ECZEMA SIMPLEX—AMETROPIA ITS CAUSE.* 
By S. O. RICHEY, M.D., Washington, D. C. 
SLIGHT degrees of ametropia are often followed by con- 
sequences seemingly incommensurate with the cause. 
The reflexes of ametropia are frequent, annoying, and often 
peculiar. Neither the experience nor the reading of the 
writer have before brought to his attention a case such as 
that herewith described, and he can find in medical literature 
no case of eczema attributed to the same source. 
Oct. 14, 1882.—C. K., a girl set. ten, of robust appearance, and 
enjoying good general health, but suffering with supra-orbital pain 
after any attempt at using her eyes, was examined by me. At 
a period, varying from two to ten hours after taxing the eyes, the 
upper and lower lids of the right eye especially, became oedema- 
tous. The swelling extended over the malar prominences to the 
alae nasi, and was accompanied by an erythema of the malar 
prominences, followed by a vesicular eruption, during which the 
parts affected were sensitive to the touch. The time necessary to 
read at twenty feet distance the ordinary Snellen’s test-type was 
sufficient for this effect. 
The eyes were normal, except for a hypermetropia and a re- 
sultant amblyopia, O. I). V = f# : O. S. V = fjj_. With mydria- 
sis ; O. D. V = : O. S. V = With both eyes V = -f§_. 
With -f 1.25, O. I). V = U+. With + 1, O. S. V = §#+. With 
the lenses and both eyes, V = §g_ 
Nov. 15th.—The lenses have been worn constantly. Eserinae 
sulph. and the galvanic current have been applied topically, with 
the result that the two sides of the face are alike in size, and ten 
* This case was referred to me by Dr. C. E. Hagner, with the impression 
that the eczema depended on probable ametropia.—S. O. R. 
Reprinted from the Archives of Ophthalmology, Vol. xiii, No. i, 1884. 35 
Ecze7na Simplex—Ametropia Its Cause. 
minutes’ reading causes nothing more than a blush upon the right 
cheek, which lasts only a few hours. This effect of the use of the 
eyes is gradually diminishing, and the patient does not complain 
of any pain whatever. 
Nov. 15, 1883.—There has been no return of the eczema, al- 
though the child is using her eyes—with the glasses—beyond the 
usual school hours, probably seven or eight hours daily. 
We find infrequently this condition of swelling, extend- 
ing, from the eyelids down upon the cheeks when there is 
ametropia, and particularly in cases of mixed astigmatism; 
but extravasation of blood is rare, and it has not before been 
my fortune to observe the eruption which in this case has 
followed any attempt at use of the eyes. The eczema is an 
expression of disturbed vaso-motor action, by reflex influ- 
ence through the cavernous plexus of the sympathetic, 
which gives off filaments to the third cranial nerve 
just before it divides posterior to the sphenoidal fissure. 
As the third nerve supplies motor power to the ciliary 
muscle, the connection is very direct.