Nervous and mental diseases . nd some such ocular experience. Its temporary character is the bestevidence of its tabetic, we may even say of its syphilitic, nature. Anyof the extrinsic muscles of the eye may be selected by the disease, butthose under the control of the third cranial nerve show more than theirdue proportion of paralytic disturbances. They may be gradually in-vaded, and a progressive external ophthalmoplegia results with perma-nent disability. Lacrimation, exophthalmos, enophthalmos, nystagmus,and reduced ocular tension on one or both sides has been noticed in rareinstances. The
Nervous and mental diseases . nd some such ocular experience. Its temporary character is the bestevidence of its tabetic, we may even say of its syphilitic, nature. Anyof the extrinsic muscles of the eye may be selected by the disease, butthose under the control of the third cranial nerve show more than theirdue proportion of paralytic disturbances. They may be gradually in-vaded, and a progressive external ophthalmoplegia results with perma-nent disability. Lacrimation, exophthalmos, enophthalmos, nystagmus,and reduced ocular tension on one or both sides has been noticed in rareinstances. The pupils are affected in the great majority of tabetic cases, andfurnish some of the earliest and most important diagnostic possible pupillary modification may be encountered in tabes,—inequality, irregularity, miosis, mydriasis, sluggishness, loss of light reflex,loss of accommodation reflex, loss of reflex to pain, and absolute is only one other disease that has a parallel in this matter of. Fig. 191.—Contracted irregular visual fields in tabetic optic atrophy. 1, Left eye; unbroken line bounds form field, broken line bounds field for red in which there is a blind scotoma ; small central field is for green ; 2, right eye; unbroken line bounds form field ; small inner field is for green. pupillary disturbance, and that is paretic dementia. The analogy, ifnot identity, of these diseases has been sufficiently indicated. Thesevarious pupillary disorders may be combined in any and every of the pupils to light and slight inequalities and irregular-ities of outline are usually encountered very early in the disease. Later,contracted pupils still responding to accommodative efforts but not tolight, constituting the Robertson pupillary sign, are noted, and still later 430 DISEASES OF THE CORD PROPER. loss of reflex to pain, and eventually complete iridoplegia, with or with-out paralysis of accommodation, is often found. Dilated pupil
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