A manual of the principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones.

  • Jones, Thomas Wharton, 1808-1891
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones. Source: Wellcome Collection.

    476/620 (page 434)
    2195. The lid being thus set free, a transverse fold of its skin is then to be removed from near its ciliary margin, and the edges of the gap thus produced brought together by two or three stitches. The threads forming the stitches are to be left long. The eyelid is now to he everted and turned up, and kept in this position for a few days by means of the threads fixed to the forehead by strips of plaister. The per- pendicidar incisions are thus prevented from uniting by the first intention. They are permitted to heal only by granula- tion. After the removal of the ligatures, the eyelid is, by the cicatrization of the perpendicular wounds which ensues, gradually drawn into its natural position without being again inverted. During the time the eyelid is kept everted and turned up, it is to be covered with a piece of linen spread with simple cerate. 2196. In cases of entropium of the lower eyelid from transversely contracted tarsus, I have performed the opera- tion in the following manner with perfect success. An in- cision though the whole thickness of the lid being made i! perpendicular to its edge near the outer canthus, a piece of ! the skin of the lid is excised, and then the lid kept in the everted position by fixing on the cheek the end of the thread forming the suture, which unites the edges of the wound ( left by the excision of the piece of skin. 2197. When, as often happens, in inveterate cases of the form of entropium under consideration, the operations just described prove ineffectual, recourse must be had to extir- pation of the bulbs of the eyelashes as in trichiasis. Trichiasis and distichiasis. 2198. Trichiasis is a growing in of eyelashes against the ! eyeball, the border of the eyelid remaining in its proper ' < position, which circumstance constitutes the distinction be- tween trichiasis and entropium (s. 2175)- lacrymal gland, together with some of the lacrymal ducts ; hut in the cases in which I have performed the operation, I have not ob- served any lacrymal fistula or other bad consequence follow. The incision near the inner canthus ought always to be on the temporal side of the punctual, in order to avoid cutting the canalicule. $ 5; It ; h