56 SURGICAL APPLIED ANATOMY. [Chap. iv. 



account it is inadvisable to apply leeches to the 

 lids, on account of the extensive " black eye" that 

 may follow. This tissue is peculiar in containing no 

 fat. At the edge of the lids are found the eyelashes, 

 the orifices of the Meibomian glands, and of some 

 modified sweat and sebaceous glands. This edge, like 

 other points of junction of skin and mucous mem- 

 brane, is apt to be the seat of irritative affections. 

 Being a free border also, the circulation is terminal, 

 and stagnation in the blood current is not difficult to 

 produce. Sycosis, an inflammation involving the 

 hair follicles and some of the glands at the edge of the 

 lid, is among the most common of ophthalmic affec- 

 tions. The common stye also is a suppuration in the 

 connective tissue or in one of the glands at the 

 margin. On everting the lid the Meibomian glands 

 can be seen through the conjunctiva as lines of 

 yellowish granules. The common tarsal cyst is a 

 retention cyst developed in one of these glands. 



The conjunctiva. The ocular part of this 

 membrane is thin, very loosely attached, and not very 

 extensively supplied with blood ; the palpebral portion 

 is thicker, more closely adherent, and more vascular. 

 At the edge of the cornea the conjunctiva becomes 

 continuous with the epithelium covering that tunic. 

 The looseness of the ocular conjunctiva allows it to be 

 freely moved about, and is of great value in some 

 operations : as, for example, in Teale's operation for 

 symblepharon, where a bridge of conjunctiva, dis- 

 sected up from the globe above the cornea, is drawn 

 down over the cornea to cover a raw surface in 

 contact with the lower lid. This lax tissue favours 

 the development of oedema (chemosis), which in 

 extreme cases may reach such a degree that the patient 

 cannot close his eye. The vessels also, being feebly 

 supported, are prone to give way under no great 

 provocation. Thus, subconjunctival haemorrhages may 



