Excerpt from The Ophthalmic Record, Vol. 7: June, 1898
History - The patient says that he has had good eyesight until eighteen months before he applied for treatment, when ion left him in half an hour. It gradually returned, and now he sees better than at that time, but still cannot use his eyes for anything like accurate ion. The central ual acuity was 30 - 2 and Eff respectively; the Ophthalmoscopic record is: both nerves grayish, retinal vessels small, central scotomas for red and green. He was referred to the Nervous Clinic for further examination; but the examinations were nega tive so far as central nervous disease is concerned. There was no history of syphilis or rheumatism. The knee jerks were increased.
I first examined the patient on the 12th of February, 1898, ion at that time in the right eye being Io/cc and in the left eye 20/cc. Both nerves showed general gray-white atrophy; the veins were slightly tortuous and, compared with the arteries, large; the arteries were small, and there was well-marked, though not exaggerated, perivasitis. Both pupils reacted normally, and there was no paresis of the external oar muscles. The field of ion was as follows: Marked concentric contraction, especially upon the right side, very decided contraction of the red field and green blindness. In each eye there was a central scotoma extending from somewhat on the nasal side of the fixing point to about twenty degrees beyond it, in which area the appreciation of red and green was entirely lost. There was, however, no scotoma for blue, and no Spots of absolute loss within the relative area.
The patient had nothing in his history which gave any good excuse for this optic nerve atrophy and perivasitis, except exposure to lead. He smoked two cigars a day, was not a drinking man, had worked steadily at his trade, but not quite recently, had no history of painter's colic, nor had he ever suffered from wrist-drop.
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