Cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Cataract extraction / by H. Herbert. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    But an additional thread or flake of mucus lying in the lower fornix suggests the need for caution. As a rule, the operation must be postponed for a few days' treatment, or at least the decision as to operation must be deferred for a few hours. If at a second inspection after this interval—i.e., about the usual hour for operating—any fresh mucus is found in the fornix, operation should be postponed. At this second examination, also, one may judge to what extent conjunctival congestion seen on removal of the bandage was due simply to occlusion of the eye. Such congestion will have disappeared in an hour or two, and any injection still remaining may be attributed to the presence of pathogenic organisms. Much less importance attaches to scanty discharge from a conjunctiva roughened and thickened by very chronic inflammation, than from a membrane nearly normal in appearance. For in the former instance, not only may the altered mucous membrane be expected to withstand very vigorous perchlor'de douching, but we have learnt from practical experience not to fear the result of operation performed on such an eye after the suitable douching. It seems reasonable to admit that such con- junctivae may furnish a little abnormal secretion quite independently of the action of any existing micro- organisms. And it is a matter of fairly general observa- tion that in very chronic conjunctivitis the only pathogenic organisms likely to be found are staphylococci of feeble virulence or Morax-Axenfeld diplobacilli. And there ap- pears to be little difficulty in getting rid of diplo-bacilli— temporarily at least (see Chapter IV, Asepsis). We are much more afraid of quite recent conjunctival changes— slight injection, with a mere trace of thickening and rough- ness and of discharge. We fear these, knowing from bac- teriological examination that the conjunctivae of some of
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