MIXED ASTIGMATISM, THE RESULT OF 
SEVERE INFLAMMATION OF 
AN EYE. 
To the Editor of The Polyclinic:— 
Permit me to add an interesting fact con- 
nected with the case of Herpes Zoster Ophthal- 
micus described in your last issue, and which I 
have discovered since sending you the report. 
The eye has entirely recovered and presents a 
normal appearance in every respect. The skin 
of the lids and adjacent parts is without 
a trace of the usual scars, due to the use, during 
the herpetic inflammation, of softening, anti- 
septic and healing ointments. There are no 
iritic adhesions, and the fundus is clear and 
normal. But I have been interested to find 
that during and since the convalescence there 
has been an increasing amblyopia, due, as I 
first supposed, to some intimate lesion of the 
retina or nerve consequent upon the severe 
inflammation through which the eye had passed. 
The right, or unaffected eye has throughout 
preserved its perfection of visual acuteness, 
and to-day registers and J. I at the usual 
distances, without glasses. During the conva- 
lescence the vision of the inflamed eye was at 
one time under a mydriatic. Later it was y 
likewise with paralyzed accommodation. At 
this time I only made a hurried test, owing to the 
weakness of the eye, but found that Sph.—1.50 
D. 3 cyl. + I-2S Ax. 1800, brought 
vision up to fg. To-day, with a perfectly 
recovered eye, I find vision and J. 14, with 
difficulty. The amblyopia is now shown to be 
entirely due to refractive errors. I have tested 
the refraction both without and with paralysis of 
the accommodation, and find it almost iden- 
tical. Sph. —1.25 D. 3 cyl. + 3-75 D., Ax. 1800 
gives V. f§, and J. 1 at 12 inches, with ease. 
The fact that the patient is perfectly certain 
that the eyes, before his illness, were equally 
good, combined with the demonstrated increase 
of the refractive error during convalescence, 
shows that, as a result of the ordeal through 
which the eye has passed, there has been an 
increase of the antero-posterior diameter of the 
globe, and changes in the corneal symmetry, 
resulting in the mixed astigmatism indicated by 
the combined lens before mentioned. 
I am, Sir, very respectfully yours, 
George M.jCipuLp. 
Tig S. 17th. Si., Philadelphia, 
Nov. 6th, 1888.