On the certainty and safety with which the operation for the extraction of a cataract from the human eye may be performed, and on the means by which it is to be accomplished / by G.J. Guthrie ; with remarks by Captain Kater on certain spots discoverable in the human eye, and on the manner of detecting their situation.

George James Guthrie

Date:: 1834

Credit: On the certainty and safety with which the operation for the extraction of a cataract from the human eye may be performed, and on the means by which it is to be accomplished / by G.J. Guthrie ; with remarks by Captain Kater on certain spots discoverable in the human eye, and on the manner of detecting their situation. 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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former case it cannot; and of the two evils, the last should always be chosen, inasmuch as it will lead to the recovery of the patient with a good eye, which the other cannot do. The eyelid, being at last closed, is to be retained in that situation by compress and bandage ; and it is not to be raised, or the eye opened, for a certain length of time, the duration of which is different, according to different writers. It ought to depend on circumstances ; the earliest period is on the third day, but the fourth is much better ; and if any difficul- ties have been experienced during the operation, and there is reason to suspect that union has not taken l)lace, the lid should not be raised for at least a week ; although the lower lid may be depressed, to enable the surgeon to see the state of the ball of the eye, and to prevent the accumulation of fluids in it. I never open the eye before the fourth day, although I frequently depress and clear the lower lid on the third, and obtain a view of the globe, the whiteness of which is the best sign of the absence of inflam- mation. When the eyelid is raised too soon, that is before the union of the cut parts of the cornea is complete, the movement of the globe of the eye, which inevitably follows the raising of the lid, often sepa- rates the incompletely united parts; pain of a more or less acute nature is soon felt in the line of the incision, inflammation follows, ulceration succeeds, and the cornea is only completely united by a slow process, attended by opacity, and generally by a drawing up of the pupil; all of which evils would have been avoided in a great measure by delaying the raising

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