Note.—The special tropical diseases of the skin are discussed under their respective headings.
The Eye
Glaucoma.—According to Elliott glaucoma is very much more common in the East than in Europe. He states that simple chronic glaucoma is extraordinarily common in India. Often the only symptoms are retraction of the field, cupping of the disc and at a later stage impairment of the central visual acuity. He notes that the advancement of the disease is often as unobtrusive as it is relentless. These patients often only present themselves at the clinic in the late stages of the disease; thus at the Madras hospital the vision was only that of hand perception, or less, in 40% of cases.
Cataract.—The general impression is that cataract is more frequent in the tropical regions than in Europe and as bearing out this view Elliott notes that cataract among those Europeans who have served in India seems more frequent than among those who have remained in England. Cataract is also more common in the southern part of China than in the northern portion.
Lachrymal Obstruction.—Elliott notes the extreme frequency of this condition in India, and states that in the Madras Ophthalmic Hospital 125 operations for excision of one or both lachrymal sacs were performed in 1907.
Trachoma.—There are certain tropical countries where trachoma is a disease of the greatest importance. Thus in China its prevalence is great, as is also true of India, Egypt and Japan.
Outside of imported cases it is very prevalent in many parts of the United States.
In this disease there is hypertrophy of the conjunctiva, granule formation and subsequent cicatricial changes. Pannus and corneal ulcerations are frequent complications.
The disease is contagious through transfer of the secretion by hands or flies. It is usually considered as caused by the so-called trachoma bodies or cell inclusions, which are best brought out by Giemsa staining. The trachoma granules are yellowish, translucent bodies set in the reddened conjunctiva.