The anatomy and diseases of the lachrymal passages / by W. Spencer Watson.

  • Watson, W. Spencer (William Spencer), 1836-1906.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: The anatomy and diseases of the lachrymal passages / by W. Spencer Watson. Source: Wellcome Collection.

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    secondary result to irritation and even excoriation of the ad- jacent skin. b. Any inflammatory conjunctivitis with general swelling forces the eyelids away from the eyeball, and with them the puncta. Polypoid outgrowths and tarsal cysts act in the same way. c. Senile entropium is the most frequent cause of inversion of the eyelid and is due to the wasting of the fatty tissue of the orbit'in aged persons. The eyelid becomes rotated inwards on its horizontal axis. The same thing sometimes results from purulent ophthalmia. The lower puncta are then directed downwards, or may even be turned forwards by a complete in- volution of the lid and their proper functions are interrupted partly by their abnormal position and partly by the extension of inflammatory swelling to their orifices. Entropium, due to cicatricial contraction of the ciliary margin of the eyelids, whether from chronic blepharitis or inverted and irregular eye- lashes, or from contraction of the conjunctival surface of the lid due to cysts or ulcers or injuries, has a similar result to those described under c. Besides the overflow of tears with its attendant discomforts which result from their inversion or eversion, the puncta may in the course of months or years, if not replaced, become atro- phied or contracted by inflammatory effusion and may even be obliterated. Treatment—The displacements due to temporary causes of an inflammatory nature may often be restored to a normal condition by remedies applied to the primary mischief. The eczema or blepharitis may in acute cases be cured rapidly and the puncta may then regain their normal condition. The same may be predicated in the early stages of relaxed lower eyelid of aged persons, and in the senile entropium it is sometimes possible to restore their position by suitable remedies com- menced early. These, however, are the exceptions. As a rule, the overflow once established the local oedema and swelling are aggravated by the irritation of the morbid secretions, and hence it is necessary in the majority of cases to restore the flow by surgical means as a preliminary to treatment of the primary affection. For this purpose the lower punctum should be laid open by a Bowman's or Weber's canaliculus knife (see figs. 4