An analysis of a series of 500 consecutive operations for primary cataract performed in five months in the Government Ophthlamic Hospital, Madras / by R.H. Elliot.

  • Elliot, Robert Henry, 1864-1936.
Date:
1902
Catalogue details

Licence: In copyright

Credit: An analysis of a series of 500 consecutive operations for primary cataract performed in five months in the Government Ophthlamic Hospital, Madras / by R.H. Elliot. 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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    G or of iritis. Such cases, which are fortunately few in number, are detained as in-patients till the eye is absolutely quiet. A little catarrh, unaccompanied by pain or photo- phobia, is not an uncommon complication of convalescence , this does not prevent the patient being discharged and I have no recollection of having ever seen any harm come of it. Preparation of the patient.—In an Indian hospital, with many waiting for every empty bed it is not possible to keep a patient long under observation before operation, lam- inations of the conjunctiva are carefully seen to. Ihe common type met with was a very subacute catarrh which was dealt with by the daily application of a solution of nitrate of silver (three grains to the ounce). Lacrymal obstruction was always deflt with beforehand when possible but provided that the discharge, on pressure was clear and non-purulent an operation was not deferred a-ter dilatation of the stricture. In addition to the measures suggested by ordinary cleanliness the lashes of the temporal half of the upper lid were cut the day previous to operation in order to avoid soiling the knife during operation. For hospital patients atrfpine is used on the day before ^Sinction for private patients homatropine is used. The distinction is due to the necessity for taking notes of so large a number of cases previously to operation and to other equa ly nlwinns needs imposed by routine when dealing with 30 or more operation cases in a day. For quiet patients cocaine suffices and the majority do not appear to suffer any pain from the operation, even though an iridectomy is peiformed , when patients are nervous morphia (from a quarter to one- third of a grain subcutaneously a quarter of an hour before tniraoi g Whenever a patient gives trouble °^rtrlst e4 or wni not lie quiet when brought on the tobt el g ven moTphia. The^esult is marvellous. He then lies still and obeys every order, making the operation easy and safe. The eye is freely irrigated with chmosol solution (1 in 5000) immediately before the operation. Any flakes o mucus are removed with cotton-wool sponges mounted on sticks and carefully sterilised beforehand by bolting The method of irrigating the conjunctival sac with nerchloride of mercury was carefully tried ; the resulting dOTMlesl due to the quality of the perohloride supplied.