Causes of various ophthalmic diseases and the characteristic symptoms they produce in an alphabetical index form….

From The Eye as an Aid in General Diagnosis by E.H. Linnell. M.D.

Abdominal growths.-More or less pigmentation of the skin of the eyelids.

Addison’s disease of the supra-renal capsules.-Pigmentation of the skin of the lids and of the sclera.

Albuminuria.-Retinitis and neuro-retinitis.

Alcoholism.-Paretic mydriasis. Paralysis of accommodation, or spastic myosis in the early excitable stage. Paralysis of the external ocular muscles. Ptosis.

Anaemia (Cerebral).-Paretic mydriasis.

Anaemia (Constitutional).-Paralysis of accommodation, chorodiitis, retinitis and retinal haemorrhages.

Aneurism of orbital artery, or internal carotid.- Exophthalmus.

Aneurism of aorta and arteria innominata.-Reflex spastic mydriasis on the side of the lesion. Retinal pulsation.

Apoplexy.-Dilation or contraction of the pupils distinguishes it from embolism, in which the pupils are unaffected. Spastic myosis in premonitory stage. When, during a seizure, mydriasis occurs after a previous myosis, it is an unfavorable symptom, signifying increasing pressure. Nystagmus. Homonymous hemianopsia.

Apoplexy of cortex or corona radiata.-Eyes and extremities paralyzed on the same side. Eyes deviate towards the side of the lesion.

Apoplexy of the crus or pons varolii.-Eyes and extremities paralyzed on opposite sides. Eyes deviate away from the side on which the lesion exists.

Apoplexy of the pons.-Spastic myosis.

Apoplexy of ventricles.-Spastic myosis.

Atheroma.-Conjunctival haemorrhage. Intra-ocular haemorrhages.

Atrophy, progressive, muscular.-Ocular paralyses.

Basedow’s disease or exophthalmic goitre.-Diminished frequency of winking. Spasm of the levator of the upper lid. (Abadie’s sign.) Widening of the palpebral fissure, owing to contraction of Mueller’s muscle. (Stellwag’s or Dalrymple’s sign.) Loss of associated movement of the upper lid and the eyeball. (Von Graefe’s sign.) Exophthalmus.

Brain, abscess of.-Neuritis.

Brain, basilar affections of.-Loss of pupillary reflexes. Homonymous hemianopsia. Paralyses of ocular muscles.

Brain, cerebral cortical affections.-Conjugate ocular paralyses (or ophthalmoplegias), loss of voluntary movements of the eyes, with preservation of involuntary or reflex movements of pupil and eye-ball. Eyes paralyzed on side opposite the cerebral lesion. Eyes deviate towards side of lesion. Psychic visual disorder.

Brain, cerebral affections, with increased intra-cranial pressure.-

Paretic mydriasis ordinarily. Sometimes reflex spastic mydriasis.

Brain, cerebellum, affections of.-Nystagmus.

Brain, concussion of.-Sluggish action of pupils without marked dilatation or contraction.

Brain, hyperaemia of.-Spastic myosis.

Brain, tumor of.-Nystagmus. Paretic mydriasis. Choked disc.

Choked neuritis. Atrophy of optic nerve. Homonymous hemianopsia, when pressure is extended upon fibres of one tract. Cholera.-Conjunctival haemorrhage. Anaesthesia of cornea. Neuro- paralytic keratitis. Loss of the light reflex indicates a fatal termination even in apparently mild cases. Preservation of the light reflex warrants a favorable prognosis, even in severe cases. Black patches appear in the sclerotic below the cornea in severe cases. They are of irregular form and size and tend to coalesce. Their presence is of very unfavorable significance.

Coma, alcoholic or uraemic.-Mydriasis.

Coma, syphilitic.-Myosis and reflex iridoplegia.

Death, signs of.-Opacity and insensibility of the cornea. Desiccation of the sclera. Abolition of pupillary reflexes. Absence of the red reflex from the fundus.

Dental affections.-Various forms of inflammation of the cornea. Nictitation.

Diabetes.-Eczema of the eyelids. Conjunctival haemorrhage. Ulceration of the cornea. Paralysis of the external ocular muscles and of the accommodation. Cortical cataract. Retinitis and neuro-retinitis. Atrophy of the optic nerve. Degeneration of the retinal vessels and haemorrhages. Lagrange found, in 52 cases of diabetes, 13 of intra-ocular haemorrhage and the same number of cases of cataract. (See “Arch. d’Ophth.,” Jan., 1887.) Galezowski found, in 144 cases of diabetes, 5 of paresis of accommodation, 4 of keratitis, 7 of iritis, 4 of glaucoma, 46 of cataract, 27 of retinitis, 31 of amblyopia, 3 of. amotio retinae, and 3 of atrophy of the optic nerve. (See “Jahr. f. Aug.,” 1883, p. 297.)

Digestion, disorders of.-Styes. Nictitation.

Diphtheria.-Diphtheritic conjunctivitis. Paralyses of the external eye muscles rare; of accommodation more frequent.

Embolism, cerebral. No pupillary symptoms; in contradiction from apoplexy.

Epilepsy.-Paretic mydriasis during the seizure or spastic myosis. Hippus as consciousness returns and frequently during the intervals. Spasms of the ocular muscles.

Fever, puerperal and typhoid.-Metastatic suppurative choroiditis.

Fever, relapsing.-Iritis.

Fifth nerve, affections of.-Reflex spastic myosis.

Fourth ventricle, lesions in.-Nuclear ocular paralyses affecting separate nuclei of the third nerve, or successive implication of its various branches. Also total paralysis of all the muscles of both eyes.

Friedreich’s disease (hereditary ataxia).-Nystagmus.


Heart, aortic insufficiency.-Alternate reddening and pallor of the optic.

Heart, endocarditis.- Embolism of the arteria centralis retinae.

Heart, organic affection of.- OEdema of lids. Venous hyperaemia of retina and pulsation retinal arteries. Seen with valvular affection fatty heart and aortic insufficiency.

Heart, hypertrophy of left ventrical- Retinal haemorrhages.

Heart valvular lesions of.- Retinal haemorrhages.

Helminthiasis.- Reflex spastic mydriasis.

Hepatic affection.- Pigmentation of the skin of the lids. Coloration of sclera.

Hydraemia.- OEdema of lids.

Hydrocephalus.- Paretic mydriasis. Neuritis and atrophy of optic nerve.

Hysteria.- Chromidrosis. Epiphora. Ptosis. Spastic myosis (during a hysterical convulsion). Hippus. Hyperaesthesia of the retina. Spasm of accommodation Amblyopia. Contraction of the visual field. Sudden onset, erratic course, sudden disappearance.

Insanity.- Monocular mydriasis and paralysis of accommodation are suspicious premonitory sign, as is also transient recurrent mydriasis.

Kidney, diseases of.- Degeneration of the retinal vessels with or without haemorrhages. Retinitis and neuro-retinitis. Amblyopia. OEdema of lids.

Leprosy.- Leprous nodules in eyelids, conjunctiva, cornea and iris. Anaesthetic spots and white patches in the lids. According to Lopez (” Archiv. f. Aug., ” xxii, 2 and 3) ” the eye is affected in half the cases, the eye with its appendages in all cases.” Knies.

Lung, diseases of apex.- Reflex spastic mydriasis.

Malaria.- Chronic superficial non-suppurative keratitis. Sensitiveness of supra-orbital nerves. Retinal haemorrhages. Choroiditis.

Mania.- Reflex spastic mydriasis.

Masturbation.- Paralysis of accomodation Hyperaesthesia of retina.

Melancholia.- Reflex spastic mydriasis.

Meningitis, cerebral, acute.- Mydriasis or myosis, photophobia. Injection of conjunctiva.

Meningitis, cerebral, chronic.- Interstitial and per- neuritis Atrophy of the optic nerve.

Meningitis, of the convexity.- Cortical blindness or hemianopsia with preserved pupillary light reflex. Hyperaesthesia of the retina. Photophobia, phosphenes. etc.

Meningitis, cerebro-spinal.- Eye symptoms frequent conjunctivitis in early stages. Later oedema of conjunctiva, denoting exudation in cranial cavity. Strabismus. Nystagmus. Spastic myosis in early stages. Reflex spastic mydriasis from pinching the skin at the back of the neck. (Parrot’s sign). Hippus Choroiditis. Photophobia. Neuritis.

Meningitis, spinal.- Spastic mydriasis in the early stage.

Meningitis, tubercular.- Strabismus. nystagmus. Ocular paralyses spastic myosis in earl;y stage. Rapid alternation of myosis and mydriasis. Paretic mydriasis in later stages in contra-distinction from cerebro-spinal meningitis. in which it is rare. Tuberculosis of the choroid. Homonymous hemianopsia.

Meningeal haemorrhage.- Nystagmus. Hemianopsia.

Menstruation, disorders of.- Styes.

Myelitis, acute and chronic.- Neuritis or simple atrophy of the optic nerve.

Myxoedema.- Thickening and swelling of the lids.

Nephritis.- See diseases of the kidney.

Neuralgia of the fifth nerve.- Paralysis of accommodation.

Neuritis, multiple or pseudo tabes.- Axial neuritis with central scotoma. Absence of pupillary symptoms, in contra- distinction from true tabes.

Nicotine poisoning.- Spastic myosis. Retro-bulbar neuritis with central scotoma.

Paralysis agitans.- Tremor of the lids. Ptosis.

Paralysis, general (paralysis of insane, paresis). Monocular mydriasis and paralysis of the accommodation and transient recurrent mydriasis are suspicious premonitory symptoms. Paretic mydriasis in an `early symptoms. The “Argyll Robertson pupil,” is found in fifty per cent of the cases. Anisocorea. Paretic myosis. Optic-neuritis. Atrophy of optic nerve. Soul blindness. Sudden development and transient duration of ocular symptoms similar to multiple sclerosis and tabes.

Polio encephalitis superior (inflammation of the floor of the fourth ventricle).- Progressive paralyses of the ocular muscles is the essential feature.

A. B. Norton
Norton, A. B. (Arthur Brigham), 1856-1919
Professor of Ophthalmology in the College of the New York Ophthalmic Hospital; Surgeon to the New York Ophthalmic Hospital. Visiting Oculist to the Laura Franklin Free Hospital for Children; Ex-President American Homoeopathic Ophthalmological, Otological and Laryngological Society. First Vice-President American Institute of Homoeopathy : President Homoeopathic Medical Society of the State of New York ; Editor Homoeopathic Eye. Ear and Throat Journal : Associate Editor. Department of Ophthalmology, North American Journal of Homoeopathy, etc.