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Show 6:2 or am: summons. or THE summons. 65 The best way of applying the caustic is to have it set in a The intention of the operation is to evacuate the humours quill, and put on the stick of a pretty large camel-hair brush; the caustic must be cut down to a small point -, a little mill: is beside the sm'geon, in which he (lips the brush. He then raises the eyelids, and at the same time presses them to fix the eyeball, he touches the ulcer with the caustic, and presses it of the eye, that the coats may contract, and be within the margin of the eyelids. OPERATION. he to the bottom of the ulcer, and when he has done this g: .fi -'n'".'4350W mom l; i. i K. '5. brushes the liquified caustic from the eye with a motion of his brush-In a day or two the irritability of the eye returns, for the deadencd surface of the ulcer has separated, and the tears again come in contact with the sensible surface, but the pain and intolerance of light is less than before; it is to be touched again with caustic, with a more permanent relief of symptoms. And if things go on successfully on the clearing of the ulcer in successive times, instead of being eaten deep it is shallower, and fills up, and the inflammation subsides. . The caustic need not be applied after the irritability ceases, and the ulcer looks red and granulatiog, instead of being irre~ gular and cineriticus in colour. {I Tn: patient is seated as for the extraction of the cataract, and the assistant supports the eyelid in the same manner. The surgeon takes the largest of his knives for the extraction of the cataract, and pushes it through tlfe tumour, in the direction he would cut the cornea in the operation of extraction; but he does not enter the knife so near the margin of the cornea as in that operation. Having made a section of the lower half of the tumour, he takes hold of the flap with the forceps or sharp hook, and completes the circular incision. The tumour being cut oil", and the chamber of the aqueous humour largely opened, the humours of the eye are gently squeezed out of the coats, when the eye subsides within the eyelids. i ~ .. mm "*&vamrfir~ka [W7? _ , """i-r . ‘mfi‘sfit‘t‘fl "mw ‘2' 01' THE STAPHYLOMA . 'l‘nr. Staphyloma is an opaque conical tumour of the cornea, it is often of a white or pearl colour, sometimes dark or variegated by the accretion of the iris to it. The staphyloma is most generally a consequence of small-pox. The opacity of the cornea produces blindness of that eye, but the worst circumstance of the disease is, that although it has no malignity, it is always liable to be aggravated, and 10 , ail‘ect the other eye also. The tumour of the cornea projecting from betwixt the eyelids, remains dry, and becomes ulcrru ated; there is a continued inflammation of the eye produced, and from the intimate sympathy which exists betwixt the the eyes, the other becomes sore also, and even ulcers form on of e consequenc a be to cornea of it. When we know this the staphyloma, we cannot hesitate about cutting it ofi‘. The cornea being the only part cut in this operation, and this being apart neither vascular nor very sensible, the inflammation is some time of commencing. On the fourth day the eyelids are inflamed, and on the seventh or eighth there is pus on the pooh ices applied to the eye. Scarpa in particular recommends the operation to be performed as I have here de- scribed, saying, that very terrible consequences result from including the sclerotic coat in the incision. But I have seen the operation performed by cutting off 'the whole anterior segment of the eye without any bad consequence; notwithstanding this, the reasoning as well as the facts alleged by Professor Scarpa, must sway us, where there is no advantage . resulting from a practice opposed to his. After the operation a pledget of soft lint soaked in oil, may be applied over the eyelids, and when the inflammation rises, if the fever and pain be great, we must bleed largely, and, as we Wish to produce suppuration on the surface of the memvor.. n. ,- Missal", 2%.... |
