A case of permanent blindness due to toxaemia of pregnancy.

THE fact that permanent blindness is such a rare complication in the toxaemia of pregnancy has prompted me to set the following casq on record. I can find no account of permanent blindness resulting from pregnancy in the records of the Rotunda Hospital, Dublin. Certainly no case has occurred in the last 73,572 pregnancies covered by the hospital (1935-4&), and three Masters who held office before 1935 (Dr. Fitzgibbon, 1919-26; Dr. Bethel Solomons, 1926-33, and Dr. Davidson, 1932) have kindly allowed me to state that during.their periods of mastership no case of permanent blindness occurred. Thus, this case appears to be the first in over 150,000 births. Since the classification of what constitutes " toxaemia of pregnancy " has undergone modification during the last 30 years, it would be valueless to give statistics. Any marked degree of permanent reduction in sight after toxaemia of pregnancy has been an unusual occurrence in the Rotunda Hospital. No mother in these last 73,572 births has required blind assistance as a result of her pregnancy. An investigation of the literature has produced only one case of permanent blindpess due to pregnancy toxaemia. A 30-yearold woman had a transient loss of sight on her third pregnancy, lost the sight of one eye (with marked diminution in the other) on her fourth pregnancy, and went totally and permanently blind on the fourth day after the birth of her fifth child. Six years later she developed presenile dementia. She was examined generally and ophthalmologically seven weeks after the birth of her fourth child, and again two years after going blind following her fifth pregnancy. On both occasions the urine showed no albumen and exhaustive examination of the central nervous system revealed no abnormality. There is no record of urine analysis or blood pressure. Her blindness was caused by post-neuritic atrophy.