E. ae Joun H. : Towacco AMBLYOPIA. (Note-book, p. 137.) Dec. 15th, 1878. 10-11 a.m. Field for Red. Left Eye. 4 Right Eye. (V. 16 J. barely.) (V. 12 J. barely.) Marked central scotoma for red and green, and peripheral contraction of same colours. Patient irritable and difficult to test. Scotoma perhaps not really so large as shown. Shaded part = remains of red and green fields. Taken after some months of treatment, considerable improvement of V. having taken place under abstinence from tubacco. ahr 1PT ‘md g “gzgi “38T¢e Ane marked + where the othe W. G. Jenkins. 4%. Rina kGee < aie A wen wen. Tuos. Maxninaton. 47. Topacco AmBLyopia (? ALCOHOLIC). Jan. 23rd, 1879. Dull sky. No fog. Jan. 9th, 1879, Left Eve. Right Eye. (V. same »s Right.) (V. 28, and with + 10-inch lens, 6 or 8 J.) B ty improved from ?§ and 10 J. in Sept. /78, to 29 and 4 or 1 J. in Jan. /79. | Small, nearly circular, central, scotoma in each eye, about 5° diameter; most dense just below centre, and, contrary to rule, not extending towards blind spot; indeed, colour-perception is good at outer side of scotoma (the place marked + on chart). The scotoma could only be detected by means of a spot 1°5 m.m. diameter (observe that the patient was a painter, and therefore accustomed to judge colours). The fields for red and green seem contracted in R., but the charts were taken on dull January days. Perception of yellow was good only upwards and inwards from centre ; just below centre it was nearly white. At the sides it was usually “greenish.” The blue spot was seen hest just below centre where the other colours were worst, and worst at the spot colours were scen comparatively well. Field for white, normal. n compa Sisk Fo ne sy — . a ae ee a ae Oe en Bl ae a ; A Wu ame tok : roy, ert t far Cee MISO e Terie ne 2 hey +) az aie BRAG" FERS Gere eae YS An bP yey : 2 ‘ec33 ‘ ie + ct top yxy ict J c Steneyer ; ToBacco AMBLYOPIA. Yd (Note-book, p. 118.) Jan. 23rd, 1879. 12 noon. Dull sky. No fog. Left Eye. Y. 16 J. with + 16 inch lens (other eye affected by cataract). Ceased smoking entirely for two years, and improved greatly ; then resumed smoking about a third of the original quantity. Seen 11 years after first admission (aged 57). V. had not deteriorated again, and was now very good, namely, 3%. pa ort, a - - Fields for white, blue, yellow, red, green, eight months after commencement of failure, showing typical central scotoma, which reaches from about 8° on inner side of centre to 20° on outer side. and includes the blind spot; it is most dense just below the centre, the cvlour fields seem to be all somewhat contracted, but this may be ere it appeared a ee gaa a a . at slightly pale just below the — W. Stevens. 58. Tobacco AMBLYOPIA. Feb. 6th, 1879. Right Eye. V. 7§ improved to 28 by + 24-inch lens ; reads 16 J. improved to 14 J. with + 18, and 6 J. slowly with + 8. V. soon tired, and went down to 10 or 12 J. at end of trial; 3} months previously V. was 330; barely, and 19 J. with + 18-inch failure of V. 5 months before admission. Fs ES ee eee | £cotoma most dense at patch most shaded. _Size of test spot not noted. Gress. 42. Topacco AMBLYOPIA Feb. 13th, 1879. 10.30 a.m. Gray sky. Green not taken. Left Eye. Right Eye. 90 eA : x 7 ‘ : Y. each eye 23; or Yoo and 10 J. with + 12 inch lens refraction ; hypermetropic j,; V. failing 3 months. No notes of progress. Boundary for white is normal. Very marked scotoma for red spot, 5 m m. diameter; this is most dense on the small cross-shaded ar*a just below centre, and on this area a white spot of 5 m.m. diameter is also very badly seen. Red is nowhere well seen until he com- | pares its appearance on the scotoma area with that to inner side | of fixing puint, when ke exclaims “It looks fiery red there,” while on the scotoma it looks no colour. Iam not at all sure that the scotonia is not enlarged above, as in other eye. Ww. By. 36. LocomMorer ATAXY. (Note-book IT., 131.) Mar., 1879. Left Eye. Right Eye. V. left eye with — 20-inch lens, 49; ; reads 6 J. badly. V. right eye less than 49; ; reads 10 J. badly. 9 Dy Ue Py LI 4 Symmetrical invasion of visual fields in progressive atrophy of optic nerves. See Mr. Packineton. 32. Topacco AMBLYOPIA,. (Note-book 11., 146.) | May 15th, 1879. Noon. sa ee V. each 6 J. badly; 12 J. well Ala ~_ se __(V, each eye 3 ; 6 J. badly; 12 J. well.) No notes of progress. | an Seotoma for red exactly symmetrical with that in other eye. Outer | Central relative scotoma for red and green. The colours are recog- boundary for red not taken. White not taken. v nized correctly, but look paler (i.e., “less red” or “less green”) than farther out. The scotoma mapped is for red; green quite similar, but not mapped, and perhaps not of quite same dimensions. Middle line — outer boundary for red, which is unusually large; here he recognizes the colour at once; it gets darker (i.¢., more red) on approaching centre, till the inner boundary, when it is at once paler. erified carefully. Probably his outer “ red” boundary corresponds 5 to my orange. Outer line — boundary for white, which is normal. The scotoma is as large as in more severe cases, but much leas intense. Mr. A., Note-book, p. 4, 211. Mr. Arnton. 47. Nov. 18th, 1880. Test objects for white, red, green, and yellow = 2 . 15 m.m. diameter; blue not tried. Nov. 18th, 1880. (V. 32 & 2) slowly. Dull day. (V. Af; & 114 J. barely; fixative excentric.) The relative defect for Test objects of same size as for right eye (15 m.m.). white no doubt comes quite up to fixation point in some degree. Left Eye. Right Eye. Symmetrical alteration vf visus fields in progressive atrophy of optic nerves, due to locomotor ataxy. The lower inner quadrant of each field re ~entral part (shown by black shading) damaged alike for white and colours; this par arge white test object 15 m.m., the defect appeared to stop a few degrees short of the centre. The area coloured red in each figure shows the area of red perception for a was entirely lost in the lower and inner part, and this loss for red appears to be ] red field ‘s much contracted, the dotted part of each red are & corresponding loss, and it was the same in the right. spot 15 m.m. in diameter; in both perception of red arger than the corresponding loss for white; in the rignt the residual part of the a shows where the colour perception is heginning to be lost. The field for green \G@ G in chart J) shows The examination for yellow gave indefinite results, the sample used being too white.