A treatise on the diseases of the eye / By J. Soelberg Wells... Together with selections from the test-types of Prof. E. Jaeger and Prof. H. Snellen.

  • Wells, J. Soelberg (John Soelberg), -1879
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the eye / By J. Soelberg Wells... Together with selections from the test-types of Prof. E. Jaeger and Prof. H. Snellen. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    sometimes dilated. This affection is not unfrequently due to prolonged ex- posure to very bright sunlight or intense heat, and is also met with in persons suffering from some irregularity of the general circulation. Compresses, soaked in cold water or in Goulard lotion, should be frequently applied; and a solution of nitrate of silver (gr. iv ad f^j) may be painted over the outside of the lids. If there is much vascularity of the conjunctiva, and a slight muco-purulent discharge, a weak collyrium of sulphate of zinc or alum should be prescribed. A peculiar bluish discoloration of the eyelids (more especially the lower one) is occasionally observed in persons of feeble health, and of a very trans- parent and delicate complexion. This dark tint is especially conspicuous beneath the lower lid, producing a dark-blue, semicircular ring. This ap- pearance is due to a dilatation of the subcutaneous veins, which are more conspicuous on account of the delicacy of the skin. It is often difficult to cure this discoloration, more especially if a certain degree of oedema of the lid coexists. I have found the most benefit from the use of a solution of tannin (gr. iv-viii, to f^j of water), which is to be painted frequently over the outside of the eyelids. When this has been employed for some little time, a solution of acetate of lead or of nitrate of silver should be substituted. Care must, however, be taken that the nitrate of silver does not discolor the skin, which is especially apt to happen at the points where the latter is a little wrinkled. The general health should, at the same time, be attended to, irregularities in the circulation or the digestive functions be rectified, and abstinence from every form of dissipation strictly enforced. [Hemorrhages beneath the skin and in the tissues of the lid occur as the result of rupture of the palpebral vessels, or from the extension of an oi'bital or intra-cranial hemorrhage into the lids. Any blow or fall upon the eye- lids may cause a hemorrhage, and likewise any operation. The palpebral vessels may also be ruptured by any undue stretching of their walls, as during violent vomiting, or sneezing, or coughing. Symptomatic hemor- rhages by dia|)edesis, without any rujiture of the vessels, also occur in scurvy and purpura.—B.] 2._I]SrFLAMMATI0N OF THE EYELIDS, ETC. In the acute phlegmojious inflammation (abscess) of the eyelids, there is great redness, heat, and swelling of the lids, which are also acutely sensitive to the touch. The skin is greatly reddened, and, as the disease advances, it assumes a darker and more dusky hue. The conjunctiva is also injected, and there is often a considerable degree of chemosis. The swelling is firm and hard, and not oedematous; it often extends over the eyebrow and cheek, and may become so considerable that the upper lid is swollen up to the size of a pigeon's egg, or even larger. This hardness is at first especially con- spicuous at one point, which feels like a little, firm, circumscribed nodule; this increases more and more in size, then the hardness gradually yields, the swelling becomes softer, more doughy, and there is a distinct sense of fluctua- tion. The skin becomes thinned and yellow at one point, gives way, and a large quanity of thick creamy pus escapes. In rarer instances, the perfora- tion occurs through the conjunctiva. Wlien the abscess forms at the inner angle of the eye, near the lachrymal sac, it has been termed anchylops, and may then be mistaken for acute inflammation of the sac. If it perforates at the inner canthus, it is called cegilops. It generally, however, occurs in the upper lid, which, on account of the swelling, hangs immovably down, so
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