Eye Changes in Disseminated Sclerosis

Abstract

What is probably the first written account of the clinical features of disseminated sclerosis is contained in the diary of Augustus D'Este, the illegitimate son of Prince Augustus Frederick, and grandson of George III. The first manifestations of the disease in his case, as m some 30% of all such patients, were referable to the eyes. In 1822, we read, he journeyed to visit a much-loved relative; On my arrival I found him dead. I attended his

funeral-there being many persons present I struggled violently not to weep, I was however unable to prevent myself so doing; shortly after I was obliged to have my letters read to me and their answers written for me, as my eyes were so attacked that when fixed upon minute objects, indistinctness of vision was the consequence. Until I attempted to read or cut my pen, I was not aware of my eyes being in the least attacked. Soon after I went to Ireland, and without anything having been done to my eyes they completely recovered their strength, and distinctness of vision."3 It is interesting to note the temporal relationship of the onset of symptoms in this case, to a period of emotional stress, a relationship which has been much discussed in connection with disseminated sclerosis, but which has little statistical evidence in its support.