A CASE or BILATERAL SYPHILITIC 
ULCERATION OE THE PALPEBRAL 
CONJUNCTIVA. 
By Clarence A. Veasey, A. M., M. D., 
BY 
Adjunct Professor of Diseases of the Eye. Philadelphia Polyclinic; Demonstrator of Ophthalmology 
in the Jefferson Medical College. 
International Medical Magazine, 
REPRINT 
April 15, 1898. A Case of Bilateral Syphilitic Ulceration of the Palpebral Conjunctiva- A CASE OF BILATERAL SYPHILITIC ULCERATION OF THE 
PALPEBRAL CONJUNCTIVA.* 
Adjunct I’rofessor of Diseases of the Eye. Philadelphia Polyclinic; Demonstrator of Ophthalmology 
Clarence A. Veasey, A. M., M. D., 
in the Jehersoa Medical College. 
O. L., aged twenty-eight years, a male, presented himself at the 
ophthalmic dispensary of the Jefferson Medical College Hospital (ser- 
vice of Dr. de Schweinitz) in the latter part of April, 1897, for the treat- 
ment of the following ocular condition : Each upper lip was markedly 
swollen and intensely red near the ciliary margin, the tarsi were thicker, 
harder and less pliable than normal, and the eyeballs were bathed in a 
thin muco-purulent discharge. After the latter had been washed away 
the cornese were found to be normal, and the conjunctivae of the lower 
lids and of the eye-balls somewhat injected. Upon everting the lids there 
were found symmetrically situated on the external halves of the palpebral 
conjunctivae two extensive, irregularly outlined phagedenic ulcers. These 
extended from near the centre of the everted portions of the palpebral 
conjunctivae in the direction of the external angles for about twelve to 
sixteen millimeters, measuring from edge to edge, the one on the right 
side being slightly the longer; the width varied, the widest portion of the 
right being seven millimeters, of the left, ten millimeters, again meas- 
uring between the edges. The edges, however, were everywhere exten- 
sively undermined, in some places the depth of the sulcus so formed being 
half a centimeter, and nowhere being less than two and a half millimeters. 
In depth, the ulcers extended to the tarsi, but the latter were not involved 
in the process at any point. The surfaces were covered with a grayish- 
yellow slough, and so strong was the resemblance to phagedenic chan- 
croid that had the ulcers been seen upon the generative organs, I believe 
one would scarcely have hesitated to have pronounced them as such. 
The patient confessed to having acquired the initital lesion of syphilis 
seven months before our examination was made, and at the time of the 
examination there was a papular eruption of the body and limbs, and nu- 
merous mucous patches in the mouth. He was referred to the genito- 
urinary department, where he was placed upon rapidly increasing doses 
of protiodide of mercury. The local treatment of the ulcers consisted in 
frequent cleansings with a solution of formaldehyde and an occasional 
stimulation with a solution of nitrate of silver. At the expiration of two 
months the ulcers had entirely healed, leaving only slight scars and no 
distortion of the lids. The skin-eruption and the mucous patches had also 
disappeared. 
* Read in the Section on (Jpninalmology of the College of Physicians of Philadel- 
phia, January 18, 1898. INTERNATIONAL 
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