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triaitb (Bfecfricaffp. A CASE OF 
RETINITIS PIGMENTOSA 
TREATED ELECTRICALLY. 
BY 
MYLES STANDISH, M.D. ' 
Ophthalmic Surgeon to Out-patients Carney Hospital, Assistant Ophthalmic Surgeon 
Boston City Hospital, Instructor in Ophthalmology Boston Policlinic, etc. 
BOSTON: 
DAVID CLAPP & SON, PRINTERS. 
X5 Reprinted from Transactions of American Ophthalmological Society, 1887. A CASE OF RETINITIS PIGMENTOSA TREATED 
ELECTRICALLY. 
I am well aware that to report the result of the treatment 
of a single case of any disease and to draw deductions there- 
from as to the efficacy of the method of treatment is a rash 
proceeding, and I would not occupy the time of the Society 
by reporting this case except for the fact that it is one of 
several cases reported at the last meeting of this Society by 
Dr. Hasket Derby, in a paper which excited considerable 
discussion at that time. 
The patient was a woman thirty-three years of age. She 
had myopia of 1.50 diopters in each eye, and had worn cor- 
recting lenses since she was seventeen years old. Her 
parents were not relatives. She was the only child of her 
father's first marriage, and had several half brothers and 
sisters who have never had any trouble with their eyes. 
Several members of her mother's family were "near-sighted." 
When first seen by me on the 14th of April, 1886, she had 
noticed an increasing failure of vision for the previous three 
years, which had increased very rapidly in the three months 
previous to her visit to me. Her night-blindness had recently 
become so great that she could no longer go on the street 
after night-fall with safety. The ophthalmoscope showed a 4 
considerable number of the characteristic star-shaped spots 
of retinitis pigmentosa in the periphery of the fundus in each 
eye. Her vision was, right ; left 
The field of vision did not extend over 20° in any meridian 
in either eye, as will be seen in the accompanying diagram. 
--- Fmo Hn. M. 
The only treatment employed in this case was the contin- 
uous electrical current. The positive pole was placed upon 
the closed eye-lid and the negative pole on the brow or temple. 
The strength of the current used was only such as could be 
comfortably borne, and has generally been derived from not 
more than four or six cells of a Stohrer's battery. 
The current has been passed in this manner for five minutes 
at a time, at intervals of several days. 
For the last ten months there has been a uniform interval 
of five days between the sittings. The patient has not been 
restricted in the use of her eyes while under treatment, and 
has used them constantly for fine work. 5 
For the fifteen months that she has been under treatment 
there has been a steady improvement both in central and 
eccentric vision from the commencement up to the present 
time, except as hereinafter stated. These exceptions are, 
first, that there has been no improvement of vision for the 
last three months, although under treatment during that 
period; and, second, that in the summer of 1886, after the 
patient had been under treatment for four months, she went 
out of the city on a vacation, and was absent for six weeks, 
during which period the electricity was omitted, and upon her 
return it was found that her vision had fallen somewhat, both 
centrally and eccentrically, but .the loss did not exceed a 
quarter of what she had previously gained. Her present 
vision is, right ; left The present horizontal diameters 
of the fields of vision, as will be seen by the diagrams, are, 
right 750; left 70°; and the vertical diameters are, right 70°; 
left 68°. 
This rather startling result has been verified by repeated 
examinations. The fields of vision have been taken with 
great care in the earlier, as well as the later periods of obser- 
vation ; upon a perimeter, at noon, on a clear day, with the 
perimeter facing the light, and at the same distance from the 
window at each trial. The objects used in determining the 
areas of the fields have been pieces of white paper, one centi- 
metre square. On testing central vision the test types have 
been changed from time to time to avoid the danger of making 
too high a record by the use of familiar letters. 
Some ophthalmoscopic changes have taken place while the 
patient has been under treatment; but these changes have 
been confined to a widening out of the prolongations of each 
patch of pigment, so that they do not now present such char- 6 
acteristic bone-corpuscle-like shapes as they did when first 
seen. No new patches of pigment have appeared. 
To argue from this case that all or even a very considerable 
number of cases of retinitis pigmentosa would be similarly 
benefited by the use of electricity would be manifestly 
absurd ; but that such an improvement in central and eccen- 
tric vision should happen to any case of retinitis pigmentosa, 
either with or without treatment, is a noteworthy fact, and 
one that should draw our attention to the circumstances of 
that particular case. 
We have present in this case, besides the constant treatment 
during a period of fifteen months, several other peculiarities. 
It came on fully as late in life as this disease ever develops, 
that is, if we may believe the patient's statements, at about 
thirty years of age, but did not progress very rapidly until the 
last three months before she came under observation, during 
which period, however, the onset of the disease was unusually 
rapid. Again, when first seen, the impairment of vision was 
very much greater than we should be led to expect by an ex- 
amination of the fundus, from which it would appear that 
treatment was begun while the disease was yet in its active 
stage, preceding the visible deposition of pigment in the 
retina. 
From these considerations it would seem, in so far as 
one case is capable of teaching anything, that when a case of 
retinitis pigmentosa is seen in its earliest stages, or when 
there is a sudden exacerbation of the disease, as evidenced 
by diminution of the functions of the eyes, a trial of galvanism 
should be made.