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38 R A D I U M
Frequency and Distribution
Gonzales, writing from Mexico and quoting the observations of other
colleagues from that country, without citing statistics regarding the
frequency of vernal conjunctivitis m Mexico, gives the impression that
this form of conjunctivitis occurs there much more commonly than is
the case elsewhere. Juan Santo> Fernandez, on the other hand, in the
not far distant island of Cuba, where it is wann through all the year.
states that out of a total of Oi.ooo eye cases observed by him. there were
but six instances of vernal conjunctivitis, all of which came from Cuban
cities. Freingold. in Xew Orlean-. reports the disease of rare occurrence
in that locality. In a characteristically able paper based u|>on the study
of 44 cases observed over a period of 15 years and an experience gained
by 10 years of earlier observation of scattered cases in Philadelphia.
Jackson concluded that the disease is more common in the very elevated
region of the western L nited States than elsewhere in our country.
In my paper of 1903. which contained a -ummary of the experience
with the disease of leading ophthalmologists from all parts of the Cnited
States, it was ascertained that though vernal conjunctivitis existed in all
parts of our country,it was always rather a rare condition, occurring in
a proi>ortion ranging from one case of vernal conjunctivitis to every
200 to 500 of conjunctival disease. My observations during the past
twenty years lend to the corroboration of these figures. It would appear
that the same frequency maintains in Furopean countries. Xeither would
I change the figurespublished in my earlier paper regarding sex liability
to the disease, as affecting 855? of male and but 15*^ of females. The
apparent immunity of certain regions may doubtless be explained by its
failure of recognition in such localities. Thusit is scarcely to be credited
that, in 191.000 cases treated in Petrograd over a period of fiveyears*
there occurred but one case of vernal conjunctivitis.
Prognosis asp Treatmest
Xow that radium is more generally available, the prognosis in vernal
conjunctivitis may safely be asserted to lie much more favorable
and the likelihood of limiting the course of the disease greatly enhanced.
This phase of the subject was so admirably treated by Shumwav before
this Society four years ago that any extended review of the use of radium
in vernal conjunctivitis is unnecessary at this time. I shall, however,
refer briefly to a case in which the application of radium while curative
of the disease, provoked unfortunate sequells.
J. E. P., now 24 years of age. has been under my observation for
the past fiveyears. He had had competent ophthalmic oversight since
the disease firstaffected his eyes when he was but fiveyears of age. the
ocular inflammation coming on after a prolonged case of pneumonia.
The usual alleviating collyria have been prescribed but each season th^
svmptoms recurred, some years with greater severity than others.
At my firstexamination the findingscharacteristics of vernal conjunctivitis
of the palpebral type were observable in each eye. The granulations
were large and prominent, but flat,and in the right eye there
was some involvement of the perilimbal tissues, especially to the nasal
side, at which point, the cornea was also faintly hazed. Cnder atropVthe
refraction was:
O.D. + S. 1.50 = 5 15
O.S. + S. 0.75 O + C. 1.37 ax. 65 ° = 5/6