Lacrimal obstruction in the young / by Donald Gunn.

  • Gunn, Donald.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Lacrimal obstruction in the young / by Donald Gunn. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    12/20 (page 12)
    slight discharge from both eyes, but they were never red. » Under treatment the left eye recovered completely, but the right continued watery. When 2 years old the lower canaliculus was opened and a probe passed. The only effect of this was to make the discharge (which had been thick) thinner. Since then it has altered very little, except to lessen during the summer months. He has been unusually free from colds in the head, and there have never been any signs of nasal obstruction. Operation.—The sac contains muco-pus, and is easily emptied on pressure. The canaliculus is open. A No. 4 probe passes easily into a duct of normal size, the lining of which is quite smooth. At the lower end of the duct it is arrested by a solid obstruction, and the lower end cannot be felt in the nose. On applying pressure the probe passes through the obstruction, giving the sensation that it has perforated a plate of cartilage. The lower end can now be felt in the inferior meatus resting on the floor of the nose. Two months later the mother writes: There has been no discharge, not even a tear in the eye, since the day of the operation. A word as to the treatment of these cases. It is not till the canaliculus has been laid open and a probe passed that the diagnosis of dilated duct can be made with certainty. When the obstruction is formed of mucous membrane, the passage of a probe down the duct into the nose at once establishes an opening, and the case gives no further trouble. But when the lower end is occluded by cartilage and a way has been forced through it, the temporary use of some form of style, to keep the lower opening patent, is advisable. In any case, it is necessary to make sure that the end of the probe has passed on to the floor of the nose ; this can best be done by exploring the lower meatus with another probe passed in at the nostril. The metallic click when the two probes meet removes all doubt.