The radical treatment of lacrimonasal disease by rapid dilatation and allied measures / S. Lewis Ziegler.

  • S. Lewis Ziegler
Date:
1910
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Licence: In copyright

Credit: The radical treatment of lacrimonasal disease by rapid dilatation and allied measures / S. Lewis Ziegler. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Absorption of this submucous hyperplasia will often be stimulated by the mere mechanical pressure of the instrument in the canal. The most striking success of rapid dilatation is probably shown in ulcerative lesions of the cornea, and especially those of the recurrent type. The phlyctenular variety also yields promptly to this treatment. In sloughing keratitis, however, we must supplement the dilatation of the duct by disinfecting the corneal slough with formalin (1 per cent.) and by using an antiseptic wash or spray in the nostril, either hydro- gen peroxid or potassium permanganate (1 to 2,000). I do not hesitate to practice rapid dilatation in cases of wound infection (lacrimal) following operation or injury, and even after cataract extraction, thus elim- inating the focal origin of the infection. In many of these cases, however, I inject formalin (0.25 per cent.) into the anterior chamber, in addition to disinfecting the margins of the wound and cleansing the nostril. This technic has undoubtedly saved many eves that appeared to be hopelessly lost. Bapid dilatation is also of value in cases of chronic conjunctivitis, blepharitis marginalis and eczema of the lid, in which the chemical irritation of the lacrimal fluids is the chief etiologic factor. It is likewise indi- cated in ectropion and entropion of mild degree arising from persistent lacrimal irritation. Contraction of the socket, with an irritating discharge and more or less palpebral disturbance, is a positive indication for this procedure. 1 have, for many years, performed rapid dilatation in every case of enucleation, as a routine measure, for the sole purpose of preventing any sec- ondary disturbance that might arise from the accumu- lation of irritating secretions in the socket. This plan has been markedly successful in preserving a healthy socket. I have previously discussed the treatment of tra- choma5 before this section (1897) by advocating rapid dilatation of the tear-duct to relieve corneal maceration and pannus through the free drainage of acrid lacrimal secretions. At the same time I recommended that this operation should he combined with canthoplasty or external eanthotomv (cantholysis) for the purpose of re- The Surgery of Trachoma. The Journal A. M A. Jan ].r> ISOS. p. 131.
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