CONSULTATION CHART 
OF THE 
Eye-Symptoms and Eye-Complications of teal Diseases 
ARRANGED AFTER FOERSTER AND OTHERS, BY 
HEISTE,IT GT. CORNWELL, M. D„ COLUMBUS, OHIO, 
Clinical Lecturer on Ophthalmology and Otology, Starling Medical College, Columbus, Ohio 
I. 
EXCESSIVE VENERY.— Photopsia, conj., infl., 
blepharospasm. 
contract when object is carried to eye). Atrophy 
opt. nerve (may be first symptom.—Charcot). 
Marked insensibility to red and green, nystag- 
mus when object is observed closely. 
VARIOLA HEMORRHAGICA. Sub-conj. hem. 
RESPIRATION AND CIRCULATION. 
TYPHOID FEVER.—Corneal ulcers,2 paralysis of 
accommodative ap. and oc. muscles,2 dil. of pu- 
pil, atrophy opt. n.2 
CORYZA.—Acute conjunctivitis. 
Robertson’s pupils are sometimes observed in other 
diseases of cord. 
CHRONIC PULMONARY CATARRH.—Chronic 
conjunctivitis. 
V 
TETANUS.—Strab. (precursor of death.—Wunder- 
lich.) 
KELAPSING FEVER.—InH. of choroid, cil. body 
and iris, opacities of vitreous, alternating pupils 
in convalescence.—! Peltzer.) 
NASAL CATARRH—Blennorrhoea, lach. sac. 
CEREBRAL CONGESTION.—Muscse volitantes, 
conjestion of fundus oculi.1 Opt. neuritis.1 
NERVOUS SYSTEM. 
DIPHTHERIA.—Paresis of accommodation (also in 
slight diph. angina) of oc. muscles, conjunctivitis, 
metastatic tenonitis. {Am. Journ. Med Sci., Apr.. 
’BO.)3 
WHOOPING COUGH.—Sub-conj. hemorrhage, ex- 
ophthalmos, luxation of lens, retinal hem. (IMed- 
ical and Surgical Rep., Sept. 18,’80.)3 
EMBOLISM CEREBRAL ARTERIES. Pupils 
dil., or contr., or alternating. 
APOPLEXY.—Pupil dil. (hem. into Pons contract- 
ed.—Nothinagle.). Atrophy optic nerve. 
PARALYIS OF CERV. SYMPATHETIC.—SIight 
ptosis and contr. of pupil, eye ball slightly 
soft.3 
MALARlA.—Longitudinal infiltrations of cornea 
followed by ulceration. {Trans Med. Soc., N, J., 
’Bl.)3 Ischemia of retina.2 Iritis.2 
EMPHYSEMA. Intra-ocular hem. (Retina or 
vitreous, etc.)2 
Retinal apoplexy precedes cerebral apoplexy fre- 
quently. 
SUFFOCATION.—Sub-conj. hem., retinal hem.2 
CEREBRAL MILIARY ANEURISMS.—MiI. an. 
in retina. (Have only been recognized post 
mortem). 
IRRITATION OF CERVICAL SYMPATHETIC 
FROM ABSCESSES, TUMORS, ETC.—Pupils 
dil. 
CHOLERA.—Cyanosis of lids. Paresis of orbicu- 
laris. Diminished secretion of tears. Sub conj. 
and choroidal hem. Retinal art. very small, 
veins dark. During cold stage pupils smaller. 
TUBERCULOSIS.—Tubercle in choroid, iris, and 
ocular conj.2 
PARALYSIS OF THIRD NERVE.—AII ocular 
muscles, except sup. oblique and ext. rectus, 
ptosis, loss of accommodation and pupil dil. 
PULMONARY TUBERCULOSIS, PNEUMONIA, 
PLEURO PNEUMONIA. —Pupils dil. (from 
irritation, sympathetic.) 
PACHYMINGITIS. Pupils contr. later dil. and 
fixed. 
TRICHINOSIS.—Par. oc. muscles, from migration 
of parasites 2 Dil. and fixed pupils.—(Kittee.)3 
In impeded respiration, dilated pupils indicate effect 
of carbonic acid on medula. 
MENINGITIS AND CEREBRO SPINAL MEN.— 
Pupil contr. in first stage, dil. in second, opt. 
neuritis, neuro-retinitis, ptosis, paralysis ocular 
muscles; later, opt. nerve atrophy, or choroiditis, 
irido choroiditis, panophthalmitis (chiefly in 
children).1 
FOURTH.—Movements of globe restricted downward 
and inward. 
PUERPERAL DISEASES.1 
ABSCESSES.2 
ERYSIPELAS (phlegmonous).2 
DISSECTING WOUNDS.2 
Septic embolism 
of eye. 
SlXTH.—Movements restricted outward. 
VENOUS OBSTRUCTION IN HEART OR 
LUNGS.—Intra-ocular hem.2 
FAClAL.—Paralysis of orbicularis. 
THROMBOSIS, CAVERNOUS SlNUS.—Exoph- 
thalmos and panophthalmitis. 
ATHEROMA.—RetinaI hem. 
PURULENT MEN.—Ocular chemosis, exophthal- 
mos. 
PARALYSIS OF FIFTH.—Neuro paralytic ophth. 
(haziness, ulcers, and sloughing of cornea). 
The fatty crescents in cornea, above and below (arcus 
senilis), indicate fatty degeneration of arterial 
system only in exceptional instances—chiefly in 
children. 
The isolated paralysis of 3d, 4th, sth, 6th, motor br. 
of 7th—rare in brain disease; in some cases 
precedes it.2 Paralysis of single nerve with opt. 
neuritis, indicates brain disease. Auditory 
branch of 7th frequently becomes affected in 
brain tumors. Of the 6th and 7th together, al- 
ways brain disease. Strab., ptosis and wide dil. 
of pupils point to ventricular and basilar affec- 
tions.2 Contr. of pupil commencing meningitis, 
encephalitis and dement, paralytica. 
SYPHILIS.—Affects all parts of eye, except perhaps, 
lach. gland. 
(«) Eye lids, chancer,2 ulcers.3 
(b) Conjunctiva, gummata,2 mucous patches.2 
(c) Cornea, interstitial infl. in the young. 
(d) Iris, 3or 4 percent, of all cases have iritis, (Four- 
nier) gum., mydriasis. 
(e) Sclera, gum. {Arch. Ophth., Dec., ’B2).3 
(/) Cil. body, gum.,1 paralysis of accommodative ap. 
(g) Choroid, gum.,1 infl. of. 
(h) Retina, gum.,1 infl. of. 
(i) Opt. nerve, infl. of., gum.,1 atrophy1 from cere- 
bral affection, “ choked disk1,1 from gum. of 
the brain.1 
(j) Oc. muscles, paralysis. The most frequent and 
often first sympt. of cerebral syph. (cer. syph. 
may appear 20 years after innoculation, is 
usually very late). Relative frequency: First 
the 3d, then optic, facial and Gth. Paralysis 
often incomplete, preceded by transient double 
vision. Seventy-five per cent, of cases of par. 
of mot. nerves of eye due to syph. 3d, oftenest, 
dangerous sympt. indicates intra-cranial disease 
at base of brain, which may involve cerebral 
cento s. 
BASILAR TUBERCULAR MEN.—lrregular move- 
ments of globes, excessive winking, nystagmus ; 
inequality of pupils, ptosis, strabismus, unilat- 
eral dil. of pupil, opt. neuritis. Later, dil. both 
pupils, double ptosis. 
INCREASED ARTERIAL PRESSURE.—RetinaI 
hem. 
H Y PERTROPHY) OF LEFT VENTRICLE.— 
Retinal hem. 
PERNICIOUS ANAEMIA.—Retinal hem. 
CHRONIC BASILAR MEN.—Paralysis of third, 
fourth and sixth, opt. neuritis and atrophy. 
INSUFFICIENCY OF AORTIC VALVES.—Pul- 
sation retinal arteries. 
HYDROCEPHALOUS. —Pupil dil. opt. neuritis; 
later, atrophy. 
LESION OF TUBERCULA QUADRIGEMINI.— 
Sudden and complete blindness, pupils dil. and 
fixed, with other symptoms of brain disease, 
negative ophthalmoscopic results.2 Lesion on 
one side produces blindness of other eye 
(Feourens). When right tuberculum is ir- 
ritated, both eyes deviate to left, and vice versa 
{“ conjugate deviation.”) 
ANEURISMS OF CAROTID, INNOMINATA 
AND AORTA.— Myosis from pressure on 
sympathetic.1 
SEROUS EFFUSION INTO BRAIN.—Pupil dil. 
ANAEMIA OF BRAIN.--Pupils contr. 
VALVULAR DISEASES OF HEART, ENDO- 
CARDITIS AND CAROTID ANEURISMS.— 
Embolism of central artery of retina,2 or retinal 
branch.3 
CONCUSSION OF BRAlN.—First stage, pupils 
contr. second, dil. 
GENERAL CEREBRITIS.—Opt. neuritis. 
CEREBRAL PEDUNCLES.—ParaIysis of 3d of 
same side, with par. of facial or of upper and 
lower extremities of opposite, conj. deviation of 
globes. 
EXHAUSTIVE HEMORRHAGES.—Atrophy 
opt. n. 
Monocular dil. of pupil, responding to light, 
indicates threatened brain disease. 
HEMORRHAGIC DIATHESIS. Sub-conj. and 
intra oc. hemorrhage.1 
BRAIN TUMORS (17.) 
“ A BSC ESSE'' (3 ) 
“ SOFTENING (2.) 
“ HEMORRHAGE (1.) 
Intra-oc. extrem- 
ity opt. nerve 
engorged and 
swollen, “chok- 
ed disk.” 
Conjugate deviation of eye often accompanied by 
rotation of head on its axis, is observed from 
lesion of different parts of cerebrum,1 often in 
vicinity of corpus striatum or cerebral peduncles. 
(Figures indicate relative frequency in twenty- 
three cases.—ilui 1-nos Jackson.) 
MIGRAINE.—Scotoma. During attack, globe re- 
tracted, pupils dil. Toward end, pupils contr. 
Sometimes these symptoms are reversed. 
11. 
BRAIN TUMORS. —At first vision only slightly 
affected, later clonic spasm of oc. muscles, strab. 
and ptosis, pupils dil., vision lost. 
DIGESTIVE ORGANS. 
HEADACHE.—Due often to want of spectacles. In 
weak, nervous persons, pupils frequently dil. 
IX. 
VOMITING.— Sub-conj. hem. 
DISEASE OF CEREBELLUM.—Nystagmus. 
FRACTURE BASE OF SKULL.—Opt. neuritis, 
atrophy. 
HEMORRHAGE FROM STOMACH OR 
BOWELS.—Atrophy optic nerves.1 
EPILEPSY.—Sub-conj., In in., dil. pupil at com- 
mencement of fit, temporary strab., atrophy 
opt. n., color nurse (red may be blue, etc.—H. 
Jackson), rotation of globes. 
HERPES ZOSTER OPHTHALMICUS.—uIcers 
of cornea. 
POISONS. 
ICTERUS.—Yellow staining of oc. conj. 
TIC DOLOROUX.—Orbicular spasm, contr. pupil, 
photophobia lachrymation, congestion or conj. 
OPIUM NARCOSIS—PupiIs contr., near death dil. 
SPLENIC LEUKEMlA.—Leukemic retinitis.1 
HYSTERIA.—Lid tremor, uj watd rolßng'of globes. 
Amblyopia2 and temporary strab. {Centl. f. 
Augenh., May, ’BO.)3 
OPIUM SMOKING.—PupiIs contr., puffy lids. 
ALCOHOL NARCOSIS.—Pup. contr. 
TEETH.—Very doubtful. (Foeksteb.) Paresis of 
motor nerves of eye.3 
BASEDOW’S DISEASE —Exophthalmos, pupils 
dil., pulsation of retinal art.; upper lids follow 
globe only slightly, or not at all ; temporary 
paralysis of ocular muscles j1 mydriasis,1 necrosis 
of cornea and panophthalmitis. {Am. Journal 
Med. Sci., Oct. ’80).3 
ALCOHOLISM.—AmbIyopia potatorum, opt. neuri- 
tis and atrophy. 
HYPERTROPHY, CIRRHOSIS AND CHRONIC 
DISEASE OF LIVER.—Night blindness.2 
CHOREA.—Spasms of orbicularis or levator palpb , 
pupils dil., at times sluggish to light. 
TOBACCO NARCOSIS.—PupiIs contr. 
CHOLERA INFANTUM.—Eyes closed, pupils dil. 
CATALEPSY.—Pupils dil. and fixed, anaemia of fun- 
dus oculi. 
TOB A CCO S MOK I NG.—Amau rosis.2 
INTESTINAL WORMS.—Amblyopia.3 
CONVULSIONS OF CHILDHOOD.—(From teeth, 
worms, etc.)—Pnpils c< nir. strab., upward roll- 
ing of globes, later dil. of pupils, temporary 
ptosis. 
ANAESTHETICS.—PupiIs contr. 
LEAD POlSONlNG.—Paralysis of accommodative 
apparatus,1 oc. muscles,1 opt. neuritis,1 late* 
atrophy,1 pupils dil.1 
CONSTIPATION OF BOWELS.—Retinal hem. 
(CL /. A., iv, 304.)3 
VI. 
PUERPERAL CONVULSIONS. - Sudden strab., 
contr. pupils, ptosis, later dil. pupils. 
SKIN. 
BELLADONNA, HYOSCYAMUS STRAMe, 
lUM.—Par. of accommodative ap., pupil dil. 
111. 
IDIOCY.—Strab. atrophy opt. n., nystagmus. 
ECZEMA, PSORIASIS AND IMPETlGO.—Con- 
junti vitis,even when vicinity of eye is not affected. 
URINARY ORGANS. 
CEREBRAL SCLEROSIS. Nystagmus, ptosis, 
paralysis oc. muscles, mydriasis, atrophy opt. n. 
ERYSIPELAS.—OrbitaI cellulitis, and atrophy of 
opt. n, through pressure ;2 abscess of lids, gan- 
grene;2 lagophthalmos, ectropion;1 septic embo- 
lism of globe. {Am. Journ Med. Sci. Oct., ’BO.)3 
QUININE. (Large doses), hyperajmia of conj 
and fundus oculi (large repeated doses), visua. 
and color perception diminished, pupils fixed, 
anajsthesia of cornea, opt. n. pale, retinal art. 
contr.3 
BRIGHTS’ DISEASE.—Retinitis albumnurica, ure- 
mic amaurosis, cataract.2 
UREMIA OF PREGNANCY AND SCARLET 
FEVER.—Ret. alb. uremic am,1 
GENERAL CEREBRAL PA R A LYSlS.—Pupils 
unequal, opt. neuritis, later atrophy opt. n. (41 
out of 53 cases.—Albutt.) 
SALICYLIC ACID.—do.3 
If, in acute mania, contr. of pupils occurs, general cere- 
bral paralysis is to be looked for. Other forms 
of insanity have sluggish pupils, opt. neuritis 
and atrophy, 60 per cent, have unequal pupils. 
If pupils react to light in blind persons, disease 
is beyond tubercula quadragemini. 
VII. 
SALICYLATE OF SODA.—Amblyopia.3 
LITHMSMIA.—Opt. neuritis, double vision. 
DIABETES-—Cataract, iritis, retinitis.1 
RHEUMATISM, SCROFULA AND 
SCURVY. 
CHLORAL.—Conjunctivitis. 
SANTONlNE.—Xanthopsia (“yellow vision”). 
BROMISM AND lODlSM.—Pupils first contr 
dil. and immovable. 
Pressure on brain, from whatever cause, produces dil. 
of pupil. 
RHEUMATISM.—Iritis, paralysis of oc. muscles. 
SCURVY'—Night blindness, sub-conj., hem. 
ERGOT, CONIUM, HYDROCYANIC 
pupils dil. 
IV. 
Irritation of brain from whatever cause, produces 
contr. of pupil. 
SEXUAL ORGANS. 
Dil. of pupil more frequently observed in brain 
diseases. 
SCROFULA.—Conjunctivitis, blepharitis, abscesses 
and ulcers of cornea, etc. 
JABORANDI AND CALABAR BEAII 
contr. 
lEMALE SEXUAL DISEASES.—No part of eye 
is exempt from influence of female diseases, ex- 
cept perhaps lach. apparatus. 
DIGITALIS. Globes prominent, pupils di. 
fixed. 
Contr. of pupil frequently observed in spinal diseases, 
dil. very rarely. 
If nasal half of right, and temporal of left retina is 
blind, disease is in left hemisphere, beyond 
chiasm (and vice versa).2 If one eye is blind 
lesion in front of chiasm.2 If both, at chiasm, 
or general brain disease. External halves of re- 
tina, fat. degen. of circles of Willis,3 Nasal 
halves ant. part of chiasm.3 
VIII. 
ACONITE.—PupiIs dil., may be contr. 
PELVIC CELLUTITIS, UTERINE DISPLACE- 
MENTS, ANOMALIES OF MENSTRUA- 
TION, M ETRITIS, EN DO-METRITIS. 
CERVICITIS AND TUMORS.—Asthenopia, 
retinal hypenesthesia, etc., iritis. 
ACUTE AND CHRONIC INFECTIOUS 
DISEASES. 
NITRATE OF SILVER.—Dark staining of e 
junctiva. 
ARSENIC.—(Edema of lids, conjunctivitis. 
CLIMACTERIC PERIOD.—Opt. neuritis, atrophy 
opt. n., iritis.1 
MEASLES.—Conjunctivitis. 
lODOFORM.—Amblyopia.1 
PUERPERAL DISEASE.—Septic embolism of 
globe.2 
PROGRESSIVE MUSCULAR ATROPHY.—Uni- 
lateral contr. of pupils.1 
SCARLATINA. (Uremic) amaurosis,2 retinitis 
with sometimes atrophy of opt. 
n. asthenopia. 
CHRONIC MYELITIS.—Opt. neuritis, paralysis of 
eye muscles, pupils contr. 
X. 
ANOMALIES OF MENSTRUATION.—Periodi- 
caIIy aggravate affections of lid and conj. 
TABES.—More than one-half have eye affections 
(Cyon). Early symptom, transient double 
vision (ChABCOT). Robertson’s (Argyll' pupils, 
(t. e., very small, do not respond to light, but 
VARIOLV—Lids swollen, abscesses and ulcers at 
margins, destruction of hair bulbs, conjunctivi- 
tis, pustules on oc. conj., sub-conj. hem., abscesses 
and ulcers of cornea leading to panophthalmitis ; 
interstitial keratitis, iritis (late), choroiditis, 
infl. lach. sac. 
INTENSE HEAT. Conjunctivitis, blepua 
iritis, retinitis, neuro-retinitis. 
Li ACT ATlON.—Asthenopi a. 
INTENSE COLD. Conjunctivitis, blepb 
ulcers and necrosis of cornea.2 
CJHLOROSIS.—Opt. neuritis.1 
1. Rare. 
2. Very Rare. 
2. Only a few cases on record- 
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