On examination the eye appears extremely sensitive; in fact, it can scarcely be touched unless cocaine solution is previously applied.
The parasites, two or three as a rule, but in exceptional cases from five to seven in number, are seen rolled up within the anterior chamber of the eye. A week after the beginning of the attack, however, they begin to move about, and are then found close behind the cornea, upon the lens, or suspended in the aqueous humour.
The irritation produced sets up inflammation of Descemet’s membrane and the cornea, together with iritis, and, secondly, keratitis and changes in the lens.
Unless treatment is adopted verminous ophthalmia inevitably ends in cataract.
Diagnosis. Diagnosis is always uncertain on account of the difficulty of examination. When the cornea is very opaque examination necessarily gives a negative result.
The prognosis is grave.
Treatment. Eye lotions containing tincture of aloes, creolin, corrosive sublimate, etc., have been suggested, but are practically useless, because they can have no action on a parasite enclosed within the globe of the eye. The most logical treatment consists in aseptic puncture of the anterior chamber of the eye towards its lower border with a cataract needle.
The escaping liquid carries with it the parasites, and recovery is then only a matter of time, provided the wound does not become inflamed. The great danger consists in inflammation and suppuration of the eye. This, however, can be avoided by antisepsis and by applying a surgical wool dressing, which can be left in place for a few days.