A treatise on the principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones.

  • Jones, Thomas Wharton, 1808-1891.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    747/888 (page 669)
    sai aw ;■ :al anchyloblepharon, it is necessary, before proceeding operate, to direct attention to the state of the eyeball ■ regards prominence and firmness, and whether or not [L ee case is complicated with symblepharon, or adhesion • the eyelid to the eyeball. The degree of sensibility to ;ht ought also to be had regard to as an indication of tij > e condition of the eyeball. i'JTo determine whether or not the case is complicated • th syniblepharon, or adhesion of the eyelid to the eye- ' ii,ll, the united eyelids are to be pinched up into a fold, ittd the patient desired to move the eyeball about and to ako efforts as if to open and shut the eye. During is, the attention of the surgeon is to be directed as to J aether the eyeball moves freely or not behind the •elids. The point may be also ascertained by passing probe through the opening at the inner or outer angle, such exist, and observing whether or not it can be eely moved up and down in the oculo-palpobral space. The operation for partial anchyloblepharon is performed Y passing a director behind the part where the borders : the eyelids adhere, whilst an assistant stretches the pper eyelid upwards, and the lower downwards, and ^parating them with a scalpel, taking care, in the case immediate union, not to cut the proper substance of ie tarsus either of the one or other eyelid. If the anchy- iblepharon be mediate, the false membrane is to be jtached first from the border of the lower e3'elid, and ien from that of the upper, a scalpel or scissors being e instrument employed according to the thickness and : nnexions of the false membrane. In the case of total anchyloblepharon, if there is an )ening at the inner angle, a director or probe is to be issed through it behind the united eyelids, and their sparation effected in a manner similar to that just indi- ited. If, however, there is no opening, the united eye- ids are to be pinched up into a vertical fold, drawn om the eyeball, the assistant taking charge of the upper jrelid, the surgeon himself the lower, and the united lges separated at the part. Through the openino- thus lade the director is passed, and run along, first to the mer angle, and the adhesion divided in that direction, id then to the outer angle, and the adhesion divided in lat direction. The operation which has now been described, it will be bscrved, is of comparatively easy performance, but the