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 Linear extraction of the lens. The animal and the eye having
been prepared anæsthetically antiseptically, and midriatically as for
discission, the lids are fixed with a speculum, the nictitans and the
bulb with forceps, a Gräfe cataract knife is introduced through the
inner side of the cornea, close to its margin and with its point parallel
to the front of the iris. The handle is then raised and the cornea
detached from the sclera by a series of gentle sawing motions until it
has reached a point parallel to the outer margin of the cornea. If the
pupil is insufficiently dilated, the iris should now be seized by forceps
drawn out through the corneal wound and snipped off by scissors
curved on the flat. Then the cystotome (hooked knife) is introduced
with its back turned downward and carried to the further side of the
capsule and close to the iris, its cutting point is turned backward and
inserted in the capsule, and drawn across from side to side to make
an orifice large enough for the escape of the lens. It is then given a
quarter revolution so as to turn the point of the knife downward and
is withdrawn from the wound back first. The lower part of the sclera
and cornea is now gently pressed with a lens spoon so as to dislodge
the lens from the capsule and deliver it through the corneal wound.
Counter pressure may be made on the sclera at the upper part of the
eye ball. The cornea is now gently stroked with cotton dipped in
sublimate solution to pass all blood from the anterior chamber, and
render the parts antiseptic. The iris is carefully replaced inside the
cornea and any obstinately protruding parts must be excised. The eye
is now covered with cotton steeped in a sublimate solution (1 ∶ 1000)
and bandaged without undue pressure, and the animal tied to two
sides of the stall so that it is impossible to rub the eye.
It is well to dress the eye on the second day, and if adhesion of the
wound is complete it may be left without bandage at the end of a
week or a fortnight.
Success depends mainly on the avoidance of infection. Therefore
every indication of local or general infection should forbid the
operation. Any existing infectious disease or any local eczema,
conjunctivitis or disease of the lachrymal apparatus should be cured
and the region thoroughly disinfected before proceeding. The head
should have a good soapy wash, followed by a sponging with
sublimate solution (1 ∶ 1000), the conjunctiva carefully washed out
with the same and a bandage damp with it applied over the eye. This
bandage is only removed on the operating table. Cloths dampened
with the solution are laid on the face around the eye, the eye is
cocainized with a 5 per cent. solution applied at intervals of one
minute and when quite insensible the operation is commenced. The
greatest care must be taken to render the hands of operator and
assistants and all instruments thoroughly aseptic. The instruments
are taken from a 4 per cent. solution of carbolic acid and placed in
water (which has just been boiled) until needed, and to wipe the eye
or make any application, sterilized cotton only is used and never
touched to the eye more than once. A sublimate bandage is placed
over the eye and worn for ten days or a fortnight. Then if the corneal
incision is healed and pale it may be left off. The pupil should be kept
dilated by a few drops of atropia daily for this length of time.
Any occurrence of iritis or choroiditis usually indicates infection
and must be treated on general principles, but with especial
reference to disinfection, and if this cannot be secured the eye will be
almost inevitably lost.
In case of renewed opacity through thickening of the capsule an
aperture must be torn in that membrane by the same method as in
discission. This is commonly known as needling. It must be
conducted under the same antiseptic precautions as in extraction.
Suction. This is only applicable to a lens which has become fluid as
well as opaque. It consists in withdrawing the liquid lens through a
hollow needle.
 DISLOCATION OF THE LENS.

Congenital; acquired; traumatic, softening of suspensory ligament: hinge

motion, lens drops behind iris, protrudes through pupil, cataract. Apparent
increased depth of anterior chamber, tremulous iris, projecting edge of lens like
black ring. Treatment: extraction.

Dislocation of the lens may be congenital, or acquired. In the latter

case it is explained by a traumatism or a liquefaction of the vitreous
and coincident softening of the suspensory ligament. In either case,
if the ligament is torn through in more than one-half its
circumference, the lens will hang by the remainder and move on it as
on a hinge so as to change its location in the different positions of the
head. This is especially so where the vitreous has become abnormally
fluid as there is then no resistance to the free backward movement of
the lens. The writer has seen the eye of a cow affected in this way, so
that the cataractous lens advances to the pupil and recedes from it as
the eye is moved. In other cases the dislocated lens, being attached
below only, drops down and virtually disappears behind the lower
part of the iris. In still other cases it becomes wedged into the pupil,
or protrudes into the anterior chamber and lies in front of the pupil
and iris. The semi-detached lens sooner or later becomes opaque. A
cataract with contraction of the newly formed tissue on the capsule
and undue tension on the suspensory ligament may, however,
precede the dislocation which is then precipitated by some shock, as
a blow, fall, sneeze, cough or emesis.
The condition leads to an apparent increase in the depth of the
anterior chamber, and tremulous movement of the iris, and if
illuminated the impacted condition of the lens or its changes of
position can be detected. If its edge is exposed it appears as a black
ring.
 Treatment is useless, unless it be extraction of the lens, or
iridectomy in suitable cases.
 PERSISTENT ARTERIA HYALOIDEA.

In the embryo this artery occupies the central canal of the vitreous
and extends from the optic papilla to the posterior pole of the lens.
At times it persists after birth and even to mature life and is then
detected as a gray or dark thread on ophthalmoscopic examination.
Berlin records a case in an old horse and others in young cats, and
Möller other cases in dogs. Treatment is manifestly hopeless.
 OPACITY OF THE VITREOUS.

From inflammation of the ciliary body, choroid or retina. Pupil copperas green
with white points, lines or patches, move in opposite direction from the eye,
liquefied vitreous, crystals of cholesterine, scintillance, opacity. Treatment.

Opacities visible with the ophthalmoscope usually come from

effusion of blood into the vitreous, or inflammation of the retina,
choroid, or ciliary body. Blood thrown into the vitreous will usually
leave some permanent turbidity. In choroiditis or retinitis the
ophthalmoscope may reveal the changes in these structures. A
turbidity appearing in the anterior portion of the vitreous, without
any apparent cause, is probably due to cyclitis which cannot be seen
with the ophthalmoscope, but may cause special tenderness around
the sclero-corneal zone. It is common in recurrent ophthalmia of the
horse and in irido-choroiditis in animals generally, and may be a
distinct feature of glaucoma. The general reflection of the pupil is
copperas green, but gray or white points, lines, bars or patches may
often be recognized. These being back of the lens and axis of the eye,
move in the opposite direction from the line of vision, thus if the eye
looks upward they descend, if it looks downward they ascend, if it
turns to the right, they turn to the left and vice versa. Tested by a
burning candle the three reflections remain clear and distinct unless
lens or cornea are affected.
Not infrequently the vitreous is found abnormally fluid, and
among its solid particles in affected horses have been found crystals
of cholesterin (Jacobi) and tyrosin (Möller). In the illuminated
vitreous such crystals may be seen to reflect the light like a shower of
sparks (synchysis scintillans). Opacity of the vitreous has been seen
in cases of amaurosis in horses (Hertwig) and glaucoma in lambs
(Prinz).
 Treatment is rarely satisfactory, though in some recent cases, and
in the absence of any other irremovable lesion, reabsorption of a
slight exudate may take place, in connection with the use of mild
saline laxatives and diuretics.
 RETINITIS.

With choroiditis and cyclitis, albuminuria, nephritis, mellituria, leukæmia,

petechial fever, contagious pneumonia. Photophobia, contracted pupil, redness
around optic disc, enlarged retinal vessels, white and gray spots and radiating
lines, exudates, clots, fatty degeneration. Treatment: correct primary disease.

Retinitis is usually an accompaniment of choroiditis and cyclitis,

but it also occurs as a complication in a number of constitutional
maladies, such as albuminuria, nephritis, mellituria, leukæmia,
petechial fever, contagious pneumonia, etc. Fröhner records a case in
a leukæmic horse, Peters in one suffering from petechial fever,
Schindelka in cases of contagious pneumonia in the horse, and
Eversbusch in recurrent ophthalmia of the horse, and under other
conditions in dogs.
The attack is accompanied at the outset with much photophobia
and contraction of the pupil. When this is dilated and the fundus of
the eye examined with the ophthalmoscope, the retina is seen to be
reddened for some distance around the optic disc and the blood-
vessels are materially enlarged. Later, white or gray spots and lines
are seen in and around the disc, tending to assume a radiating
direction, and the retina at large, on careful examination may have a
distinctly striped appearance. Brownish, reddish or light colored
exudates and hæmorrhages may be made out in certain cases
between retina and hyaloid, or between the retina and choroid. Fatty
degeneration of the fibrous tissue is common.
Treatment must be first that for the primary disease of which the
retinitis is a complication, and the result will depend on how
amenable that affection is to therapeutic measures. In advanced
albuminuria or mellituria, the retinitis, which is usually double, is
hopeless, while in contagious pneumonia, petechial fever, leukæmia
and other less fatal affections, retinitis in its initial stages may
recover. In cases of advanced disease with serious structural changes
in the retina, recovery cannot be looked for.
 DETACHMENT OF THE RETINA.

This may occur in any case of retinitis or choroiditis. It is

especially common in recurrent ophthalmia in horses. It may also
occur through the dragging by contracting inflammatory products in
organization. Spontaneous recoveries have taken place through
reabsorption, and attempts have been made by the injection of iodide
lotion to hasten this, or more safely by rest and diaphoresis.
Puncture and aspiration have also been tried with most varied
results. As a rule in the lower animals the treatment of the
inflammation, with rest, a pressure bandage, and pilocarpin will be
indicated.
 RETINAL HEMORRHAGE.

This occurs in inflammations of the retina or choroid, also in

degenerations of the vascular walls and as a result of traumas, or
poisons. Schindelka quotes a case in a dog from ptomaines,
Eversbusch, one from scurvy in the dog, Appenroth, one in a calf
from a blow with a cow’s horn, and others in cats and horses from
traumas. It is present to a slight extent in all inflammations of the
retina. With the ophthalmoscope the recent lesion appears as a
bluish red blotch on a bright red ground, and the older lesion of a
brownish red. Rest and a pressure bandage may be employed after
subsidence of the inflammation.
 TUMORS OF THE RETINA.

Eversbusch found subretinal cysts in a 24 year old horse, Merkel

and others have found similar bodies in old dogs and cattle.
Sarcomata and melanosarcoma are found on the surface of the
choroid in gray horses, implicating the retina. The only remedy is
enucleation of the bulb.
 INFLAMMATION OF THE OPTIC NERVE.
PAPILLITIS.

Choked disc. Neuro-retinitis. Papillo-retinitis. Nerve swelling blocks veins.

Causes: lead, tumors in brain bilateral, in orbit unilateral, influenza, petechial
fever. Symptoms: redness of optic disc, retinal arteries contracted, veins gorged,
papilla swollen (woolly), vitreous opacity. Treatment.

This is also known as choked disc from the obstruction of the

return of blood by the veins of the retina which pass out at the
cribriform lamina. The swelling of the nerve ending and papilla
compress the veins, causing stagnation and venous congestion in the
retina. When the retina is thus involved the term neuro-retinitis or
papillo-retinitis is often applied.
Causes. The condition has been traced to lead poisoning, brain or
orbital tumors, and various infectious diseases. Except in orbital
tumor the disease is usually bilateral. In horses Schindelka has seen
the condition in influenza and Peters in petechial fever, heart failure
and dyspnœa. In a necropsy on a horse the writer found complete
cataract, atrophy of the bulb to less than two-thirds the size of its
fellow, thickening and furrowing of the sclera, the presence of an
extensive old blood clot in the seat of the vitreous, cupping of the
disc, retro-ocular neuritis with exudate inside the sheath, and a
considerable reddish brown tumor of the choroid plexus on the same
side. The trouble was attributed to the blow of a rope on the eye a
considerable time before. The blood in the vitreous retained its dark
hue and showed no evidence of microbian invasion.
Symptoms. To the phenomena of retinitis there is added violent
injection of the capillary plexus of the papilla. The arteries of the
retina are contracted while the veins are dilated and tortuous. The
papilla is swollen and is said to have a woolly appearance. The
vitreous may be opaque by reason of exudation or blood
extravasation into its substance. Retro-ocular neuritis is usually
present, and brain tumor in certain cases. Möller calls attention to
the fact that with atrophy of the bulb the elliptical outline of the
papilla gradually lessens and it becomes more nearly round. In dogs,
too, the form of the papilla is also changed and the same author has
found it distinctly triangular. The pupil may be at first strongly
contracted and later freely dilated.
Treatment is usually of little avail and does not differ materially
from that adopted in retinitis. In tumor of the orbit pressing on the
optic nerve it may sometimes be reached through the temporal fossa,
but usually in all such cases enucleation of the eyeball is demanded.
 RETRO-BULBAR OPTIC NEURITIS.

Definition. Neurites descendens and ascendens. Extension to bulb, other eye, or

brain. Causes: traumas, meningitis, infectious diseases, toxins, lead, tobacco, etc.
Symptoms: partial blindness: congestion of papilla, exudates in adjacent retina.
Treatment: eliminate poisons, lead, toxins, correct precedent disease, saline
laxatives, diuretics, potassium iodide, cupping, local bleeding, counter-irritants.
Hygiene.

This is inflammation of the optic nerve commencing behind the

eyeball and only involving the papilla secondarily. Extension to the
papilla has been called neuritis descendens in contradistinction to
neuritis ascendens in which the inflammation extends along the
nerve toward the brain. There is always a tendency to extension, it
may be to the papilla and retina, it may be to the chiasma and
opposite eye, and it may be inward toward the ganglia and choroid
plexus.
Causes. Apart from traumatic causes, retro-bulbar neuritis in the
domestic animals has been mainly seen in connection with
constitutional or infectious diseases; in the horse with petechial fever
(Peters), contagious pneumonia (Schindelka), meningitis (Peters,
Straub) and parotitis (Möller). It has also followed meningitis in
cattle (Nebelen). In man it has been traced to lead, tobacco, alcohol
and other poisons.
Symptoms. At first the patient may seem partially blind without
apparent cause. Later ophthalmoscopic examination reveals
congestion and swelling of the papilla, and congestion (especially
venous and capillary) of the retinal vessels. The discolorations in
streaks and spots, from exudates and degenerations follow as noticed
under papillitis. It is difficult to distinguish between this and
papillitis during life.
 Treatment should be first directed toward the elimination of any
poisons, such as lead or tobacco, which may act as a causative factor.
Saline laxatives and in chronic cases potassium iodide would be
indicated. Every attention should be given to the maintenance of
good general health, and in acute attacks, local bleeding and counter-
irritation may be resorted to.
 ATROPHY. PARALYSIS OF THE OPTIC NERVE.
AMBLYOPIA. AMAUROSIS.

Definition. Horses, dogs, cattle, sheep. Amblyopia, Amaurosis. Causes: retinal

paresis from brilliant light, of cerebral ganglia, snow blindness, poisons, lead,
opium, atropine, lolium, tobacco, carbon bisulphide, cryptogams, mushrooms,
“loco” plants, carbon monoxide, illuminating gas, quinine, heat apoplexy, cerebral
concussion, brain parasites, exudates, pressure, degeneration, gastric or intestinal
disorder, hæmorrhage, anæmia, diarrhœa, diuresis, excessive milk secretion,
gestation, embolism. Symptoms: constant excessive dilatation of pupil, no
response to light, brilliant reflection from retina and choroid, blue or yellow, (glass
eyes); bilateral, cerebral, tract or chiasma; unilateral, bulbar or nervous; face
without expression, ears alert, head to one side, nose elevated, nostrils dilated, ox
and dog smell ground, slow pace, high stepping, does not dodge a feint to strike.
Lesions: inflammatory exudate and retinal atrophy, congested, “woolly” papilla,
retro-bulbar congestion or atrophy of nerve, thickening of neurilemma, tumors of
orbit or foramen optica, cœnurus, cysts, abscesses, cholesteatomata, psammomata,
hydrocephalus, meningitis, pineal hypertrophy, cranial fractures or tumors,
embolisms or aneurisms, hypertrophy of dura, apoplexy. Treatment: remove
causes, laxatives, diuretics, for lead, sulphuric acid and potassium iodide,
darkness, extract cœnurus, elevate depressed fractures, ice, cold snow, to head,
blisters, setons, electricity, strychnia, remove tumors.

Blindness without adequate, corresponding, visible changes in the

structure of the eye, has long been recognized in the lower animals,
having been observed in horses, dogs, cattle and sheep. When partial
it is known as amblyopia, and when complete as amaurosis or
blindness. The term amaurosis is, however, being gradually
eliminated from ophthalmological nomenclature in favor of that of
atrophy.
Causes. These may be factors which act directly on the retina, as
the intense light of the sun, of an electric, lime or magnesium light,
of the reflection from snow, ice, water, sand, or white dust. These
exhaust the power of vision by over-stimulating it, but whether the
blindness is due to fatigue of the retina or of the cerebral ganglia
which preside over sight, it is difficult to decide. This form is much
more likely to occur in horses which spend most of their time in
darkness, as in unlighted stables or mines, when they are suddenly
brought into the sunlight. Snow blindness, however, from prolonged
exposure, is common in animals as in man, and the case of the
staghound reported by Johan, is by no means an isolated one.
Much more common are factors which act primarily on the nerve
centres. Poisoning with lead, poppy, belladonna (sheep and goats,
Gerlach), lolium temulentum (Klüver), tobacco, carbon bisulphide,
cryptogams (musty fodder), mushrooms, astragalus mollissimus,
etc., abolishes vision more or less perfectly. Common illuminating
gas and carbon monoxide have shown this effect on dogs and
chickens. Quinia subcutem has induced the condition in dogs
(Becker and Eversbusch). More or less complete amaurosis is noticed
in connection with heat apoplexy in horses and fat cattle.
Cerebral concussion from blows on the head, knocking the head
against a post or wall, or from violent falls induce blindness which is
to be attributed rather to lesion of the brain. The same remark
applies to cases that appear during the progress of brain disease,
parasitic or otherwise, to those that occur in connection with
overloading of the stomach or intestines, and from gestation (Riss).
In cases appearing after severe depletion, like profuse
hæmorrhage, diarrhœa, or diuresis, or excessive secretion of milk
(bitch), the anæmia of both eye and brain may be taken into account.
When amaurosis develops during some inflammatory or infectious
disease, as in parturition fever in cows, the immediate cause may
sometimes be found in embolism of the retinal, or cerebral arteries.
Symptoms. The most striking feature of amaurosis is the constant
excessive dilatation of the pupil. This is the same in light and
darkness, and in fully developed cases the animal may be taken from
perfect darkness to the full glare of sunlight or electric light without
the slightest contraction of the pupil. The pupillary reflex to light is
entirely lost. In the slighter cases (amblyopia) there remains some
slight response of the iris to light but always far short of the normal.
The widely dilated pupil admits a flood of light, and in the absence of
cataract, lights up the chamber of the vitreous to an unusual degree.
The blue or yellowish reflection of the tapetum is very striking, and
led to the obsolete names of gutta serena and glass eyes. Sometimes
the disease is unilateral and at others bilateral. In case it is unilateral
there is a strong presumption that the causative lesion is in the
affected eye or in the optic nerve in front of the chiasma. In the
bilateral cases it is more likely to depend on disease of the brain or
some more distant organ.
Certain important indications are to be drawn from the expression
of the face, the position of the head and ears and the mode of
locomotion. In all blind animals the face is without expression. The
dilated pupils give no suggestion of mind looking through them, they
have on the contrary an uniform stony stare. There is no sense of fire
or life, but the face is like a dull sculptured mass. The immobile face
finds a sharp contrast in the alertness of the ears, which may be
carried one forward and another back, but fixed and yet ready to turn
to catch every sound. In the horse the head is usually carried a little
to one side for the same reason, and with the nose elevated (star-
gazer) and nostrils dilated. The ox inclines to carry the head low,
while the dog keeps his nose near the ground to guide himself by the
sense of smell. All blind animals are disposed to move slowly and
carefully, and the horse acquires a habit of high stepping to avoid
stumbling.
A common and important test where both eyes are equally affected
and cannot be contrasted with each other, is to strike the lower part
of the face with the hand and immediately threaten to repeat the
blow. If the animal can see, it will seek to jerk the head out of the way
as soon as the hand is raised for the second blow, while if blind there
will be no such movement provided the motion of the hand has not
been such as to induce a current of air on the face.
Lesions. Blindness, or the general symptoms of amblyopia or
amaurosis, may attend on the atrophy of the retinal fibres in
connection with inflammatory exudation or blood extravasation on,
in, or beneath, the retina. In other cases the lesion is in the papilla
which is inflamed and swollen with the woolly aspect characteristic
of choked disc. In others there is congestion of the optic nerve
behind the bulb, with exudation into its substance or beneath its
sheath, or the nerve has already undergone extensive atrophy with
thickening of its neurilemma. In other cases there is atrophy of the
arteria centralis retinæ, or tumors of the orbit or optic foramen
pressing upon the nerve. Cases of this kind are reported in the larger
animals by Leblanc and Tscheulin, and in dogs and ducks by Hilbert.
Much more frequently the determining lesions are situated in the
brain or its meninges. In sheep it is very common from the
development of cœnurus cerebralis over the optic lobes. Kühnert
found a cyst with delicate walls in the brain of a horse affected in this
way. Amaurosis is occasionally seen in connection with the cerebral
abscesses which form in complicated cases of strangles or in pyæmia,
also in cases of cholesteatoma of the choroid plexus. Other
conditions of its occurrence are hydrocephalus, meningitis,
hypertrophy of the pineal gland, fracture of the cranium, tumors of
the cranium or dura mater, embolism or aneurism of the cerebral
arteries, hypertrophy and induration of the dura mater (ox, Leblanc),
or sanguineous apoplexy. In a certain number of cases there may be
no lesion of brain or eye, or only a congestion of the former in
connection with lead poisoning, rye grass poisoning or other gastric
disorder, or of gestation.
Treatment. Success will depend on the sympathetic nature of the
condition or on the transient and removable character of its
causative factor. When the condition is but a symptom of overloaded
stomach or a transient poisoning by vegetable or mineral agents a
direct recovery may be expected to follow their disuse and
elimination from the system. This may be hastened by the exhibition
of laxatives and diuretics, and in the case of lead by sulphuric acid
followed by iodide of potassium. In cases of snow blindness it is only
necessary as a rule to place the animal in the shade until the over-
stimulation shall have subsided. In all these cases the attack has
come on abruptly and without any local symptom of ocular
hyperæmia and this with the preservation of the general senses can
always be looked on as a favorable indication.
In cases that come on slowly and which are accompanied by
symptoms of vascular disturbance or structural changes in the eye,
or brain, treatment is likely to be less successful. Nevertheless
cœnurus may be removed by surgical means, depressed fractures
may be elevated, and acute cerebral and meningeal congestions may
be met by appropriate measures. If the cerebral congestion is acute,
free bleeding from the jugular with a strong purgative and the