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)

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    Any abnormal growth or persistence of the cartilages might, therefore, block the duct. In cases Nos. 3 and 7 there was evidence of this condition being present. (2) The fact that the margins of the eyelids are cemented together till shortly before birth does not do away with the possibility of tears passing from the con- junctival sac into the lacrimal passage, for, the puncta being inclined backwards, they are free to work even when the lids are closed—as in sleep. As, however, the eyes are completely protected from external stimuli, the secretion of tears, if it takes place at all, is probably very slight. (3) During late foetal life all mucous surfaces secrete a certain amount of fluid and shed their epithelial waste. The meconium contains bile, but consists mainly of waste matters derived from the lining mem- brane of the gut and its accessory glands. . The cavity of the vagina at birth is filled with a solid mass of epithelial cells. The lacrimal sac and duct, as they are lined by epithelium and possess mucous and acinous glands, are doubtless able to secrete the material for their own distension—given, that is, an obstruction low down in the duct. On looking through the notes of my cases of lacrimal disease in children, most of which have come under my care at the Hospital for Sick Children, Great Ormond Street, I find that they fall most readily into two main groups, an early and a late. ist. The early group to include those cases in which the trouble was present at birth or soon after birth. 2nd. The late group of those cases in which the child for the first few years of its life has been free from any suspicion of lacrimal obstruction, but de- velops a lacrimal abscess later on. These, being obviously not congenital cases, contrast most fairly with the adult class. 1 will further subdivide my two main groups thus :—