Diseases and injuries of the eye : their medical and surgical treatment / by George Lawson.

  • Lawson, George, 1831-1903.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Diseases and injuries of the eye : their medical and surgical treatment / by George Lawson. 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.

    381/420 (page 365)
    Wlien tlie distension is acute it is due to inflammation of the mucous membi-ane of tlie sinus, which leads to the formation of pus. There is generally a dull aching pain over the brow and i*oot of the nose, accompanied by con- siderable constitutional disturbance. The pus gradually accumulates in the frontal sinus, and ultimately dis- charges itself either by bursting into the nose, or by making an exit for itself through the upper and inner part ot the orbit. When the latter site is selected there is usually some bulging of the distended sinus into the orbit, and a slight displacement of the eye downwards and outwards. The upper lid becomes red and swollen, and the tumour examined with the finger is tender, and will, if sufficient thinning of the bone has taken place, impart a sense of fluctuation. In most cases the distension of the frontal sinus is chronic, and the collection of fluid within its walls is the pent-up secretion of many years. Sealed ^vithin a bony cavity, no decomposition ensues, and increasing year by year in quantity it distends the sinus and displaces the eye. There is frequently no pain, not even a sense of weight over the brow. The only symptoms which are manifest to the patient are, the gradual formation of a tumour at the upper and inner portion of the orbit, and a slow but steadily increasing protrusion of the eye downwards, outwards, and forwards. In one patient under my care (fig. 85), the displacement was so extreme that the upper margin of the cornea of the left eye was below the level of the TUjlit lower lid. Occasionally the early symptoms are chronic, whilst the later ones are sub- acute, and productive of a feeling of constant heaviness and aching across the forehead. The disease is usually confined to the frontal sinus of one side, but a case oc- curred under Mr. Hulke of a man in whom both frontal sinuses were affected. Treatment of Distension of the Frontal Sinus.—The objects to be attained are, first to evacuate the pent-up fluid, and then to establish a free communication between the frontal sinus and the nose, through which the secre- tion may continue to drain as fast as it is secreted. By these means the cavity of the sinus will gradually collapse, and the eye will be restored in a great measure to its normal position. The ends to be desired will be accom- plished by the following operation :— A single curved incision parallel with the fold above