So strongly and confidently impressed are Messrs Welch and Marston of the connection between unhealthy surroundings and prevalent ophthalmia, that they regard the two as cause and effect, and state their belief “that the presence or absence of ‘sago grains’ affords a delicate test of the sanitary state of a school, a regiment, or any similar community.”
Ample and painful confirmation of these views is afforded by the prevalence of the disease amongst the children, more particularly those who live in very poor and crowded districts. The pitiable, blear-eyed little creatures that one meets with in these localities are very frequently the victims of purulent ophthalmia, and as such bear unfailing testimony to the insalubrity and squalor of the homes in which they dwell.
Stromeyer states that he has met with the ‘sago grains’ in the eyelids of many domestic animals, more particularly pigs, the granules being always in proportion to the more or less dirty condition in which the animals were kept.
The above statements plainly indicate the means by which the disease is to be combated. Of these, thorough ventilation and pure air are the most important. Stromeyer records how, by simply ventilating some barracks, he reduced to an amazing extent a number of cases of the disease, which had broken out in the Hanoverian army. Possibly this result was due to the removal, by the current of air from the apartment of the dried particles of contagious matter.
Ablution, which, carefully performed, is, in addition to ventilation, an important curative agent, may, through the neglect of certain precautions, assist to spread the disease.
This it will assuredly do if the basins employed by the patients for washing their eyes are not thoroughly cleansed and disinfected after being used. Furthermore, the towels may be made to spread the infection, unless they too are thrown into some disinfecting solution after use, and unless a separate towel is appropriated to each patient. The danger of reinoculation may ensue if each towel is not changed sufficiently often. The bed-clothes of the affected persons, as well as the pillowcases, should be frequently renewed, the latter every day, since they collect and disseminate the discharges falling on them from the patient.
Medical authorities also strongly recommend the isolation of the patient, and then consequent separation from healthy persons as soon as ever the disease shows itself in a regiment, a school, or amongst any body of persons congregated together; a daily inspection of the eyes of each is recommended, so that whenever the “sago grains” develop themselves, the individuals so attacked may be removed, and placed under proper treatment.
The after effects of the various forms of contagious ophthalmia are thickening and distortion of the eyelids, more or less serious defect of vision, and not unfrequently total blindness.
During the course of the disease relapses from the most trifling causes frequently occur, and Warmolow states that a person who has once been affected with it is not safe against a recurrence, and should be assiduously watched.
Ophthalmia, Infantile, Purulent. This disease very frequently attacks infants of 3 or 4 days old. It is distinguished by redness of the edges of the eyes, the lids of which are often glued together. Upon looking into the eye the lining membrane is seen to be swollen and red. Infantile purulent ophthalmia, although yielding much more readily to proper treatment than that which attacks adults, makes rapid progress if neglected, and may jeopardise the sight of the babe; hence the great importance of calling in efficient medical aid as soon as ever it makes its appearance.