Christian Georg Theodor Ruete (1810-1867)

Christian Georg Theodor Ruete (1810-1867). (See here)

The first medical illustration of a visual migraine aura symptom in the European medical litarature stems from the German ophthalmologist Christian Georg Theodor Ruete, who occupied the chair of ophthalmology at the University of Göttingen (1841-1852) and Leipzig (1852-1867). In his Textbook of Ophthalmology (1845), he included a drawing of three successive stages of a personal visual aura, where "d" denotes the area of the disc of the optic nerve (i.e. the blind spot), "A" the axis of vision (i.e. the point of fixation), and "c" and "b" the last two stages of the aura.

Christian Georg Theodor Ruete, Illustration of scintillating scotoma from "Textbook of Ophthalmology", 1845.

The general characteristics of these visual phenomena were described thus: "Most frequently they are half moon shaped, but rarely circular, with zigzagged, silver and gold shimmering, coloured borders. The zigzags exhibit continuous, extremely intense scintillating movement. ... They follow movements of the eye and with accomodation for distant objects increase in apparent size and decrease in intensity, like all other scotomas. ... Accomodation being constant, they frequently remain the same size for only a short period, then begin to expand on the side and towards the rear ... Pressure on different parts of the eye does not influence the appearance. It retains its brightness with the eye opened or closed, but if closed it is somewhat brighter and clearer. Eyesight is not affected and during the vision one sees objects not encroaching upon its zigzags clearly and well defined, but those objects which fall into its zigzags are seen as blurred and as if surrounded by a halo. As a rule, its disappearance is followed by an intense headache, a feeling of tension and pressure in the eye ..."

References

Ruete CGT. Lehrbuch der Ophthalmologie für Aerzte und Studirende. Vieweg, Braunschweig 1845.
Zehender W. Christian Georg Theodor Ruete. Nekrolog. Klin Mbl Augenheilk 1867; 5: 187-209.

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