DISEASES OF THE EYE. 285 



OBSTRUCTION OF THE LACRIMAL APPARATUS, OR WATERING 



EYE. 



The escai)e of teaib on the tiicle of the cheek is a svinptoiu of exter- 

 nal infhiuunation of the eye, but it nnxy also occur from any disease 

 of the lacrimal apparatus Nvhich interferes^ Avith the normal prog- 

 ress of the tears to the no>e; hence, in all cases when this symptom 

 is not attended with special redness (ir swelling of the eyelids, it is 

 well to examine the lacrimal ap[)aratus. In some instances the orilice 

 of the lacrimal duct on the iloor of the nasal chamber and close to 

 its anterior outlet will be found blocked by a i)ortion of dry muco- 

 purulent matter, on the removal of which tears may begin to escape. 

 This implies an inllammation of the canal, which may be helped by 

 occasional sponging out of the nose with warm water, and the a})- 

 plication of the same on the face. Another remedy is to feed warm 

 mashes of wheat bran from a nosebag, so that the relaxing effects 

 of the water vapor nuiy be secured. 



The two lacrimal openings, situated at the uiner angle of the eye, 

 may fail to admit the tears by reason of their deviation outward in 

 connection with the e version of the lower lid or b}' reason of their 

 constriction in inflammation of the mucous membrane. The lacrimal 

 sac, into which the lacrimal ducts open, may fail to discharge its 

 contents by reason of constriction or closure of the duct leading to the 

 nose, and it then forms a rounded swelling beneath the inner angle of 

 the eye. The duct leading froui the sac to the nose may be compressed 

 or obliterated by fractures of the bones of the face, and in disease of 

 these bones (osteosarcoma, so-called osteoporosis, diseased teeth, 

 glanders of the nasal sinuses, abscess of the same cavities). 



The narrowed or obstructed ducts may be made pervious by a fine, 

 silver probe passed down to the lacrimal sac, and any existing inflam- 

 mation of the passages may be counteracted by the use of steaming 

 mashes of wheat bran, by fomentations or wet cloths over the face, 

 and even by the use of astringent eyewashes and the injection of 

 similar lifjuids into the lacriuial canal from its nasal opening. The 

 ordinary eyewash may be used for this purpose, or it may be injected 

 after dilution to half its strength. The fractures and diseases of the 

 bones and teeth must be treated according to their special demands 

 when, if the canal is still left ])ervif)ns. it may be again rendered 

 useful. 



EXTERNAL OPHTHALMIA, OR CONJUNCTIVITIS. 



In inflammation of the outer parts of the eyeball the exposed vas- 

 cular and sensitive mucous membrane (conjunctiva) which covers the 

 ball, the eyelids, the haw, and the lacrimal apparatus, is usiuilly the 

 most deeply involved, yet adjacent parts are more or less implicated, 

 and when disease is concentrated on these contiguous parts it consti- 



