Epiphora, or watery eye : its successful treatment by the new method of dilatation / by James Vose Solomon.

  • Solomon, James Vose.
Date:
[1860?]
Catalogue details

Licence: Public Domain Mark

Credit: Epiphora, or watery eye : its successful treatment by the new method of dilatation / by James Vose Solomon. 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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    S2 of the cartilage; and the palpebral irritation is extended to the skin of the lid, which, with the attempts made by the patient to allay it by frequent wiping, causes the cuticle to become more rough and contracted than normal. I have a patient under my care with eversion of the lower punctum consequent on thickening of the submucous tissue of the lid, in whom I can at any time produce this eczemoid condition by applying a feebly-acidulated solution of atropine to the eyes for a few days, and so exciting marked conjunc- tival irritation and chemosis. Moreover, the cure olF the epiphora has been followed, in the cases which I have observed, by the subsidence of the integumental disorder (Case XX). The description given above relates to the lower eyelid almost exclusively. In some of the cases, in order to find the punctum it is necessary to try the spot which we conjecture it to occupy with Oritchett's grooved steel probe. The orifice is sometimes blocked up with epithelial scales, sometimes cicatrised over, in others con- tracted to the extent of being invisible. The punctum may be displaced quite independently of any rounding of the edge of the lid which is simply thickened. In these cases the punctum is set vertically in the extremity of the cartilage, and a narrow border of lid substance intervenes between it and the surface of the eye: in some there is also enlargement of the caruncle and thickening of the semilunar membrane. In the first kind of displacement the new method of treatment and the application of the usual means employed for chronic tarsal ophthalmia or its sequences are followed by very satisfactory results. When there is ectropion, such a procedure as the study of the case may indicate must be adopted : — In the second, in addition to division of the pimctum and canaliculus, and the use of the sound, the inner margin of the channel must be excised. I have met with instances in which it was impossible to obtain a sufficient proximity of the canal until a portion of the caruncle had been removed.
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