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Show 70 nxrmruron or THE era. EXTIRPATION OF THE EYE. sub; It was with great satisfaction I read Searpa, on the ject of the artificial pupil. -:-<:;- ~;;__r'-;.-.«_w-_v-g_. was ual for those that operation is rare, but if it shall prove effect how much pupil, l opacities which are opposite the natura more extensive must the benefit prove. EXTIRPATION OF THE EYE. l "Lush-1 F!" m ._-‘4350w Ilium . i , resting on THE patient is placed on a chair, with his head his hand in hold d the assistant's breast. The assistant shoul The sura blunt hook with which he is to raise the eyelid. anteri~ geon is seated before the patient. He now pierces the s stroke first The ulum. or segment of the eye with his tenac INSTRUMENTS. A strong flat tenaeulum may do to pierce the ball of the eye with; or a large ligature is put through the eye with the common surgeon's needle, or what will be found more useful, and which will much shorten the painful period of prepara- tion, is a hook of the form of the tenaculum, with a shoulder, to prevent its going farther into the globe of the eye than just to permit the point to transfix it. A crooked knife is recommended for this operation, but it. will be found a bad exchange for the common scalpel. gh the of the knife are two semicircular incisions, to cut throu l l. it9 .._ _--~.' - n «gnaw-(4.30,. arm," . «rulxsm. l rww'C‘W'WJ "Wasted-,1?- an. who en The cause for which he performs l. tunica conjunctiva, and to separate the eyelid from the eyebal , socket the fills and Then if the eye is very much distended the next motion of the surgeon's knife ought to be to puncture the eyeball, and allow some of the humours to escape; for, if this is not done, he is cutting in a constrained and nar~ row way, betwixt the distended eye and the socket, making a tedious operation, and endangering more than necessary, the bones of the socket. lth the conjunctiva is cut, and the knife has gone quite round the eye and the attachments of the two oblique muscles are cut through, the eye would lie loose, only that the optic nerve retains it very strongly. I have seen the surgeon unac- countably forget this, and make repeated and most painful Cf~ forts, by cutting and pulling, when it only was required that he should have cut across the optic nerve. T0 cut. across the optic nerve, the knife ought to be carried flat under the superciliary ridge, and made to glide along the orbital plate. \Vhrn passed over the eyeball in this direction, a single cut will sever the nerve and muscles which surround it, so as to relieve the diseased parts, and they may be drawn out with only a little adhering cellular membrane. A good deal of blood should be allowed to flow. If it be required to stop the too profuse bleeding, it may be done by pressing a little dry lint in the inner angle. The disease sometimes returns. It may be expected if the disease has been really cancerous, and if the parts exter- nal to the eyeball have been the seat of the disease. From the. confined nature of the part, the whole soft parts within the bone may have been tainted. If so, it will probably happen that when the wound has gone on regularly towards a cure for some time, when you would expect that it was about. to close finally, it will stop, and instead of merely filling up, a fungus will rise from the orbit. When this has got to some head, the acute lancinating pain in the head will follow. Or if the wound has healed some months perhaps after the operation, hard tubercles will be felt in the surrounding integu- ments. Then comes pain striking to the back'of the head, with burning pain deep in the orbit, and the brain being at last affected, the patient dies. |
