These lesions are not rare, and must be recognized by the physician. A systematic examination of the eye, to find out the condition of the retina in certain diseases, is necessary.

Retinitis

This disease occurs as a symptom in Bright's disease of the kidneys, syphilis, leukemia, and anemia. The common symptom in all cases is the occurrence of hemorrhage and the development of opacities. Where hemorrhage occurs there is a diffused cloudiness. This is due to an effusion of the serum. The hemorrhage takes place between the layers of the nerve fibers. When recent, the color is bright red; but as times goes on there is a change. In old hemorrhages the color is almost black. The white spots are due to exudates of a fibrous character, or fatty degeneration. The most important form of retinitis is albuminuric retinitis. This occurs in patients suffering from kidney disease, particularly that variety known as interstitial nephritis. The percentage of cases of nephritis presenting this peculiar condition of the retina ranges from fifteen to twenty-five. This disease, when associated with granular kidney, occurs at a stage when the amount of albumin may be slight or even absent. Arteriosclerosis often accompanies this affection. There is a hemorrhagic form, where hemorrhages are repeated, with very slight signs of inflammation; and then there is an inflammatory form, in which there is much swelling of the retina. This latter variety obscures the disk, and in some instances the inflammation of the optic nerve predominates over the retinal changes. This frequently throws one in doubt as to whether the condition is really associated with the retinal changes.

Retinitis In Anemia

After large hemorrhages, it is not infrequent for a patient to lose the sight of one or both eyes temporarily. Sometimes the lost sight will be permanent. In such cases there is usually a retinitis of sufficient severity to account for the symptoms. There is also a malarial retinitis, and then a retinitis due to leukemia.

Treatment

There is no special treatment of any importance for these affections. The real derangement, which the retinitis represents as a symptom, must be corrected; hence the treatment must be for those diseases. Certainly all stimulants must be given up, including coffee and tea, with an absolute fast until all discomfort is gone, then fruit and vegetables until health is established.