412 DISEASES OF THE EYES 



obtained very satisfactory results with hot fomentations of boric acid 

 (3 parts to 100). These shoukl be applied three times daily, ten minutes 

 at a time. They are far better than cauterizations with nitrate of silver 

 or painting with pyoktanin. 



Besides the antiseptic treatment we can use atropine or eserine 

 solution, of which a few drops are put in the eye. The first-named 

 agent should be applied when the ulcer is located centrally, as it dilates 

 the iris, and consecjuently the pupil is enlarged, and the latter when 

 the ulceration is located on the borders as it contracts the pupil and 

 draws it away from the seat of irritation. There is an objection to 

 atropine in that it increases the internal pressure by widely dilating the 

 pupil. The iris is dilated or contracted by these drugs and removed 

 from the neighl^orhood of the ulcer, so that if the perforation does not 

 occur the iris will be drawn far enough out of the road to prevent any 

 adhesion. 



Good results have been obtained with cocaine, alternating with 

 atropine : 



J\. Atropine sulphate, 0.1 



Aqua distil., 10.0 



M. S. In order to produce a dilatation of the pupil we 

 must introduce five drops of this remedy into the 

 conjunctiva, drop by drop, by means of a brush or a 

 dropper. 



I}. Eserine salicylate, 0.05 



Aqua distil., 10.0 



When a keratocele is developed we may prevent rupture by punc- 

 turing the membrane with a needle and allowing the water in the chamber 

 to escape. In prolapsus and adhesion of the iris we can do very little, 

 as it is impossible to push back the iris into place. We must dust the 

 protruded portion with calomel; at the same time we may reduce the 

 enlargement by means of nitrate of silver or sulphate of copper solutions, 

 or a powder of oxide of mercury blown on the eyeball. In iris staphy- 

 loma, where the tissue does not wedge and contain a portion of the con- 

 tents of the anterior chamber, the eye may be cocained and by means 

 of a very sharp pair of scissors the staphyloma may be carefully cut 

 down; if, however, the protruded portion is filled with the fluid portion 

 of the anterior chamlier, a threaded needle is carried through the centre 

 of the protruded portion and the thread cut at the needle and thus 

 making two ligatures which are tied right and left dividing the enlarge- 

 ment into two poi'tions, the ligatcd portion of the cornea will dry and pull 

 off in a few days with the ligatures, leaving a surface which dries up very 

 quickly with the ordinary antiseptic treatment. 



