PROLAPSE OF THE EYEBALL 427 



the cornea, which assumes a horny appearance, the eye must be con- 

 sidered as lost. 



The therapeutic treatment consists in returning the eyeball as soon 

 as possil)le, especially when the organ appears to be in such a condition 

 as would encourage you to think it can be saved; but if otherv.-ise, it 

 must be removed as soon as i3ossible. 



We try to return the eye to its position as soon as possible. 



First, clean it thoroughly by means of an antiseptic that is not 

 irritating, such as a 2 per cent, solution of boric acid or a 1 to 2000 

 solution of corrosive sublimate. Place the fiat of the hand or the points 

 of the fingers on the eyeball, at the same time an assistant distending the 

 eyelids as much as possible, and by gentle pressure endeavor to push the 

 eye l^ack into the orbital cavity. 



If it is impossil)le to return it by this means, the fissure of the eye 

 must be enlarged by making a small incision in the external corner, or 

 the anterior chamber of the eye may be perforated by means of a cataract 

 needle or sharp l^istoury, so as to empty the eye to a certain extent and 

 thus allow it to return to the chamber. After returning the eye we must 

 try to prevent another prolapse by placing a bandage over the eye, 

 taking care not to compress the eyeball too much. If the animal will 

 not allow it to remain, we must join the eyelids with one or two stitches. 

 After stitching the eye we generally see great inflammation of the lids 

 and the eye itself, but the writer has found that these bad effects may be 

 easily prevented by taking care not to carry the stitch through the entire 

 lid, but only through the external membrane. At the same time it is 

 advisable to keep the animal without food for at least twenty-four hours, 

 for the use of the jaw, and especially the pressure of the prolongation of 

 the crown of the inferior maxillary, may push the injured eye out of 

 position. Cold applications are useful if the eyeball cannot be saved, or 

 if reduction is impracticable for some reason or other, on account of 

 tumors in the orbit, etc., there is nothing left to do but enucleate the 

 eyeball. 



Enucleation. Removal of the Eyeball. — Removal of the eyeball 

 should be performed under a narcotic or ether, or continual applications 

 of 4 per cent, solution of cocaine. We pull out the eyeball by means of 

 a tenaculum or a thread is put in the body of the eye, cut through the 

 conjunctiva with a pair of small curved scissors closely behind the cornea, 

 snipping the scissors around the eye, keeping as close to the bulb of the 

 eye as possible, and by this means separate the muscles and then cut 

 through the optic nerve. The author thinks it is advisable to remove 

 the membrana nictitans at the same time (Fig. 150). 



After enucleation, the cavity of the eye is washed out with an anti- 

 septic fluid and the bleeding is stopped by means of a tampon; and the 



