39S 



DISEASES OF THE EYES 



or partial paralysis of the palpebral muscles. Sometimes it may occur 

 from the shape of the cartilage, which does not consist of a firm disk, but 

 of bunches or collections of connective tissue mixed with elastic fibres. 

 In some cases it may be caused by a contraction of some of the tissues of 

 the face, especially from cicatricial contraction, as a result of wounds or 

 burns. It may also be due to a loosening or softening of the tarsal cartil- 

 age as a result of prolonged conjunctivitis. 



Clinical Symptoms. — The affected eyelid is turned up and out, so as 

 to show the conjunctiva. The latter is inflamed from the action of the 

 air and is more or less reddened, and at the same time there is consideraljle 

 secretion of mucus and tears along the cheeks (lachrymal eyes). 



Therapeutic Treatment. — If it is due to conjunctivitis, we must first 

 endeavor to I'educe it by ''touching" the connective tissue of the eyelid 

 with a pencil of nitrate of silver or sulphate of copper, or by removing a 

 portion of the mucous membrane of the lower eyelid. This, however 



Fig. 136. Fig. 137. 



Figs. 136 and 137. — Entropion operation and mode of .stitching. {Cadiot-Breton.) 



is extremely hard to do, and as a rvile it is not advisable. If these 

 measures are useless, or if they seem doubtful from the onset, Moller 

 recommends to excise from the external half of the affected lid an 

 arrow-shaped or nearly triangular piece of skin and unite it by means of 

 sutures (Figs. 130, 137). Frick's method of excising two crescent-shaped 

 pieces of skin whose concavities are toward the lid and meet at an 

 angle, 2 to 3 cm. from the edge of the lid, and uniting the edges by 

 means of button sutures, has not been found to be as satisfactory as the 

 first-mentioned operation. 



Inflammation of the Eyelids. Blepharitis. — This condition appears 

 as an inflammation of the external covering of the lid (B. superficialis), 

 inflammation of the cellular tissue of the lid (B. profunda), and inflam- 

 mation of the edge of the lid (B. ciliaris). Superficial inflammation of 

 the lid is generally caused by some irritation that involves the skin of the 

 surrounding tissues, such as eczema or parasitic mange, particularly 



