21 



of the eye on the margin of each lid. Occasionally the 

 canal or the tear ducts are obliterated, resulting from catar- 

 rhal or infectious inflammation and from fractures of bones 

 along the course of the canal. In such cases it may be 

 made pervious by forcing a small silver probe into the canal ; 

 but sometimes the canal is so completely obliterated that it 

 is impossible to open the old passage way for the tears. 

 When the conjunctiva or the eye lids are inflamed and when 

 the under lid is everted in ectropium, the openings of the 

 tear ducts are closed or are so displaced as to prevent the 

 passing ot the tears into the ducts. After recovery from 

 these diseases, the tears cease to flow over the cheek. 



DISEASES OF THE TISSUES SUEROUNDING THE 

 EYE AND IN THE ORBITAL CAVITY. 



Fractures, bruises and wounds may take place in the 

 bones and tissues surrounding the eye, and must be treated 

 according to the conditions presented. Generally speaking, 

 continual application of cold water baths or fomentations to 

 the injured parts will materially reduce and prevent inflam- 

 mation. Tumors or new growths of various kinds may ap- 

 pear in the orbital cavity outside of the eye ball. As a rule, 

 they are very serious and eventually necessitate the removal 

 of the eye ball with its surrounding tissues and sometimes 

 requires excision of the eye lids and the skin with other tis- 

 sues in the neighborhood of the eye. Whenever cancerous 

 growths begin to spread or extend to the parts around the 

 eye it is well to cut away all the parts involved. Such ma- 

 lignant growths are liable to return, even after several re- 

 movals. Deep seated, spreading tumors of the orbital region 

 should always be considered as very serious and as nearly 

 always incurable without complete incision. 



