DISEASES OF THE CONJUNCTIVA. 



115 



Fig. 47. 



(f^) 



The sac should then be fomented and thoroughly cleansed, and 

 after a few days, should any doubt exist with reference to the per- 

 viousness of the tubes and sac, an exploration is to be made by 

 probes. 



Should the obstruction be firm, the opening into the sac will 

 remain fistulous, and then a style must 

 be introduced. The object of the style Fig. 46. 



is to dilate the strictured portion of the 

 sac. The form and size is represented 

 in the cut. They are usually made of 

 lead, silver, or gold, and sometimes of 

 catgut. Some have thought best that 

 there should be a groove on the style, 

 or that it should be hollow, but this is 

 unnecessary ; for although the style 

 may occupy the whole of the calibre of 

 the duct when first introduced, the tears gradually widen it, 

 and flow readily by the side of it. 



DISEASES OF THE CONJUNCTIVA. 



Acute Conjunctivitis. — Symptoms. — Smarting, heat, stiffness, 

 with a feeling as if dust had got into the eye. Subsequently the 

 secretion of mucus increases ; which becomes puriform. The 

 vessels of the conjunctiva are turgid and numerous, giving it a 

 bright red appearance. There is slight intolerance of light and in- 

 creased flow of tears. 



Causes. — Cold or damp, bad condition of stomach, or local irri- 

 tation. 



Treatment. — A dose of calomel followed by a saline cathartic ; 

 leeches, cold applications, moderately dark room, and a solution of 

 nitrate of silver. The disease may become chronic ; when blisters 

 behind the ear, and astringent applications to the eye will be useful. 



Purulent Ophthalmia or conjunctivitis and Egyptian ophthalmia, 

 are more severe forms of the same affection, and are infective. The 

 most severe form of inflammation of the conjunctiva is gonorrhceal 

 ophthalmia ; in this variety the eye is often lost. The treatment must 

 be early and active. 



Scrofulous Conjunctivitis. — Sy')nptoms. — Extreme intolerance of 

 light, the eyelids are spasmodically contracted, the head is turned 

 away from the light, there is no general vascularity of the conjunc- 

 tiva, but a ^Q\\ vessels running towards the cornea, terminate in 

 phlyctenulae, or pustules on the cornea. This disease is most 

 obstinate and liable to perpetual recurrence, often resulting in 

 ulceration of the cornea, or opacity from effusion of lymph between 

 its layers. 



Treatment. — Local applications are of no avail unless the gene- 



