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Table of Diagnostic Points in Quinine and Malarial Amblyopia (see p. 75) | |
Quinine Amblyopia | Malarial Amblyopia |
History.—Quinine taken in large doses, not less than 30 grains. | History.—Quinine may have been taken, but not necessarily in large doses. |
Onset.—Sudden, accompanied by deafness; both eyes are affected. | Onset.—Not usually sudden, but it may be so if hæmorrhage has occurred in the macular region. There is no deafness, and both eyes are not necessarily affected. |
Pupils.—Widely dilated, and whilst loss of vision continues they do not react to light. | Pupils.—React to light. |
Vision.—Completely lost for a time. | Vision.—Never completely lost. |
Ophthalmoscopic appearances.—A white haze over fundus; cherry-red spot at macula; optic disc pale; retinal vessels markedly constricted. | Ophthalmoscopic appearances.—There is optic neuritis; optic disc is of characteristic greyish-red colour; retinal hæmorrhages, and sometimes vitreous opacities. |
Termination.—Usually some permanent defect in the field of vision or in colour vision. Central vision recovers first; optic disc is unusually white, and retinal vessels small. | Termination.—Some cases recover completely; in others greater or less permanent defect of vision remains. |
Treatment.—Stop quinine. Amyl nitrite has been recommended to induce dilatation of retinal vessels. | Treatment.—Give quinine. |