Bacillary Dysentery.—Quite a number of cases have recently been reported where along with an arthritic complication there has been conjunctivitis. In 6 cases of dysenteric conjunctivitis, Maxwell noted that 4 cases had arthritis and 3 of the latter showed anterior uveitis. The conjunctivitis lasted about a week. Relapses seem liable to occur. In none of the cases has there been recovered from the conjunctival secretion the organism of dysentery.
Cholera.—As a result of the loss of all body fluids the lachrymal secretion is scanty or absent and we have various conjunctival and corneal troubles unless the eye is frequently irrigated with normal saline. Vitreous opacities and cataract may follow cholera.
Beriberi.—In this disease there have been reported the following eye complications: (1) retrobulbar neuritis; (2) paralyses of the muscles of the eye and (3) decreased sensibility of the cornea and conjunctiva.
Night Blindness and Xerophthalmia.—Both of these conditions are quite common in certain parts of the tropics and the view that the heat of the tropics and the tropical sunlight were potent factors had precedence until our study of vitamine requirements showed the etiology to rest in deficiency of fat soluble A. It is now known that cod-liver oil is particularly rich in this vitamine and that in this agent we have our best preventive and curative agent for these eye conditions. It is well known that rats fed on a diet deficient in fat soluble A develop xerophthalmia.
Night blindness (nyctalopia) is best known among the crews of sailing ships, especially when becalmed in tropical waters, and some influence of sunlight was considered the cause, but we now know that it is among such personnel that ship beriberi and scurvy are prone to occur by reason of deficiencies in water soluble B and the antiscorbutic vitamines. In such a dietary fat soluble A would also probably be lacking.
In those parts of the tropics where famine conditions are common both night blindness and xerophthalmia are frequent in young children, not necessarily associated but frequently combined.
In a mild case of xerophthalmia there is a dry area of triangular shape extending from either side of the cornea and covered with a fine, whitish foam. In bad cases the whole eye may be dry, wrinkled and opaque and eventually the cornea may slough away and bring about destruction of the eye. There is very little pain attending this frightful condition.
Elliot notes that from earliest times it was the custom in China to treat these conditions with extracts of liver. We now know that liver and kidneys are glandular organs rich in fat soluble A although not so rich in this vitamine as cod-liver oil.
Typhus fever.—There may be a rapid development of cataract of the soft variety, particularly in young patients. Ocular palsies, especially of the third and sixth nerves may occur during the febrile period. Corneal ulcers are not uncommon during convalescence and may be severe and very painful, often accompanied by conjunctivitis and iritis.