WORM IN THE EYE

New Zealand Mail, 29 January 1902, Page 58

WORM IN THE EYE

Worm in the eye or the horse is conmon m certain parts of India, and is not unknown on the Continent and America, but is rare in England. The parasite is a thin, white, thread-like worm about 'in to lin in length, and swims about with great activity in the tlmd of the anterior chamber of the eye. Dr. Cobbold describes two sorts, Fillaria papillosia and Spiroptera sachrymalis, but 'Neumann (."Parasitic Diseases'of the Domestic Animals”) considers Cobbold’s bpn-optera sachrymalis to be the immature Tillaria papillosia. and that in the horse there is only one variety. The ova are taken by the horse into tiie stomach, and migrate to other parts of the body besides the eye, such as the muscles and kidneys, and in these situations appear to cause but little harm. As a rule, one eye only is affected, and one parasite only found; but Neumann mentions a case in which seven were ! extracted tied together. Thread worms are found in the eyes of other animals especially the ox, but they are of a different species, and not so common as in the horse. In some few cases the worm dies, and is absorbed without causing any harm, but in tlie majority when ie” moved tho sight is lost or seriously interfered with. As a rule, the first symtom noticed is a cloudiness of the cornea, which is evenly distributed over its surface, whereas in ophthalmia it is generally more pronounced in one part than another. It can also bo distinguished from ophthalmia by the eyelids not being swollen, and there being no intolerance of light. Usually the worm can bo seen moving about if looked for before the cornea becomes too opaque but occasionally it goes into the space between the ms and lens, and is then not visible. In certain text books on veterinary surgery it is stated that the parasite can be extracted without throwing the horse, and that the cornea can bo punctured with an ordinary lancet wrapped round the blade with tow, when the worm will escape with the humour. Directions arc given as to the placing of a dark-coioured doth or blanket below founder v? wh l* h the P arasite can be found. I havo attempted the operation as tw ° or three tin ? eSj with most disastrous results, and the

same has been mv " tempting to operate wSK I ** w a n , dlDg af t u er .applying local anaesthetic. fpLo adopted and found successful 1 experience is to throw the h V the eye to bo operated on nIT and place him fully un(i “ Upp e*n>o»t A pillow or bog placed under the head, so that a is raised and the nose depresse? 6 ™ l skin round the eye is well hot water, and then il and ?[ ked self are well douched with 6ye l[ ' per cent, solution of boracie eyelids are fixed open with an e y2'3 lum and the eye steadied with of fixation forceps, which are an assistant. The cornea is onemA - 1 * either a Graefe or Beer's knife S?* used in human ophthalmic surged * I prefer the latter, as the blade l broad and tapering to a point Jr? the incision being made witW.t 5 dragging and displacement of H Sny edges, which must necessarilv Rt! ,' at if Graefe's knife be used scalpel or lancet, being' thick ft? blade, is, in my opinion, ouiU „ able. The operator should kneel?I*' 1 *' behind the poll, and taking the &? between the finger and thumb ouS right hand, with the fiat of the towards the eye downwards, steady ? .. rist on the side of the face ' TL, ■ cision should be made just at the W tion of the cornea with the scler? or wlute of the eye, where they gether like a watch glass an/ ? ~ be made with a stro.fg Sl "« pressure, without any dragging or ting The position of the efreumfere? of the cornea that- I prefer to make opening is that in which figure Yr would be on the face of a watch »] though others recommend the otta side of the medium line, viz *1,!!! figure I. would be. This, howevft unimportant, always provided thatTt i, high enough up, so that the escape? the humour may be the minimum I is important that the knife should ba held parallel to the iris, for if the point is raised the cornea will be wounded if depressed the iris. By this plan tie edges of the opening are oblique, end readily adapt themselves. The knife is then withdrawn, and is followed by tie escape of a certain amount of fluid, a pair of curved human iris forceps are inserted and the parasite grasped and removed. By this method I find that an incision three-eighths of an inch long is sufficient, whereas if it be trusted to the escape of the humour working tie parasite out with it, a much larger cuff is required, necessitating the escape i most, if not all, of the fluid, which is undesirable, as the whole cornea «!• lapses, and there is danger of hernia to the iris through the opening. It a needless to say that the instrnmeafi should be sterilised, and that if the parasite be not visible, the operation should be postponed.