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ART.IV.-Choroidal Apolexy

To the ophthalmoscope this disease is characterized by irregular red spots, varying in size, form and color with the quantity of blood effused.

They may be very easily distinguished from retinal hemorrhages, which when they are small, assume a striated form, and are almost always found in the course, or in the neighborhood, of a retinal vessel. These vessels, on the other hand, pass clearly above hemorrhagic spots of the choroid.

The difficulty in vision varies with the seat of the apoplexy; it is insignificant if the apoplexy is near the equator of the eye. More pronounced if it is in the neighborhood of the posterior pole, especially if the blood penetrates to the internal layer of the retina. Moreover, in such cases vision in much more frequently influence by effusion into the vitreous body or into the retina.

The effused blood on the internal surface of the choroid may cause separation of the retina, or, after a considerable time, it may be absorbed.

During absorption the apoplectic spot changes its color, becoming yellowish, and leaving a permanent white atrophic spot with a border of black pigment.

These hemorrhages are often of traumatic origin, being due to contusion of the eye or of its neighborhood.

Sometimes they accompany acute choroiditis or sclerotico-choroiditis posterior, or are due to general affections of the circulation (diseases of the heart, antrio-sclerosis, dysmenorrhoa, ect.).

The treatment of this disease depends on the precise cause of the hemorrhage, which by itself does not afford any indication for special treatment.

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