Lectures of the diseases of the eye / by Charles Bell Taylor.

  • Bell Taylor
Date:
1888
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Licence: Public Domain Mark

Credit: Lectures of the diseases of the eye / by Charles Bell Taylor. 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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    nor can I recommend you to attempt any other operation in fulminatiug, acute, or inflammatory glaucoma. In certain specific and in some milder cases, it is true that less severe measures have sufliced, or must perforce be substituted. Sclerotomy, for instance, may take the place of iridectomy in the very incipient or doubtful stages of all forms of the disease ; in hydropthalmos, which is the glaucoma of children, where excision of the iris is so apt to be followed by rupture of the zonule, haemorrhage, escape of vitreous, and collapse of the globe; and it must also take the place of iridectomy in adults suffering from the hcemorrhagic form of the disease, where the too sudden reduction of tension by iridectomy is apt to be followed by similar accidents. It should also be adopted in glaucoma absolutum, where it is impossible to excise the iris, and in cases of long-standing simple glaucoma, where advan- cing blindness is on the eve of invading the macula or point of fixation, and where any coarse operation may precipitate the impending catastrophe. Some ophthalmic surgeons (Schweigger, Wecker) even prefer sclerotomy in inflammatory cases, providing only extreme contraction of the pupil can be previously obtained by eserine, and it is undoubtedly useful as a preliminary to iridectomy when the inherent difficulties of the latter operation may be to some extent removed by a previous reduction of tension. In performing sclerotomy, the knife should enter and emerge in the corneo sclerotic junction, precisely as if you were going to make a flap of four milimetres ; pushed upward with a to and fro movement, and then slowly withdrawn, leaving about a fourth undivided.*—(Figs. 2 and 8.) * Sclerotomy does not act, as has been supposed, by the production of a permeable scar, but probably by establishing a new path by which fluid can reach the corneal and scleral lymph spaces from the retraction of the cut membrane of Doscemet, (the posterior elastic lamina of the cornea).— Brailey.
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