American Journal of Ophthalmology (Volume 27) (Paperback)

This historic book may have numerous typos, missing text or index. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. 1910. Not illustrated. Excerpt: ... A CASE OF ORBITAL CYST. By Adolf Alt, M.D., And W. E. Sauer, M.D., ST. LOUIS, MO. On April 16th. 1908, A. W., 20 years old, was brought to me by Dr. H. J. C. Sieving, of this city, for consultation on account of a marked protrusion of the left eye. The patient gave the history that about 7 years previously he had noticed a swelling on the nasal side of the left orbit which, although at times it appeared smaller, gradually grew larger and to its present size. There had been a period in which he saw double, but this phenomenon had disappeared several years ago. Medicines which he took internally for the cure of the affection had produced no change. At times he had had considerable pain in the orbit and fever. When I saw him there was a very marked exophthalmus outward and downward, which could not be reduced by pressure. The elongated 'upper lid could only just barely protect the cornea when the eyes were closed. There was no pulsation and no vascular sound. On palpating the orbital contents, which on account of the exophthalmus was quite easy, I found a somewhat lobulated tumor reaching from behind the lacrimal sac region back into the orbit upwards and somewhat downwards behind the lower lid. This tumor seemed to be but loosely connected with the inner and upper orhital walls. Fluctuation seemed plainly preceptible. Yet the tumor could not be compressed. Holding the breath, bending the head downwards and coughing apparently did not change the size and position of the tumor. The ophthalmoscope showed a papilla which was slightly (Edematous, with blurred outlines; the retinal bloodvessels were thin. Vision=20/20?. The right eye was normal. Vision= 20/20. The probability was that we had to deal with a large cystic tumor, probably of nasal origin, although the patie...