Created by William Clark Souter
6 Jan 1915
Description:

‘Notes of a Chinese Albino

By

W.C. Souter, Aberdeen.

The notes in this case are accompanied by photographs of the Chinese Albino and coloured drawings of the fundus and of the iris, and for comparison corresponding photographs and coloured drawings of a normal Chinese [note: ‘The normal was a male, aged 17, born in Penang of Chinese parents; skin dark yellow-brown, hair jet black, iris very dark brown, pupils black, brows and lashes quite black; with the loupe one sees at the limbus small, pale brown pigment spots all round; selera darker than the Y.Y.L., a darker bluish white colour with the conjunctival bloodvessels more conspicuous; fundi normal, dark; choroidal vessels refraction about emmentropic. See Plate I. figg.[sic] 2, 4, and Plate II. figg. 1, 2.’] There is also added a tabulated statement of a microscopical examination of the hair of head, lashes and brows in the two cases. A chart is given of the small pedigree obtained.

Y.Y.L., III.2, male, aged 18 (1914), second in sibship of seven, born in Batavia of Chinese parents; barely 2 years resident in Britain; complains of not seeing the blackboard at school even with his glasses, has to hold things close to him, has always worn glasses. Cornea clear, no limbus pigment seen even with the loupe, pupils equal, active to light, black; tension normal, movements of globes barely full, scars on inner and outer parts of right eye and inner side of left resulting from operation done in 1912 for squint of right eye; constant, slow, variable lateral, nystigmus with wide jerks, at times nystigmus is quite rapid; convergence is defective. Irides are dull blue or greenish blue with golden russet-brown stroma pigment which forms around the pupil a broad belt with an ill-defined peripheral margin. There is less dark pigment along the surface of the radiating stroma ridges [note: ‘See Plate I. fig. 3.’]. Slight epicanthus, no photophobia, lashes pale yellow, almost white, brows pale-yellow, slightly more coloured than lashes, sciera bluish white with faint yellow tinge.

Refraction: right eye, myopia 2D in horizon meridian, 4.5D in vertical meridian, Vision with correction = 6/60; left eye, myopia 2.5D in horizontal meridian and 4D in vertical meridian, vision with correction = 6/36 partly; without glasses reads Jaeger 1 at 5”.

After a mydriatic pupils wide and circular, marked red reflex is seen in pupils; lenses clear; ciliary processes not seen, no red reflex through iris tissue. Ophthalmoscopic examination: - periphery of each fundus just as pale, or almost as pale, as an ordinary European albino fundus; the other parts are exceedingly pale also, choroidal vessels being sharply defined over nearly whole of fundus; even at macula choroidal vessels are quite distinct, although not very well shown in Plate I. fig. 1. In upper part of each macula there is obvious, well-defined, dark pigmentation, (more marked in right than in left,) most of which lies below superior temporal vessels – it gives a “tigroid” impression, and suggests the greyish black colour of congenital retinal pigmentation rather than the coal-black pigmentation of choroido-retinitis. It lies between choroidal vessels. In the right eye it is continued downwards and outwards, apparently just beyond the fovea, and in a less marked degree it extends inwards close to the upper edge of the optic disc. The pigment external to fovea is in dark islands. There is no deeper red area to be made out at what would be the site of macula. There is a pale area, with choroidal vessels seen in it, between outer side of each optic disc and the site of fovea, similar to those in other more peripheral parts of fundus beyond the area illustrated in the drawing. Quite apart from these pale areas, there is a narrow ragged myopic crescent at the outer side of each optic disc but the discs themselves are normal. Left foveal region is redder than the pale belt between optic disc and fovea but even there choroidal vessels can be made out. One minute patch of quite dark pigment lies between situation of left fovea and superior retinal vessels.

Hair of head is brown, though formerly, he says, his hair was nearly white; skin blonde, not at all yellow, slight pink on cheeks, no freckles; lean, feeble-looking lad; several moles on both sides of back, and on left nape of neck[;] no Mongolian birth-mark present; no large patches of pigmented skin, but well up on right side of scrotum is a roughly oval area of dark pigmentation - a pigmented wart – about ¾ inches thick in diameter; skin around anus not at all darkly pigmented; well developed pubic hair, of very light brown colour.

Commencing moustache with hair short and nearly white; cheeks have a good deal of downy white hair; weight 7 stones 10 lbs. with clothes on, height 5’6” with boots on; teeth excellent, hearing good, knees not swollen.

Family History -  Father, II. 5, alive, in Batavia, born in Java of Chinese parents; hair and eyes black, skin normal. Mother II. 2, alive, in Batavia, born in China, hair and eyes black. III. l, female, dark; III. 2, Y.L.L., is the only one of the pedigree who has been seen, and he has supplied the information regarding his relatives. III. 3, female, alive hair and eyes black, good vision; III. 4, male, aged 12, hair and eyes fairer than Y.Y.L.’s, photophobia, no nystagmus, very short-sighted; III. 5-6, female twins, with black hair and eyes, - both died immediately after birth; III. 7, female, alive, black hair and eyes.

III. 8, a daughter of the father’s sister is like Y.Y.L. but it is doubtful whether she has any nystagmus.  III. 9 and 10 are both dark. I. 1-5 are all dark and were born in China except I. 3, an only child, born in Java. II. 4-7, all dark. II. 8, 9-11 all dark, also III. 11 [sic]. II. 1, 3, 6, 7, 10, 11, have all been married for several years and have no issue.’

 

Examination of hair – by courtesy of Prof. Karl Pearson.

 [table in following format:]

                                                                                Normal                                                                 Y.Y.L.                                    

Head hair             Macroscopic                       Majority of a dense black colour                               Dark brown

                                Microscopic                        ...                                                                            ...

 

[repeated for:]

Eyebrows

Eyelashes

[accompanied by hand-written notes from which table constructed – ‘Y.Y.L.’ identified as ‘Yin Yan Lim’ here.]

[inc. descriptions of numbered plates (not present)]