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May 1946


Author Affiliations

From the Wilmer Ophthalmological Institute of the Johns Hopkins Hospital and University School of Medicine.

Arch Ophthalmol. 1946;35(5):490-508. doi:10.1001/archopht.1946.00890200501002

IN a previous paper published in collaboration with Guyton,1 the statement was made that there was reason to believe that in some instances nummular infiltrates in the cornea, the so-called nummular keratitis Dimmer, might be due to an infection with Brucella. Since the presentation of this paper several further observations have been made which strengthen this opinion. The clinical and experimental observations which prompt this belief are here presented.

HISTORICAL REVIEW  The term "nummular keratitis" was first used by von Stellwag in 18892 to describe a form of keratitis characterized by a relatively acute onset and the occurrence of multiple, round, sharply delineated, grayish or yellowish white areas, about 0.5 to 1.5 mm. in diameter, throughout the various layers of the cornea. These areas were often elevated and had a tendency to break down and ulcerate. There was marked general inflammatory reaction and often vascularization. The course of