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Textbook Ophthalmic Disease in Veterinary Medicine Second Edition Martin Ebook All Chapter PDF
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The new edition of Ophthalmic Disease in Veterinary small animal species, the readers will appreciate the inter-
Medicine is the ideal textbook for trainee and practicing esting comparative notes on the horse and the cow, and
veterinarians needing a quick reference in their daily work. a section dedicated to presumed inherited eye disorders.
Expert veterinary ophthalmologists will also appreciate Ophthalmic Disease in Veterinary Medicine deserves a special
this updated completely revised edition, the achievement space in the library of everyone interested in veterinary
of a teamwork involving three authors and five contribu- ophthalmology. Actually, it is a book to leave on your desk
tors, outstanding members of the international veterinary for daily use, so that you can read the notes and show the
ophthalmology community. Hundreds of beautiful pic- pictures to owners to help explain what is happening in
tures and drawings facilitate a quick, easy, practical con- their pet’s eyes.
sultation and allow direct comparison to clinical cases. For
each ophthalmic disease and disorder, the authors provide Prof. Claudio Peruccio, DVM, SCMPA,
a detailed description of diagnosis, etiology, clinical signs, Dipl ECVO, Hon Dipl ACVO, MRCVS, EBVS®
prognosis, and therapy. Although the main focus is on European & RCVS Specialist in Veterinary Ophthalmology
The most recent edition of Ophthalmic Disease in Veterinary cutting edge in vision science and clinical ophthalmology,
Medicine is a welcome addition to the body of literature in and their wealth of experience brings context and perspec-
veterinary ophthalmology. This text is certainly straight- tive to new developments in the specialty. The other con-
forward and pragmatic enough to be valuable in the library tributing authors have followed that lead. Photographs,
of the general practitioner. But such a statement belies the illustrations, schematics, and flowcharts are particularly
700 pages of depth, detail, and scholarship that the special- useful in enriching the reader’s understanding in the
ist in veterinary ophthalmology will find extremely useful specialty of ophthalmology, and this book is loaded with
and informative; indeed, this text will become required extremely well-done examples of these visual aids. The
reading for my ophthalmology residents. It is obvious that text is very carefully and thoroughly indexed and cross-
this work has fallen under the watchful eye of Dr. Charles indexed, which makes it very user friendly. Without ques-
Martin, whose attention to detail and ability to piece tion this work will be referenced daily in my clinical work,
together not-so-obvious connections are legendary in classroom teaching, and residency training.
our specialty. Drs. Martin, Pickett, and Spiess have over
100 years of combined experience in veterinary ophthal- Daniel A. Ward, DVM, PhD, Dipl. ACVO
mology as clinicians, teachers, and researchers. This text Professor of Ophthalmology
provides abundant evidence that they have maintained a University of Tennessee College of Veterinary Medicine
Ophthalmic Disease in
Veterinary Medicine
Ophthalmic Disease in
Veterinary Medicine
Second Edition
Charles L. Martin
J. Phillip Pickett
Bernhard M. Spiess
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
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Index������������������������������������������������������������������������ 697
7 EYELIDS 173
J. Phillip Pickett
PREFACE
vii
Writing a text has often been compared to marriage as demonstrated not only great professional skills but a
it engenders an obligation to keep the covenant intact great deal of patience as the timeline for fruition of pub-
short of death. When contemplating another edition of lication has been greatly extended from the original tar-
the text Ophthalmic Disease in Veterinary Medicine, my get date. I would like to thank all the authors for their
considerations were how to improve the book as well participation and thoroughness, and we hope that the
as updating the text. Updating the information is quite readers will appreciate the expertise that this diversity
straightforward, while changing the format is more has brought to the text.
challenging and risky. Previous editions were essen- I would be remiss if I did not recognize Ms. Alice Oven
tially single authored, which has the advantage of more and Pam Tagg and their staff at CRC Press/Taylor &
consistency between chapters in writing style and phi- Francis for keeping faith in the project and the contribu-
losophy, but it also has the disadvantage of limiting the tors. I am sure it has probably been one of their most chal-
expression of clinical experience to a single author. For lenging projects.
this edition, we have chosen to increase the breadth of Last but not least I thank my daughter Christena Hughes
clinical expertise with a diverse group of authors from for her help and patience in the copy editing process and
many geographic regions of training and practice and my wife Marilyn for her encouragement and advice.
who have actively participated in student training and Charles L. Martin
research in veterinary ophthalmology. They have also
AUTHORS AND EDITORS
ix
Charles L. Martin, BS, DVM, MS, Charter Diplomate, He taught at the University of Wisconsin, and was a
American College of Veterinary Ophthalmologist, faculty member at the Virginia–Maryland College of
(ACVO), Emeritus Diplomate ACVO, Professor Emeritus, Veterinary Medicine at Virginia Tech where he reached
the University of Georgia, past president of the ACVO the rank of Professor.
and American Society of Veterinary Ophthalmology.
Dr. Martin trained at Washington State University, the Bernhard M. Spiess, DVM, Dr. med. vet., Diplomate,
University of Pennsylvania, and The Ohio State University American and European College of Veterinary
and taught at the Western College of Veterinary Medicine, Ophthalmologists (ACVO/ECVO), Professor Emeritus
Kansas State University, the University of Georgia, and is Charter Diplomate and past president of the ECVO.
Auburn University. He began his career in Switzerland, at the Veterinary
School in Lausanne/Zurich, then moved to the Veterinary
J. Phillip Pickett, DVM, DACVO, Emeritus Professor, Teaching Hospital at the University of Bern. He com-
Virginia–Maryland College of Veterinary Medicine pleted a residency in veterinary ophthalmology at the
is a graduate of Louisiana State University College University of Guelph, Canada, where he stayed on as
of Veterinary Medicine. Following three years in a Assistant Professor after becoming a Diplomate of ACVO.
mixed practice, he did a residency in Comparative In 1987, he returned to University of Zurich as Assistant
Ophthalmology at the University of Wisconsin, College Professor of Veterinary Ophthalmology, becoming full
of Veterinary Medicine. He is a Diplomate of the ACVO. Professor in 1994 and Professor Emeritus in 2015.
AUTHORS
xi
Eva Abarca obtained her DVM degree from the Veterinary the Ludwig Maximilian University in Munich. She is
College at the University of Zaragoza, Spain followed by a boarded Diplomate of both ACVO and ECVO and a
two years in the School of Veterinary Medicine in Alfort, recognized RCVS specialist in veterinary ophthalmol-
Paris, France. After practicing general medicine for several ogy. Her special interests include corneal disease and
years, she completed an ACVO residency program and a corneal surgery, feline ophthalmology, and in particu-
master’s degree at the Biomedical Research Institute of lar, glaucoma.
the National Autonomous University of Mexico, becom-
ing a Diplomate of ACVO in 2012. She worked as an oph- Phillip A. Moore received his DVM from Auburn
thalmology research scholar in the Laboratory of Ocular University, College of Veterinary Medicine. He completed
Immunology, Toxicology, and Drug Delivery at North an internship in small animal medicine and surgery and
Carolina State University. Dr. Abarca has taught at Auburn an ophthalmology residency at the University of Georgia,
University and is currently in the Ophthalmology Service College of Veterinary Medicine. Dr. Moore has taught
at Vetsuisse-Fakultat, Bern University, Switzerland, where at Tufts University, School of Veterinary Medicine the
she works as a senior clinician in ophthalmology. University of Georgia, College of Veterinary Medicine,
and is currently a Professor in the Department of Clinical
Shannon D. Boveland received her DVM from Tuskegee Sciences at Auburn University, College of Veterinary
University, College of Veterinary Medicine. She com- Medicine. Dr. Moore is a member of ACVO.
pleted an internship in small animal medicine and sur-
gery at Tuskegee and an ophthalmology residency at the Kate Myrna has a BA from Vassar College and received
University of Georgia, College of Veterinary Medicine. her DVM from the Virginia–Maryland Regional College
Following her residency, Dr. Boveland taught at the of Veterinary Medicine. She completed a one-year intern-
University of Georgia, Tuskegee University and is cur- ship at the Western College of Veterinary Medicine at
rently teaching at Auburn University. Dr. Boveland is a the University of Saskatchewan and a one-year specialty
member of the ACVO. internship in small animal ophthalmology at Angell Animal
Medical Center—Western New England. Dr. Myrna then
Ursula Dietrich, Dr. med. vet. MRCVS, is senior completed a residency in comparative ophthalmology and
lecturer in veterinary ophthalmology at the Royal obtained a master of science in comparative biomedical sci-
Veterinary College, University of London. She received ences at the University of Wisconsin–Madison. Dr. Myrna
both her veterinary medical degree and doctorate from is a diplomate of the ACVO.
CHAPTER 1
URSULA DIETRICH
intense neovascularization and engorgement and with pete- While buphthalmia is a true enlargement of the globe
chial/ecchymotic hemorrhage in the blue irides. The latter (most often caused by chronic glaucoma), exophthalmia
changes are not often obvious in the darker compact irides. is forward placement of an otherwise normal-sized globe.
Occasionally, a blue iris may turn green in an icteric animal. Differentiation between exophthalmos and buphthalmos is
Lens color changes are typically in shades of gray-white usually not difficult, but in brachycephalic breeds and ani-
with aging and white with cataract formation. Rarely, mals with only one eye, mild degrees of the problem may
hemorrhage may occur into the lens associated with con- be difficult to detect for even the experienced examiner.
genital vascular anomalies such as persistent hyperplastic
primary vitreous (PHPV). General comments
The initial clinical appearance of the problem and its
Ocular pain modification with time, therapy, and environmental
Blepharospasm and rubbing the eye(s) are obvious signs of change should be documented. Measurement of corneal
pain noted by owners, but ocular pain often manifests in diameters or ultrasonography for measuring globe dimen-
a subtle manner with general malaise, depression, exces- sions may be used to determine subtle differences between
sive sleeping, and a worsening of the temperament. These eyes. Information on the administration of prior “home”
signs are often not noted by the owners until improve- or professional remedies should be obtained, particu-
ment occurs and retrospective comparisons are made. In larly for chronic cases. With new clients, it is necessary
humans, conjunctival pain is described as a foreign body to obtain historical data on previous ocular problems and
sensation, corneal pain as a sharp ocular pain, and intra- their course and response to therapy. The disease process
ocular pain is often a headache pain radiating over the may have been modified, and the interpretation of the
trigeminal nerve distribution. Paradoxically, superficial ocular examination, such as pupillary light reflexes and
corneal ulceration is often more painful than deep ulcer- intraocular pressures, may be complicated by prior ther-
ation due to the concentration of nerve fibers under the apy (such as atropine). Failure of response to previously
corneal epithelium.1,2 Species variations also exist, as cats prescribed therapy should provoke questions to determine
and horses are typically more symptomatic with conjunc- the owner’s compliance with instructions. Asking to see
tivitis and corneal disease than dogs. the remaining medication may allow an assessment of
whether the medication has been given as frequently or
Opacities for as long as was claimed.
Opacities or film over or in the eye may result from pro- Many ocular problems are breed related, and it is often
lapse of the third eyelid, tenacious ocular discharges, desirable to establish possible inheritance, although the
corneal opacities, fibrin, blood, inflammatory cells or necessary information is often not available. In most
masses in the anterior chamber, and cataracts. Historical instances, genetic syndromes are inferred by the occur-
data regarding chronicity, laterality, constant or intermit- rence of a known syndrome in a particular age and breed
tent occurrence, progression, and precipitating factors of animal (see Chapter 15).
should be obtained. Protrusion of the third eyelid is often As the eye often manifests systemic illness, it is impera-
described by owners as “the eye rolling up into the head.” tive that possible systemic ramifications be considered.
In addition, topical medications may have systemic side
Pupillary changes effects, and, conversely, systemic drugs may have ocular
Alterations in pupil size are usually noted when unilateral side effects. Candidates for ocular surgery need to be eval-
or when accompanied by another ocular complaint such as uated preoperatively for systemic disease.
blindness, which draws the owner’s attention to the eye. Historical data pertaining to environmental factors
Alterations in pupil size are most easily observed in eyes such as animal exposure, type of housing, bedding, fenced
with lightly pigmented irides or against the background yard, dusts, irritants such as fumes and fiberglass, and
of a white cataract. Ocular disease should always be ruled function of the animal may help to establish an etiologic
out as the cause for altered pupil size, shape, and mobility diagnosis for a previously unresolved problem.
before proceeding to neurologic causes.
disease, as clinical studies in healthy dogs and in dogs with the palpebral or corneal reflex. In dogs with facial nerve
retinal or optic nerve disorders showed.11,12 Assessment of paralysis but normal vision, the menace response is sub-
cPLR is especially helpful in eyes with cataracts, prior tler, and retraction of the globe may be observed due to
to cataract surgery to rule out underlying retinal dis- contraction of all extraocular muscles and the retractor
ease, particularly if an electroretinogram is not available. bulbi muscle.
It could be shown that both blue and red light elicited a While menacing can still be performed without an
strong pupillary light constriction in normal eyes and in intact facial nerve, the response is subtler. The afferent arm
cataractous eyes without underlying retinal disease.11 of this response is the visual fibers up to the visual cortex
and the efferent arm is the facial nerve. Additional centers
Retinal degeneration, retinal detachment involved with the menace response are the cerebellum, the
Both the blue and red light cPLR responses are signifi- rostral colliculus, and the motor cortex. Cerebellar disease
cantly decreased in eyes with cataracts and concurrent produces an ipsilateral deficit in the menace response with
underlying retinal disease (degeneration or retinal detach- retention of vision (Figure 1.7) (see Chapter 4).13–15 The
ment), with the blue light response showing a higher menace response can be altered by nonvisual influences
sensitivity and specificity in the detection of retinal degen- such as mental status and cerebellar disease.
eration or retinal detachment.11 When trying to elicit a menace response, avoid air cur-
rents that may stimulate the blink reflex. Presentation
Sudden acquired retinal degeneration (SARDS) of fingers rather than a broad hand are used to avoid air
In dogs with SARDS, the red light cPLR response cannot currents. Complacent or trusting animals should have
be elicited, but the blue light response is retained in those the eyelids occasionally tapped to make them more alert.
eyes. This is explained by the complete loss of photore- The contralateral eye should be closed to determine that
ceptor function but retained intrinsic melanopsin–retinal it was not a binocular response to the stimulus. Due to
ganglion cell mediated chromatic PLR.
Optic neuritis
Blue and red light stimulation both show complete absence
of cPLR function in dogs with optic neuritis.
Orbicularis
oculi muscle
Vision evaluation
Vision evaluation in small animals Optic nerve
Vision testing in animals is based on a combination of
behavioral abnormalities and visual reflex testing. In many
instances, the owner is not aware of an ongoing vision Motor cortex
problem if only one eye is affected, as most dogs can adjust
very well to decreased vision or blindness in one eye. In
the dog with partial decrease in vision, multiple forms of
visual testing are performed to satisfy the examiner that Internal
capsule
there is a deficit and to characterize it. With complete loss
of vision, the result of maze or obstacle course testing is Lateral
geniculate
usually dramatic. Cats present a special problem in testing nucleus
their functional vision because they are often reluctant to
explore an area, making it difficult to differentiate a nor- Optic radiations
mal shy behavior pattern from a visual deficit. Testing cats
in their playing behavior (e.g., pulling a string in front of Pontine nucleus
them) or visual cliff testing can be very useful vision test- Cerebellar (midbrain)
ing procedures in this species. cortex
Facial
Menace response nerve
The menace response is a threatening, sudden movement Facial nucleus
(brain stem)
presented near the eye, which elicits a blink. Before test-
ing for a menace response, the examiner must make sure
the facial nerve is intact by eliciting a blink reflex through Figure 1.7 Menace response pathways.
A na m n e sis a n d t h e O ph t h a l m ic E x a m i nat ion 7
Table 1.1 Comparative visual reflexes with unilateral complete lesions within the visual system.
Mydriasis
PLRs are evaluated before instilling the mydriatic of
choice. Most mydriatics take 10–15 minutes to act, so to
conserve time, they should be given early in the examina-
tion. Mydriasis is necessary for complete ophthalmoscopy
and for a thorough examination of the lens.
The mydriatic of choice for diagnostic use should be effec-
tive and short in action. Atropine in the normal dog eye lasts
for 3 days and in the horse eye for 5–11 days. Tropicamide
1% (0.5% may be preferred in cats) is the preferred myd-
riatic for diagnostics (Figure 1.9).26,27 The alkaloid drops
Figure 1.8 Schirmer tear strips with an integral ruler on
traverse the nasolacrimal duct and, when licked from the
the strip and dye in the paper.
nose, may stimulate profuse salivation in some animals
due to the bitter taste. A transient, dramatic enlargement
over the medial lower lid into the conjunctival cul-de-sac of the submandibular salivary glands has been occasionally
(Figure 1.8). Once the strip is in place, the retention can
be improved by closing the lids. The strip is removed after
1 minute, and the amount of wetting, measured in mil-
limeters, is immediately recorded. The normal values of
wetting for the dog are 20 ± 5 mm/min and for the cat are
15–17 mm/min.16,17 The horse has been variably reported
to have Schirmer values of 20–30 mm/min and 13 mm/
min.18,19 Schirmer values in the cat may be quite variable,
and often a reading of 0 will be found in a perfectly normal
eye. Unless there are clinical signs to reinforce the find-
ing of a low Schirmer value, it is prudent to repeat the test
later before prescribing medication for a tear deficiency.
Berger and King20 found a statistical difference over
time and between breeds in the Schirmer values of dogs,
but while statistically significant, the variation would
rarely be significant in making clinical decisions. Large
breeds of dogs have higher Schirmer values than small
breeds of dogs.20 Hamor et al.21 evaluated the Schirmer
values in five breeds of dogs and found a difference only
in the Shetland sheepdog, where values were 4–5 mm/min
lower. In the dog, ocular signs are usually not associated
with decreased tear production until values are between
5 and 10 mm. In the past, variations in the readings were
attributable to the type of paper used in manufacture of
the strips.22 Newer strips have the measuring rule on the Figure 1.9 The two common mydriatics used in
strip and a dye in the paper that is taken up with the tears to diagnostic work. Note the red caps, which are typical for
delineate the amount of wetting. No clinically significant any mydriatic solution.
A na m n e sis a n d t h e O ph t h a l m ic E x a m i nat ion 9
Figure 1.10 Examples of head loupes used for Figure 1.12 Relatively inexpensive portable slit lamp that
magnification. consists of a 20 D lens and a focused light.
10 Chapter 1
Ocular staining
Fluorescein
Topical sodium fluorescein is an invaluable tool in detect-
ing corneal epithelial defects as well as in monitoring the
healing process. Fluorescein is utilized mainly as single-use
strips, since it was discovered that the solution was a good
Figure 1.16 Application of a moist fluorescein strip to the
culture medium for Pseudomonas spp.,42 although this has
conjunctiva.
recently been brought into question.43 If used as a 1%–2%
solution in multiple-use bottles, care must be taken to If a dry strip is touched to the eye for moisture, it should be
avoid contamination. Some clinicians make a fresh solu- placed on the conjunctiva rather than the cornea (Figure
tion daily by placing a strip in a 3- to 6-mL syringe and 1.16). Touching the cornea with the strip may give a slight
filling it with sterile saline. This may be easier to apply in positive staining at the point of contact. The eye is rinsed
the horse, but false-negative staining may be encountered thoroughly with eyewash to remove excess fluorescein and
with this method because the fluorescein is too dilute. mucus, and the retention of stain is evaluated. With small
Hydrophilic fluorescein cannot penetrate the normal defects such as herpes epithelial ulcers in cats, the use of
lipophilic epithelium, and thus is not normally retained. an ultraviolet light (Wood’s light) or cobalt-blue filter in a
If intercellular junctions are widened or loss of epithe- dark room causes fluorescence of the fluorescein, making
lium occurs, fluorescein is retained by the epithelium or minute stain retention visible.
stroma, respectively, and is visible as a bright green stain Other uses for topical fluorescein stain in ophthal-
(Figure 1.15).44 Staining of extensive ulcerations may mology are to detect aqueous leaks in perforating cor-
result in the fluorescein being visible in the aqueous. The neal wounds (Seidel test) and to determine patency of the
corneal staining is transient (about 15–30 min), although lacrimal outflow system. The Seidel test is performed by
in devitalized corneas it may persist for several hours. applying a high concentration of fluorescein at the site in
If fluorescein strips are used and the ocular surface is question without rinsing. The concentrated fluorescein is
not very moist, adding one to two drops of eyewash to the orange; if aqueous is leaking from the site, a dark rivulet
strip ensures an adequate quantity of solution on the eye. forms in the orange background. Evaluation of nasolacri-
mal duct patency with fluorescein is performed by apply-
ing fluorescein to the eye and observing its appearance
at the nostril (Figure 1.17). Fluorescein can normally be
observed at the nostrils within a few minutes. A normal
test does not ensure the entire lacrimal ductal system is
patent, as only one patent lacrimal canaliculus and punc-
tum is necessary for a positive test. The absence of fluo-
rescein may be due to ductal obstruction or an anomalous
orifice into the nasal cavity.
Fluorescein may be given IV as a 10% solution to visu-
alize the fundus vasculature or the iris vessels (see section
Fluorescein angiography) and to measure limb-to-retina
circulation time.
Rose bengal
Rose bengal is a fluorescein derivative of the xanthene
Figure 1.15 Fluorescein staining of a superficial ulcer. group, and it has been used in ophthalmology as a 1%
12 Chapter 1
Special ophthalmic
examination procedures
Microbiologic cultures of conjunctiva/cornea
If the type of discharge, history of chronicity, lack of
response to therapy, or severity of the problem indicates
serious or resistant infectious agents are involved, cultures
should be obtained early in the examination before the use
of topical anesthetics. Topical anesthetics may be bacteri-
cidal. Ideally, even if the problem is unilateral, cultures of
both eyes are preferred for comparative purposes, but due
to the additional expense, this practice is usually not fol-
Figure 1.17 Fluorescein staining visible in the nose after lowed. Staphylococcus spp. and Streptococcus spp. are the most
application to the eye of a dog.
consistent flora of the normal and diseased conjunctiva.48–53
The swab may be moistened with sterile nutrient broth or
solution. Rose bengal was originally characterized as a saline before use to make the procedure more comfortable
supravital stain that only stained degenerate epithelial and increase the growth rate.54 Calcium alginate swabs
cells and mucus. Its main use has been in staining devi- have been reported to yield a higher growth rate.50 Swabs
talized cells in keratoconjunctivitis sicca (KCS), and it is should be placed in a transport medium or immediately
thought to be more sensitive than the Schirmer tear test plated to prevent drying of the small samples. Commercial
(Figure 1.18).45 Rose bengal has also been used to stain culturettes with transport media and fine tipped swabs are
herpes epithelial ulcers and dysplastic epithelial cells with convenient and easy to place on small lesions and avoid
squamous neoplasia. Recently, the mechanism of action contamination from adjacent structures (Figure 1.19).
of rose bengal has been questioned. Cell culture evidence
indicates that rose bengal stains cells that do not have a Conjunctival and corneal cytology
mucus layer or the cornea with a deficiency of the pre- Scraping the conjunctiva and/or the corneal surface after
ocular tear film.46 Rose bengal, therefore, stains healthy topical anesthesia and examining the cells may enable a
cells if they are not protected by mucin, and it is intrinsi- rapid etiologic diagnosis to be made or may guide initial
cally toxic to cells in concentrations >0.01%. Exposure to therapy. The scraping may be performed with various
light releases oxygen radicals, which are toxic to cells.46 instruments. A metal instrument is used if the surface must
Rose bengal is also virucidal and bactericidal, and cultures be debrided to get to the level of the pathology. A mallea-
should be obtained before application of the stain. In a ble platinum spatula (Kimura) is commercially available
but expensive. The author simply uses the noncutting end
of a sterile scalpel blade as a convenient disposable ster-
ile scraper (Figure 1.20). For surface cytology, a small
Figure 1.18 Faint rose bengal staining of the cornea and Figure 1.19 Fine- and course-tipped culture swabs with
conjunctiva of a dog with KCS. transport media.
A na m n e sis a n d t h e O ph t h a l m ic E x a m i nat ion 13
Figure 1.23 Double eversion of the upper eyelid of a dog Figure 1.25 Application of the Schiotz tonometer to the
to examine the palpebral conjunctiva. axial cornea with the dog in dorsal recumbency.
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dans ses calculs. Treize cent dix-sept mille écus de détournés!
—Il les aura enfouis dans quelque retrait, dit le roi qui
commençait à trouver la somme royalement belle. Voilà l’aimant qui
l’attirait toujours ici. Il sentait son trésor.
Là-dessus Coyctier entra. Voyant l’attitude de Cornélius, il
l’observa savamment pendant que le roi lui racontait l’aventure.
—Sire, répondit le médecin, rien n’est surnaturel en cette affaire.
Notre torçonnier a la propriété de marcher pendant son sommeil.
Voici le troisième exemple que je rencontre de cette singulière
maladie. Si vous vouliez vous donner le plaisir d’être témoin de ses
effets, vous pourriez voir ce vieillard aller sans danger au bord des
toits, à la première nuit où il sera pris par un accès. J’ai remarqué,
dans les deux hommes que j’ai déjà observés, des liaisons
curieuses entre les affections de cette vie nocturne et leurs affaires,
ou leurs occupations du jour.
—Ah! maître Coyctier, tu es savant.
—Ne suis-je pas votre médecin, dit insolemment le physicien.
A cette réponse, Louis XI laissa échapper le geste qu’il lui était
familier de faire lorsqu’il rencontrait une bonne idée, et qui consistait
à rehausser vivement son bonnet.
—Dans cette occurrence, reprit Coyctier en continuant, les gens
font leurs affaires en dormant. Comme celui-ci ne hait pas de
thésauriser, il se sera livré tout doucement à sa plus chère habitude.
Aussi a-t-il dû avoir des accès toutes les fois qu’il a pu concevoir
pendant la journée des craintes pour ses trésors.
—Pasques Dieu! quel trésor, s’écria le roi.
—Où est-il? demanda Cornélius, qui par un singulier privilége de
notre nature, entendait les propos du médecin et du roi, tout en
restant presque engourdi par ses idées et par son malheur.
—Ah! reprit Coyctier avec un gros rire diabolique, les
noctambules n’ont au réveil aucun souvenir de leurs faits et gestes.
—Laissez-nous, dit le roi.
Quand Louis XI fut seul avec son compère, il le regarda en
ricanant à froid.
—Messire Hoogworst, ajouta-t-il en s’inclinant, tous les trésors
enfouis en France sont au roi.
—Oui, sire, tout est à vous, et vous êtes le maître absolu de nos
vies et de nos fortunes; mais jusqu’à présent vous avez eu la
clémence de ne prendre que ce qui vous était nécessaire.
—Écoute, mon compère? Si je t’aide à retrouver ce trésor, tu
peux hardiment et sans crainte en faire le partage avec moi.
—Non, sire, je ne veux pas le partager, mais vous l’offrir tout
entier, après ma mort. Mais quel est votre expédient?
—Je n’aurai qu’à t’épier moi-même pendant que tu feras tes
courses nocturnes. Un autre que moi serait à craindre.
—Ah! sire, reprit Cornélius en se jetant aux pieds de Louis XI,
vous êtes le seul homme du royaume à qui je voudrais me confier
pour cet office, et je saurai bien vous prouver ma reconnaissance
pour la bonté dont vous usez envers votre serviteur, en m’employant
de mes quatre fers au mariage de l’héritière de Bourgogne avec
monseigneur. Voilà un beau trésor, non plus d’écus, mais de
domaines, qui saura rendre votre couronne toute ronde.
—La la, Flamand, tu me trompes, dit le roi en fronçant les
sourcils, ou tu m’as mal servi.
—Comment, sire, pouvez-vous douter de mon dévouement?
vous qui êtes le seul homme que j’aime.
—Paroles que ceci, reprit le roi en envisageant le Brabançon. Tu
ne devais pas attendre cette occasion pour m’être utile. Tu me vends
ta protection, Pasques Dieu! à moi Louis le Onzième. Est-ce toi qui
es le maître, et suis-je donc le serviteur?
—Ah! sire, répliqua le vieux torçonnier, je voulais vous
surprendre agréablement par la nouvelle des intelligences que je
vous ai ménagées avec ceux de Gand; et j’en attendais la
confirmation par l’apprenti d’Oosterlinck. Mais, qu’est-il devenu?
—Assez, dit le roi. Nouvelle faute. Je n’aime pas qu’on se mêle,
malgré moi, de mes affaires. Assez! Je veux réfléchir à tout ceci.
Maître Cornélius retrouva l’agilité de la jeunesse pour courir à la
salle basse, où était sa sœur.
—Ah! Jeanne, ma chère âme, nous avons ici un trésor où j’ai mis
les treize cent mille écus! Et c’est moi! moi! qui suis le voleur.
Jeanne Hoogworst se leva de son escabelle, et se dressa sur
ses pieds, comme si le siége qu’elle quittait eût été de fer rouge.
Cette secousse était si violente pour une vieille fille accoutumée
depuis de longues années à s’exténuer par des jeûnes volontaires,
qu’elle tressaillit de tous ses membres et ressentit une horrible
douleur dans le dos. Elle pâlit par degrés, et sa face, dont il était si
difficile de déchiffrer les altérations parmi les rides, se décomposa
pendant que son frère lui expliquait et la maladie dont il était la
victime, et l’étrange situation dans laquelle ils se trouvaient tous
deux.
—Nous venons, Louis XI et moi, dit-il en finissant, de nous mentir
l’un à l’autre comme deux marchands de myrobolan. Tu comprends,
mon enfant, que, s’il me suivait, il aurait à lui seul le secret du trésor.
Le roi seul au monde peut épier mes courses nocturnes. Je ne sais
si la conscience du roi, tout près qu’il soit de la mort, pourrait résister
à treize cent dix-sept mille écus. Il faut le prévenir, dénicher les
merles, envoyer tous nos trésors à Gand, et toi seule...
Cornélius s’arrêta soudain, en ayant l’air de peser le cœur de ce
souverain, qui rêvait déjà le parricide à vingt-deux ans. Lorsque
l’argentier eut jugé Louis XI, il se leva brusquement, comme un
homme pressé de fuir un danger. A ce mouvement, sa sœur, trop
faible ou trop forte pour une telle crise, tomba roide; elle était morte.
Maître Cornélius saisit sa sœur, la remua violemment, en lui disant:
—Il ne s’agit pas de mourir. Après, tu en auras tout le temps. Oh!
c’est fini. La vieille guenon n’a jamais rien su faire à propos. Il lui
ferma les yeux et la coucha sur le plancher; mais alors il revint à
tous les sentiments nobles et bons qui étaient dans le plus profond
de son âme; et, oubliant à demi son trésor inconnu:—Ma pauvre
compagne, s’écria-t-il douloureusement, je t’ai donc perdue, toi qui
me comprenais si bien! Oh! tu étais un vrai trésor. Le voilà, le trésor.
Avec toi, s’en vont ma tranquillité, mes affections. Si tu avais su quel
profit il y avait à vivre seulement encore deux nuits, tu ne serais pas
morte, uniquement pour me plaire, pauvre petite! Eh! Jeanne, treize
cent dix-sept mille écus! Ah! si cela ne te réveille pas... Non. Elle est
morte!
Là-dessus, il s’assit, ne dit plus rien; mais deux grosses larmes
sortirent de ses yeux et roulèrent dans ses joues creuses; puis, en
laissant échapper plusieurs ha! ha! il ferma la salle et remonta chez
le roi. Louis XI fut frappé par la douleur empreinte dans les traits
mouillés de son vieil ami.
—Qu’est ceci? demanda-t-il.
—Ah! sire, un malheur n’arrive jamais seul. Ma sœur est morte.
Elle me précède là-dessous, dit-il en montrant le plancher par un
geste effrayant.
—Assez! s’écria Louis XI qui n’aimait pas à entendre parler de la
mort.
—Je vous fais mon héritier. Je ne tiens plus à rien. Voilà mes
clefs. Pendez-moi, si c’est votre bon plaisir, prenez tout, fouillez la
maison, elle est pleine d’or. Je vous donne tout...
—Allons, compère, reprit Louis XI, qui fut à demi attendri par le
spectacle de cette étrange peine, nous retrouverons le trésor par
quelque belle nuit, et la vue de tant de richesses te redonnera cœur
à la vie. Je reviendrai cette semaine...
—Quand il vous plaira, sire...
A cette réponse, Louis XI, qui avait fait quelques pas vers la
porte de sa chambre, se retourna brusquement. Alors, ces deux
hommes se regardèrent l’un l’autre avec une expression que ni le
pinceau ni la parole ne peuvent reproduire.
—Adieu, mon compère! dit enfin Louis XI d’une voix brève et en
redressant son bonnet.
—Que Dieu et la Vierge vous conservent leurs bonnes grâces!
répondit humblement le torçonnier en reconduisant le roi.
Après une si longue amitié, ces deux hommes trouvaient entre
eux une barrière élevée par la défiance et par l’argent, lorsqu’ils
s’étaient toujours entendus en fait d’argent et de défiance; mais ils
se connaissaient si bien, ils avaient tous deux une telle habitude l’un
de l’autre, que le roi devait deviner, par l’accent dont Cornélius
prononça l’imprudent—Quand il vous plaira, sire! la répugnance que
sa visite causerait désormais à l’argentier, comme celui-ci reconnut
une déclaration de guerre dans—l’Adieu, mon compère! dit par le
roi. Aussi, Louis XI et son torçonnier se quittèrent-ils bien
embarrassés de la conduite qu’ils devaient tenir l’un envers l’autre.
Le monarque possédait bien le secret du Brabançon; mais celui-ci
pouvait aussi, par ses relations, assurer le succès de la plus belle
conquête que jamais roi de France ait pu faire, celle des domaines
appartenant à la maison de Bourgogne, et qui excitaient alors l’envie
de tous les souverains de l’Europe. Le mariage de la célèbre
Marguerite dépendait des gens de Gand et des Flamands, qui
l’entouraient. L’or et l’influence de Cornélius devaient puissamment
servir les négociations entamées par Desquerdes, le général auquel
Louis XI avait confié le commandement de l’armée campée sur la
frontière de Belgique. Ces deux maîtres renards étaient donc
comme deux duellistes dont les forces auraient été neutralisées par
le hasard. Aussi, soit que depuis cette matinée la santé de Louis XI
eût empiré, soit que Cornélius eût contribué à faire venir en France
Marguerite de Bourgogne, qui arriva effectivement à Amboise, au
mois de juillet de l’année 1483, pour épouser le dauphin, auquel elle
fut fiancée dans la chapelle du château, le roi ne leva point
d’amende sur son argentier, aucune procédure n’eut lieu, mais ils
restèrent l’un et l’autre dans les demi-mesures d’une amitié armée.
Heureusement pour le torçonnier, le bruit se répandit à Tours que sa
sœur était l’auteur des vols, et qu’elle avait été secrètement mise à
mort par Tristan. Autrement, si la véritable histoire y eût été connue,
la ville entière se serait ameutée pour détruire la Malemaison avant
qu’il eût été possible au roi de la défendre. Mais si toutes ces
présomptions historiques ont quelque fondement relativement à
l’inaction dans laquelle resta Louis XI, il n’en fut pas de même chez
maître Cornélius Hoogworst. Le torçonnier passa les premiers jours
qui suivirent cette fatale matinée dans une occupation continuelle.
Semblable aux animaux carnassiers enfermés dans une cage, il
allait et venait, flairant l’or à tous les coins de sa maison, il en
étudiait les crevasses, il en consultait les murs, redemandant son
trésor aux arbres du jardin, aux fondations et aux toits des tourelles,
à la terre et au ciel. Souvent il demeurait pendant des heures
entières debout, jetant ses yeux sur tout à la fois, les plongeant dans
le vide. Sollicitant les miracles de l’extase et la puissance des
sorciers, il tâchait de voir ses richesses à travers les espaces et les
obstacles. Il était constamment perdu dans une pensée accablante,
dévoré par un désir qui lui brûlait les entrailles, mais rongé plus
grièvement encore par les angoisses renaissantes du duel qu’il avait
avec lui-même, depuis que sa passion pour l’or s’était tournée contre
elle-même; espèce de suicide inachevé qui comprenait toutes les
douleurs de la vie et celles de la mort. Jamais le vice ne s’était
mieux étreint lui-même; car l’avare, s’enfermant par imprudence
dans le cachot souterrain où gît son or, a, comme Sardanapale, la
jouissance de mourir au sein de sa fortune. Mais Cornélius, tout à la
fois le voleur et le volé, n’ayant le secret ni de l’un ni de l’autre,
possédait et ne possédait pas ses trésors: torture toute nouvelle,
toute bizarre, mais continuellement terrible. Quelquefois, devenu
presque oublieux, il laissait ouvertes les petites grilles de sa porte, et
alors les passants pouvaient voir cet homme déjà desséché, planté
sur ses deux jambes au milieu de son jardin inculte, y restant dans
une immobilité complète, et jetant à ceux qui l’examinaient un regard
fixe, dont la lueur insupportable les glaçait d’effroi. Si, par hasard, il
allait dans les rues de Tours, vous eussiez dit d’un étranger; il ne
savait jamais où il était, ni s’il faisait soleil ou clair de lune. Souvent il
demandait son chemin aux gens qui passaient, en se croyant à
Gand, et semblait toujours en quête de son bien perdu. L’idée la plus
vivace et la mieux matérialisée de toutes les idées humaines, l’idée
par laquelle l’homme se représente lui-même en créant en dehors
de lui cet être tout fictif, nommé la propriété, ce démon moral lui
enfonçait à chaque instant ses griffes acérées dans le cœur. Puis,
au milieu de ce supplice, la Peur se dressait avec tous les
sentiments qui lui servent de cortége. En effet, deux hommes
avaient son secret, ce secret qu’il ne connaissait pas lui-même.
Louis XI ou Coyctier pouvaient aposter des gens pour surveiller ses
démarches pendant son sommeil, et deviner l’abîme ignoré dans
lequel il avait jeté ses richesses au milieu du sang de tant
d’innocents; car auprès de ses craintes veillait aussi le Remords.
Pour ne pas se laisser enlever, de son vivant, son trésor inconnu, il
prit, pendant les premiers jours qui suivirent son désastre, les
précautions les plus sévères contre son sommeil; puis ses relations
commerciales lui permirent de se procurer les antinarcotiques les
plus puissants. Ses veilles durent être affreuses; il était seul aux
prises avec la nuit, le silence, le remords, la peur, avec toutes les
pensées que l’homme a le mieux personnifiées, instinctivement
peut-être, obéissant ainsi à une vérité morale encore dénuée de
preuves sensibles. Enfin, cet homme si puissant, ce cœur endurci
par la vie politique et la vie commerciale, ce génie obscur dans
l’histoire, dut succomber aux horreurs du supplice qu’il s’était créé.
Tué par quelques pensées plus aiguës que toutes celles auxquelles
il avait résisté jusqu’alors, il se coupa la gorge avec un rasoir. Cette
mort coïncida presque avec celle de Louis XI, en sorte que la
Malemaison fut entièrement pillée par le peuple. Quelques anciens
du pays de Touraine ont prétendu qu’un traitant, nommé Bohier,
trouva le trésor du torçonnier, et s’en servit pour commencer les
constructions de Chenonceaux, château merveilleux qui, malgré les
richesses de plusieurs rois, le goût de Diane de Poitiers et celui de
sa rivale Catherine de Médicis pour les bâtiments, reste encore
inachevé.
Heureusement pour Marie de Sassenages, le sire de Saint-Vallier
mourut, comme on sait, dans son ambassade. Cette maison ne
s’éteignit pas. La comtesse eut, après le départ du comte, un fils
dont la destinée est fameuse dans notre histoire de France, sous le
règne de François Ier. Il fut sauvé par sa fille, la célèbre Diane de
Poitiers, l’arrière-petite-fille illégitime de Louis XI, laquelle devint
l’épouse illégitime, la maîtresse bien-aimée de Henri II; car la
bâtardise et l’amour furent héréditaires dans cette noble famille!
INTRODUCTION.