The Diagnosis and treatment of the diseases of the eye / by Henry W. Williams.

  • Henry Willard Williams
Date:
1886, ©1881
Catalogue details

Licence: Public Domain Mark

Credit: The Diagnosis and treatment of the diseases of the eye / by Henry W. Williams. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    Where this occurs in the lower lid the inversion may often be rectified by carefully fastening strips of isinglass or adhe- sive plaster, vertically, to the skin, near the border of the lid, and then, after drawing this downward, securing it upon the skin of the cheek. The same effect may sometimes be obtained by painting the skin of the lid, and its neighbor- hood on the cheek, with collodion, which exerts a contrac- tile action. Should these appliances become detached they must be renewed, and continued for a few days. If in aged people these prove ineffectual, on account of the laxity of the parts, excision of an oval bit of skin, with fibres of the orbicu- laris, and suture of the edges of the wound is a sure relief; or, in lieu of excision, three vertical sutures may be passed through a fold of the skin and tied. The amount of skin to be thus removed or tied may be measured by raising folds of different size with forceps till the proper effect is seen to be obtained. This slight operation is almost painless, and gives great satisfaction. In chronic entropion, resulting from injury, or from con- traction of the tarsal cartilage by trachoma, numerous oper- ations have been recommended, none of them completely satisfactory as being a permanent benefit. An expedient which may suffice in the simpler- cases is cant7io]jlasty, or division of the external commissure of the lids. One blade of strong scissors is passed as far as possible inside the outer canthus, and the skin and conjunctiva are divided at one stroke. The edges of the wound are now to be stretched wide apart without further dissection, and the skin and the mucous membrane are then to be united to each other by three or five sutures in the upper and the lower lids; so as in fact to lengthen each of these, and relax the pressure on the eye. But when the tarsal cartilage is strongly incurvated, it is necessary, if interference is deemed advisable, to devise means by which it shall be bent outward. Snellen, Streatfeild, Wells, and others have proposed meth- ods for longitudinally grooving the anterior surface of the