Practical remarks on strabismus : with some novel suggestions respecting the operation / by G. Critchett.

  • George Critchett
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: Practical remarks on strabismus : with some novel suggestions respecting the operation / by G. Critchett. 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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    tiien be passed through it, as low down—that is, as near the inner comer—as possible. Two or three sutures may be passed in this way, at intervals of about two lines. The corresponding part of each suture must then be passed through that portion of conjunctiva which has been left attached to the sclerotic near the cornea. This constitutes another difficulty, because the membrane is here so thin that the fine sillt is apt to cut through; this I found a serious difficulty, in my first operation, and one that materially interfered with success. In order to obviate this, I adopt now the following expedients:—I first separate this portion a little upwards towards the cornea; the needle must then be passed through it, and then back again, so as to include a portion, which must be tied tightly, so as to prevent it from tearing out. The next point is to cut away all that portion of the lower flap that can be spared beyond the part where the suture has entered, merely leaving a sufficient margin to hold it. The silks may be now drawn tightly, and tied to the end that is already fixed near the cornea. The immediate effect of this proceeding ought to be to procure some inversion, if the various steps of the operation have been properly performed. The hope and intention are, to get the parts to unite to the globe in their new position, and thus retain the eye. This, however, is only partially the case; there is always some tendency to relapse, and in two cases I had to repeat the operation, but with ultimate success. The sutures may be allowed to remain until they ulcerate through ; the subsequent inflammation is usually slight. The amount of mobility in the eye is very limited, but so long as it occupies a central position this circumstance is not found practically to occasion much deformity, and is an immense improvement upon the facial discord resulting from extreme eversion. My friend and colleague, Mr. Bowman, has performed this operation at the Ophthalmic Hospital, with his usual neatness and dexterity, and the effect was very perfect. My own experience would lead me now to undertake such a case with confidence in the result, if the patient would persevere; if sufficient effect is not obtained by the first operation, a second is almost sure to succeed. I may mention that one favourable effect of the operation is the drawing forward and restoring the inner caruncle to its natural place, the deformity being much increased by the sinking of this part. JOHN ANDKR80N, PRINTER, GARDEN ROW, DEPTFORD NEW TOWN
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