A handbook of ophthalmic science and practice / by Henry E. Juler.

  • Juler, Henry E. (Henry Edward), 1866-1921.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of ophthalmic science and practice / by Henry E. Juler. 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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    at the same time. They vary in size, their diameter ranging from three to ten millimetres. Each consists of a chronic hypertrophy of the deep portion of a Meibomian gland, con- taining accumulated secretion which is sometimes liquid and puriform, sometimes solid, homogeneous, and comjjosed of sebaceous substance. The tumour is generally hard and spheri- cal, fixed to the tarsus, but not to the skin. On everting the eyelid, a bluish discolouration is observed; this is due to thinning of the tissues beneath, and corresponds to the position of the tumour. It develops slowly, and may cause no incon- venience for several months, but, if left alone, it often inflames, and sometimes suppurates, pointing generally through the con- junctiva, but occasionally externally. In this way it may finally disappear by contraction. Treatment,—The tumour must be removed by surgical means. In the majority of cases it is best to operate from the Fig-. 2.—Compressing Forceps for Eyelid. inside of the lid, but when there is pointing outwards the incision must be made through the skin, and in the same direction as the fibres of the sphincter orbicularis muscle. The natm-e of the operation should vary according to the character of the tumour ; if this has fluid contents it will be sufficient to make a crucial incision thi'ough the conjunctiva of the everted lid, and to scoop out the contents with a curette. The cavity often fills with blood after the operation, but this becomes absorbed in about ten days. \\hen the tumour has thick walls and solid contents extirpation is the only remedy. This may be done by fixing the eyelid in compressing forceps (see fig. 2). If operating through the skin the solid blade must be passed under the lid and the riuof blade made to encircle the tumour. An incision must then be made over the tumom', parallel to the edge of the eyelid, through the skin and subcutaneous tissues until the