The principles and practice of ophthalmic medicine and surgery / By T. Wharton Jones. With one hundred and ten illustrations.
- Jones, Thomas Wharton, 1808-1891.
- Date:
- 1856
Licence: Public Domain Mark
Credit: The principles and practice of ophthalmic medicine and surgery / By T. Wharton Jones. With one hundred and ten illustrations. 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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![the posterior than the anterior, and parallel to them, there is ob- servable, on close inspection, a row of minute pores—the execretory mouths of the Meibomian follicles. Fig. 1. The tarsal border of the eyelids may be found inflamed—perhaps ulcerated (ophthalmia tarsi), in which case the eyelashes will be incrusted partly with dried Meibomian discharge, partly with the discharge from the ulcers. Hordeolum, or stye, is another form of inflammation of the free margin of the eyelids. Inflammation and abscess of the Meibomian follicles simulates the appearance of stye externally, but is a rarer occurrence. The eyelids, at their edges, or close to their edges, may present small tumors, thickening, and callosity, unattended by any great degree of inflammation, viz., chalazion, tylosis, &c. The eyelashes are sometimes the seat of phtheiriasis [pedicnli], which is apt to be overlooked, except a closer examination be made [with a magnifying glass.] Madarosis, or loss of the eyelashes, is at once recognized. The eyelashes are often found in greater or less numbers turned in against and irritating the eyeball, constituting trichiasis and distichiasis. The sui'geon should always take particular care to assure himself, therefore, of the direction of the eyelashes in cases of chronic ophthalmia; and in order to do so, and to see properly the broad surface of the tarsal border, and the state of the Meibo- mian apertures, the eyelids should be slightly everted by gentle pressure with the point of the finger on the skin of the eyelid, the eyelashes being kept between the finger and the skin. By this means it will generally be at once seen if any of the eyelashes are growing in against the eyeball. Sometimes, however, such eyelashes are so pale and fine that they are apt to escape notice. The presence of these may often be detected by attention to the following point when they might otherwise be overlooked :— the tears, of which there is in such cases generally more than usual, rise up around the pale, misdirected eyelashes, and between the eyelid and eyeball, by capillary attraction, and occasion a marked reflection of light at the place. [In searching for these, as well as for other conditions, a magnifying glass is of great service, and ought generally to be employed.] One or more of the Meibomian apertures may become covered with a thin film, apparently of epidermis, which prevents the escape of the secretion, so that the latter accumulates and raises the film up into a small elevation like a phlyctcnula. The Meibomian discharge is increased, whenever there is any irritation of the edges of the eyelids, and especially of the palpebral conjunctiva. The posterior edge of the tarsal border, which is in its natural state sharply defined, may be found rounded or obliterated, in con-](https://iiif.wellcomecollection.org/image/b21018339_0056.jp2/full/800%2C/0/default.jpg)
