Fundus changes in uveo-meningitis.

A housewife aged 44 complained of bilateral dimness of vision of one week's duration at the time of reporting for treatment in May, 1957. Some photophobia and ocular discomfort were also present. There was no history of antecedent disease. Her teeth were septic and she had experienced joint pains on and off and more recently a constant severe headache. Examination.-An anterior uveitis affected both eyes with a fine vitreous haze, though the fundi could be seen to be normal. The visual acuity was reduced to 6/12 in each eye, not correctable by lenses. Treatment.-Atropine drops 1 per cent. thrice and cortisone ointment 2 5 per cent. four times daily quickly brought relief for a time. Progress.-3 months later she presented herself again with pain, severe curtailment of vision and redness of both eyes, and greying and dropping of hair on the scalp. She was admitted to the Victoria Memorial Eye Hospital, Colombo, on July 25, 1957. Examination.-The visual acuity in each eye was perception of light. The ocular tension was 21a5 mm. Hg (Schiotz) in the right eye and 13 mm. Hg in the left. Both eyes showed ciliary injection, keratic precipitates, and atropine caused uneven dilatation of the pupils. Both lenses were clear, but the vitreous in both eyes was turbid with floaters precluding a clear view of the fundi. Large retinal detachments were seen in the lower parts of both eyes. There was bilateral nerve deafness of short duration. The reflexes were brisk in both arms and legs. The plantar reflexes were flexor. Laboratory Investigations.-The blood pressure was 100/65 mm. Hg. White cell count 7,800 per c.mm.; differential count, polymorphs 57 per cent., lymphocytes 46 per cent, eosinophils 3 per cent. The erythrocyte sedimentation rate was 14 mm. in the first hour and 34 mm. in the second. The Wassermann reaction (blood and cerebrospinal fluid) was negative. The cerebrospinal fluid cell count was 2, total protein 20 mg. per 100 ml. Lange 0000000000. Pandy +.