of the left eye was thickened at the 
inner angle ; the muscle was uncommonly broad and thick ; its tendon had a very 
broad attachment to the ball, and behind it was a separate bundle of muscular fibres 
attached to the sclerotica. The pupils of both eyes assumed immediately after the 
operation their proper position in the orbits. No inflammation ensued ; not even in 
the left eye, which, from the prior operation, was still rather sensitive. The muscae 
volitantes became less irksome, and the violent spasms which previously had affected 
not only the eyelids, but also the whole left side of the face, disappeared entirely. 
The right eye, which had been amaurotic, gained by this operation the power of per- 
ceiving light, so that when the left eye is closed, the patient can now distinguish light 
and shade, on the hand being moved before this eye. The sight of the left eye like- 
wise was considerably improved in acuteness and clearness, both as regarded near 
and distant objects, but especially the latter. Objects now, however, appeared in a 
different situation to that which they really held ; when, for instance, he directed his 
eye to an object situated immediately before him, he saw it more to his right, and, if 
he attempted to grasp it, he moved his hand in this wrong direction*. For this 
reason in walking across a room he always took a direction to the right, and con- 
sequently often came unawares in contact with articles of furniture, &c. This ap- 
pearance of objects in false positions lasted for two months, after which time he was 
also capable of walking forwards in a straight direction. The right atrophied eye, 
which before the operation was deeply sunk in the orbit, is now more prominent, and 
appears therefore fuller and larger, so that the difference of the two eyes is less per- 
ceptible ; he has consequently gained considerably in personal appearance. On one 
occasion when I was honoured with a visit from Mr. Lawrence, Dr. Watson, Dr. 
Kerrison, and several other medical gentlemen at my residence, I introduced him to 
them for examination. 
In the middle of October I let him try several pair of spectacles at Mr. A. Ross’s, 
in Regent Street. With a double convex lens of 5^ inch focus, he saw both near and 
remote objects of large size most clearly and distinctly, but for small objects he could 
find no glasses that improved his sight. He recognized the capitals of a large print 
with his naked eye, and on looking through a pin-hole made in a card held close 
before the eye, he could distinguish even the small letters of a very minute print. 
He had not yet learned to read. The reason for the condition of his sight with re- 
spect to small objects, and that his vision is better on cloudy days, is no doubt to be 
sought in the enlarged pupil and the immobility of the iris. 
In the middle of November he was able without spectacles to read the names over 
the windows of the shops in the streets, and to tell the time to the minute by St. 
* This phenomenon I have observed in all eyes operated upon for strabismus of a great degree and long 
standing, when the other eye was closed. I have mentioned it in the Medical Gazette for June 1840, vol. 
xxvi. p. 540, where I have also given an explanation of the physiological cause. 
K 2 
