Text-book of ophthalmology . ich latter, in 250 TEXT-BOOK OF OPHTHALMOLOGY consequence of becoming filled with the opaque mass of the cicatrix,becomes again more clouded, but at the same time constantly shallower,until finally it reaches the level of the adjacent normal cornea. Not infre-quently, however, the new formation of the cicatricial mass comes to astandstill before the loss of substance has been quite filled up, so that thesurface of the cicatrix remains permanently a little sunken. When suchcicatrices are small they are, on account of the thinness of the cicatricialtissue, almost or
Text-book of ophthalmology . ich latter, in 250 TEXT-BOOK OF OPHTHALMOLOGY consequence of becoming filled with the opaque mass of the cicatrix,becomes again more clouded, but at the same time constantly shallower,until finally it reaches the level of the adjacent normal cornea. Not infre-quently, however, the new formation of the cicatricial mass comes to astandstill before the loss of substance has been quite filled up, so that thesurface of the cicatrix remains permanently a little sunken. When suchcicatrices are small they are, on account of the thinness of the cicatricialtissue, almost or quite transparent, and disclose their presence by a flatten-ing of the cornea (corneal facet), only discernible upon examination of thecorneal reflex (Figs. 87 and 88). On the other hand, cicatrices not infre-quently occur which project above the level of the surrounding are the cases in which the cornea on the floor of the ulcer, havingbecome thinned, does not offer resistance to the intra-ocular pressure, and N. Fig. 89.—Keratectasia Produced bt an Ulcer. Magnified 25 X 1. The thinned and protruding cicatrix is distinguished by its denser texture from the adjacentnormal cornea. The epithelium, e, over it is thickened, while Bowmans membrane, b, is the other hand, Descemets membrane, d, with its epithelium, is everywhere present—a proof thatthe ulcer has not perforated. bulges forward. The bulging may disappear, owing to the contraction ofthe cicatricial tissue; but it may also remain permanently (ectatic cicatrix,keratectasia6 ex ulcere, Fig. 89). The formation of ectatic cicatrices is,however, of much more frequent occurrence after perforation of the cornea. The physician who is called to a patient with an ulcer of the cornea must, afterexamining the eye, have acquainted himself not only with the diagnosis but also the-prognosis; he must tell the patient beforehand to what extent his sight will suffer per-manent impairment, in order that such impai
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