DISEASES OF THE LIDS 37 



Lagophthalmus, or inability to close the lid, is the 

 result of paralysis of the orbicularis palpebrarum, through 

 pressure upon or disease of the seventh nerve. Usually 

 facial paralysis accompanies this condition when the 

 affection of the nerve is posterior to the branches sup- 

 plying the orbicularis. Destruction of the cornea may 

 ensue by exposure. Temporary relief may be had by 

 drawing the lids together, and keeping them closed by 

 the use of adhesive plaster. The cause of the paralysis 

 should be looked for and removed. 



Ptosis, or drooping of the lid, may be partial or com- 

 plete, and is due to paralysis of the levator palpebrarum 

 by reason of pressure upon or disease of the third nerve, 

 or that portion of it supplying this muscle. It may be 

 congenital from absence of the muscle. Injury may also 

 be the cause. In all cases of paralysis the treatment must 

 be based upon general principles. 



Tarsitis, or inflammation of the tarsus, is the result 

 of old trachoma, syphihs, tuberculosis, etc. It is a 

 chronic thickening of the tissue, with infiltration of the 

 tarsal elements. It may follow chronic infection of the 

 meibomian glands. The lid is thick and heavy over 

 the site of the tarsus, and oftentimes partial ptosis and 

 blepharitis are present. The treatment depends upon 

 the cause. Resolvent ointments have been recommended 

 combined with massage. In extreme and chronic cases 

 the tarsus has been removed. 



Elephantiasis is due to hypertrophy of the skin and 



