DESCRIPTIVE SKETCH AND DRAWINGS 
OF 
Two Cases of Symmetrically Placed 
Opacities of the Corneae, 
OCCURRING IN MOTHER AND SON. 
By CHARLES A. OLIVER, M.D., 
PHILADELPHIA, PA. 
\Reprinted from American Ophthalmological Society Transactions, 1892.] DESCRIPTIVE SKETCH AND DRAWINGS 
OF 
Two Cases of Symmetrically Placed 
Opacities of the Corneae, 
OCCURRING IN MOTHER AND SON. 
By CHARLES A. OLIVER, M.D., 
PHILADELPHIA, PA. 
\Reprinted from American Ophthalmological Society Transactions, 1892.] DESCRIPTIVE SKETCH AND DRAWINGS OF TWO 
CASES OF SYMMETRICALLY PLACED OPACI- 
TIES OF THE CORNERS, OCCURRING IN MOTHER 
AND SON. 
By CHARLES A. OLIVER, M.D., 
PHILADELPHIA, PA. 
On the 23d of February, 1891, a sturdy-appearing eight- 
year-old schoolboy, the son of German-born parents, applied at 
Wills' Eye Hospital for the removal from both eyes of what the 
physician who sent him supposed to be cataract. 
The opacities, which had been noticed for a long'time, had 
gradually increased in size and density until one year pre- 
viously, when, after an attack of malarial fever (the only illness 
that the child had ever had), they seemingly enlarged and be- 
came, just as they are now, quite conspicuous. At no time 
were the eyes ever red, irritable, or inflamed. 
The upper incisors were normal in appearance, and the boy 
failed to present any of the facial or general characteristics of 
inherited syphilis. Laveran's corpuscle was searched for, but 
was not found. With two diopters of hypermetropia and a 
slight degree of astigmatism in each eye, uncorrected vision 
was reduced to one-fourth, and the accommodative power was 
limited to eleven diopters ; and, with the exception of an eso- 
phoria of two (P. D.) degrees, no extraocular muscle disturb- 
ance was obtainable. The pupils were three millimetres in 
their horizontal meridians, and the irides were freely and 
equally mobile to light, stimulus, accommodation, and conver- 
gence. The cornea presented the dense superficial and deep 
opacities so noticeable in the accompanying sketches, which 
were kindly made for me by Dr. B. Alexander Randall. 
* See paper by Sulzen. La correction optique du kerato cone, etc. Ann. d'Ocul.t '92. 4 
Oliver : Symmetrically Placed Opacities of the Cornea. 
Careful examination of these drawings * will at once make 
it evident that in each instance there is a deeper and more 
compact central area, which is surrounded by an annulus or 
ring of superficial pin-dotted opacities, that of the left eye 
being the larger and the slightly more peripherally situated. 
Not a trace of inflammatory vascularity could be seen. The 
eye-grounds, which were plainly visible and which were most 
carefully explored, failed to reveal any gross changes. 
Although physical examination gave no evidence of any 
organic disturbance, alteratives and local treatment were experi- 
mentally and persistently tried ; yet up to the present writing, 
nearly sixteen months after the first visit, no perceptible change 
in appearance of the corneal spots is evident. 
During the first weeks of the study of this case advantage 
was taken to examine the mother, who was a widow, and her 
other child, a daughter of fifteen years of age. 
The sister of the patient failed to exhibit any ocular abnor- 
mality, except a minor degree of correctible simple hyperme- 
tropic astigmatism. 
The mother, however, a seemingly healthy woman of forty- 
five years of age, without any apparent organic lesion or his- 
tory of pronounced illness, stated that she had had a difficulty 
* It will be noticed in these sketches that the pupils are represented as though they 
were dilated. This has been done intentionally, so as to better give the configurations of 
the corneal opacities against a dark background. Oliver : Symmetrically Placed Opacities of the Cornece. 
5 
with her eyes, which was similar to that of her son's, as long 
as she could remember. 
Utterly free from any evidences of other gross ocular 
lesion, her corneae presented the peculiarly circumscribed deep 
and superficial opacities shown in the lower part of the sketch, 
they being more irregular in outline, and their central portions 
much fainter, than those of her son. 
The apparent heredity in the two cases is almost certain, 
when we for a moment consider that here we have a seemingly 
healthy woman with long-standing, peculiarly-localized, and sym- 
metrically-placed opacities of the cornea, who, although giving 
birth to an as yet unaffected daughter, has a duplicature of her 
ocular infirmity directly repeated in an otherwise healthy son ; 
a similarity in two of the most impressionable of blood rela- 
tions - a mother and son - in whom, in spite of all attempts 
at solving the problem by the most scrutinizing search into 
family and personal history, the most careful and extended gen- 
eral and local examination, and the most persistent and pro- 
longed antidyscratic treatment, have so far failed to give any 
other clue as to the true causative factor.