Text-book of ophthalmology . pia, whether temporal, nasal, or homonymous, to be caused bysymmetrical lesions affecting both optic nerves or their expansions in both retinse (cf. page 610).—D.] 616 TEXT-BOOK OF OPHTHALMOLOGY mottled with white spots or extravasations of blood (h). The papilla isoften radially striate and its outlines become indistinguishable, the exuda-tion extending over them into the adjoining retina; hence, too, the papillaappears of greater diameter than normal. The retinal blood-vessels arealtered, the arteries (a a) being thinner, while the veins (v v) are distended,owing
Text-book of ophthalmology . pia, whether temporal, nasal, or homonymous, to be caused bysymmetrical lesions affecting both optic nerves or their expansions in both retinse (cf. page 610).—D.] 616 TEXT-BOOK OF OPHTHALMOLOGY mottled with white spots or extravasations of blood (h). The papilla isoften radially striate and its outlines become indistinguishable, the exuda-tion extending over them into the adjoining retina; hence, too, the papillaappears of greater diameter than normal. The retinal blood-vessels arealtered, the arteries (a a) being thinner, while the veins (v v) are distended,owing to compression of the vessels by the swollen optic nerve. The retinalveins are exceedingly tortuous, especially where they pass down upon theretina over the edge of the swollen papilla; and wherever their coils dipdeeper into the clouded tissues they look veiled or cut off altogether. Themost important symptom is the swelling of the papilla, shown by its pro-jecting above the surrounding retina (Figs. 276 and 277).v h v v. a Fig. 274.—Ophthalmoscopic Picture of Inflammatory papilla is grayish-white, clouded, and appears considerably larger than it really is becauseit cannot be demarcated, from the surrounding retina which is likewise clouded and gray. To a di-minishing extent the cloudiness and the radial striation extend out into the retina beyond. Theretinal arteries, a, a, are contracted, the retinal veins, v, v, are exceedingly dilated and tortuous, andboth are obscured in places. In the retina, adjoining the papilla, are found radially disposed, striate,red spots (haemorrhages), h. The subjective symptoms consist in disturbed sight. This in mostcases is very great; with severe neuritis complete blindness is usually pres-ent. Nevertheless, cases of marked swelling with normal sight do also occur(in choked disk). Characteristic of many cases of neuritis is a sudden andmomentary obscuration of sight, repeated many times a day. Contractionof the field of vi
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