A clinical manual of diseases of the eye : including a sketch of its anatomy.

  • Daniel Bennett St. John Roosa
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: A clinical manual of diseases of the eye : including a sketch of its anatomy. 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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    thus raised to an extent rather greater than it is desired to per- manently obtain. The knots are tightened above from time to time, until the threads have ulcerated their way through the tracks along which they were passed. It is said to be rather a severe operation, and is followed by great swelling. It is known as Demmet's thread operation. Panas' operation is one somewhat in vogue, and is performed as follows: An assistant applies his hand to the patient's fore- head to prevent the drawing down of the skin of the lid. An ncision is then made along the line of the upper border of the tarsus. It is not continued along the whole line, but beginning immediately over one canthus, and leaving a central portion of a third of an inch uncut, it ends at a similar point above the other canthus. A second horizontal incision, with a slight con- vexity upward, and not quite an inch in length, is made in the position of the fold separating the eyebrow and lid, and, there- fore, just above the orbital margin. This incision passes through all the tissues down to the periosteum. It is then joined, by means of two short vertical incisions, with the inner extrem- ity of the external portion and the outer extremity of the in- terna] portion of the lower incision. Still another incision is made, parallel to the second, somewhat more than one inch in length, along the upper border of the eyebrow, also deep enough to extend to the periosteum. The skin marked out by the mid- dle and lower horizontal, and the two vertical incisions, is next dissected free from the tarsus down to the ciliary border. The bridge between the middle and upper incisions is then under- mined, in doing which any wounding of the periosteum or sus- pensory ligament should be avoided. When this has been done, the dissected flap is pressed up underneath the undermined bridge, and attached by three sutures to the upper edge of the upper incision. The advantage of this operation is that it raises up the tarsal portion of the lid, and, at the same time, causes the occipito-frontalis muscle to act for the absent or paralyzed levator. Berry ' speaks well of the efficiency of this operation. 1 Text-Book, p. 662 et seq.