342 On the Staphyloma, Hydrophthahnia, 



the cornea being both opake and prominent, an aperture 

 had taken place spontaneously on the side of tlie eye next 

 the temple, just in that part where tlie cornea is joined to 

 the sclerotica, and through it a small portion of matter had 

 escaped; but the tension of the eye coiitinutd, and the 

 wound was only large enough to. admit tlie blunt end of a 

 probe. The propriety of enlarging the aperture naturally 

 suggested itself f and as the eye had not been useful for a 

 long time as an organ of vision, a suiall blunt-pointed bi- 

 stoury was immediately intr.iduced through the wound, to 

 the depth of at least a quarter of an inch, and the incision 

 was carried three quarters of an inch in a direction towards 

 the temple, dividing at the same time the sclerotica cho- 

 roides and retina, and making a large opening into the body 

 of the vitreous humour. No part of this humour, how- 

 over, nor any sort of fluid, issued through the wound at the 

 time of the operation. The eyelids were immediately closed, 

 without any pressure being marie on the eye, and directions 

 were given to apply an anodyne fermentation, in the same 

 way in which it had been frequently before used. An anodyne 

 draught was intended to be given; but within half an hour 

 the patient fell into a sound sleep, which lasted several hours. 

 She awoke much refreshed and perfectly easy. The wound 

 discharged more or less of matter for a fortnight; the pain 

 did not return; and the eye gradually diminished, so that 

 in. a short lime it did not appear to he more than one half 

 of its natural size. 



Purulent matter is sometimes also formed behind the eye 

 in the adipose substance that supports this organ in the 

 orbit. If the suppuration be quick in its progress, and be 

 not situated deep, the fluctuation of the matter may be easily 

 felt, and the propriety of discharging it be determined at 

 once; but if, as I have occasionally found, the suppuration 

 be slow, and the matter lie considerably below the surface, 

 the eye will be protruded before any fluctuation can be dis- 

 covered ; and the existence of the matter will only be learned 

 by paying attention to the accompanying symptoms, sucl^ 

 as a quick pulse, white tongue, shiveriiigs, &c. In a case 

 of this kind, which occurred in a child six years old, which 

 was attended also by Mr. Hill in Bedford-row, I passed a 

 lancet, on the side of the eye next the nose, a little below 

 the commi.-.sure of the eyelids, at least an inch into the orbit, 

 before I reached the matier. On withdrawing the instru- 

 ment its point was evidently marked with pus. ^ I therefore 

 enlarged the aperture with a b'unt-poinied bistourv, and 

 discharged a considerable quautiiVj which was thTck and 



puliid, 



