. A treatise on the diseases of the eye. n place, when it at once begins to heal. Another and very dangerous form is the crescentic ulcer, which com-mences near the edge of the cornea, and looks as if a little portion had beenchipped out with the finger-nail. It shows a great tendency to extend moreand more round the edge of the cornea like a trench (in which the corneais much thinned), until it may even encircle the whole cornea. The vitalityof the central portion is generally greatly impaired, and it becomes moreand more opaque, and shrivels up until it may look like a yellow, dry, friable,o
. A treatise on the diseases of the eye. n place, when it at once begins to heal. Another and very dangerous form is the crescentic ulcer, which com-mences near the edge of the cornea, and looks as if a little portion had beenchipped out with the finger-nail. It shows a great tendency to extend moreand more round the edge of the cornea like a trench (in which the corneais much thinned), until it may even encircle the whole cornea. The vitalityof the central portion is generally greatly impaired, and it becomes moreand more opaque, and shrivels up until it may look like a yellow, dry, friable,or cheesy substance, portions of the surface of which may be thrown off, orit may give way and a very extensive rupture of the cornea take crescentic ulcer is extremely dangerous and intractable, resisting oftenmost obstinately every form of treatment. In some cases great advantagehas been derived from syndectomy, either partial, if the ulcer was but ofslight extent; or complete, if a considerable portion of the cornea had be-. 228 DISEASES OF THE CORNEA AND SCLERA. come involved. In other cases I have, however, seen it do but very littlegood. Iridectomy has also been sometimes found of benefit, and should bepreferred to paracentesis. The patient should be placed upon a very nutri-tious and generous diet, and tonics, together perhaps with mixed acids, shouldbe administered. AVhilst these different forms of corneal ulcer are always accompanied bymore or less irritation and inflammation, there are some forms in which theinflammatory symptoms are almost entirely absent; they, indeed, in theircharacter and course may closely resemble the non-inflammatory suppura-tive keratitis. We notice that the ulcer is white in color, and clearly de-fined against the transparent cornea, and not surrounded by a gray, swollenzone of demarcation. It is accompanied by very little, if indeed any, pho-tophobia, lachrymation, redness, or pain; there is also more tendency tonecrosis, and exten
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