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abnormally small opening between, the lids, often connected with imper- 

 fect development of the eye, and closure of the lids by adhesioii. The 

 first is to be remedied by paring the edges of the division and then 

 bringing them, together, as in torn lids. The last two, if remediable 

 at all, require seiDaration by the knife, and subsequent treatment 

 with a cooling astringent eye wash. 



Nervous disorders. — Spasm of the eyelids maybe owing to constitu- 

 tional susceptibility, or to the presence of local irritants (insects, 

 chemical irritants, sand, etc. ) in the eye, to wounds or inflammation 

 of the mucous membrane, or to disease of the brain. When due to 

 local irritation, it may be temporarily overcome by instilling a few 

 drops of a 4 per cent solution of cocaine into the eye, when the true 

 cause may be ascertained and removed. The nervous or constitutional 

 disease must be treated according to its nature. 



Drooping eyelids — Ptosis. — This is usually present in the upper lid, 

 or is at least little noticed in the lower. It is sometimes but a symp- 

 tom of paralysis of one-half of the face, in which case the ear, lips, 

 and nostrils on the same side will be found soft, drooping, and inac- 

 tive, and even the half of the tongue may partake of the palsy. If the 

 same condition exists on both sides there is difficult snuffling breath- 

 ing, from the air drawing in the flaps of the nostrils in inspiration, 

 and all food is taken in by the teeth, as the lips are useless. In both 

 there is a free discharge of saliva from the mouth during mastication. 

 This paralysis is a frequent result of injury, by a poke, to the seventh 

 nerve, as it passes over the back of the lower jaw. In some cases 

 the paralysis is confined to the lid, the injury having been sustained 

 by the muscles which raise it, or by the supra-orbital nerve which 

 emerges from the bone just above the eye. Such injury to the nerve 

 may have resulted from fracture of the orbital process of the frontal 

 bone above the eye ball. 



The condition may, however, be due to spasm of the sphincter 

 muscle, which closes the lids, or to inflammation of the upper lid, 

 usually a result of blows on the orbit. In the latter case it may run 

 a slow course with chronic thickening of the lid. 



The paralysis due to the poke may be often remedied by, first, the 

 removal of any remaining inflammation by a wet sponge worn beneath 

 the ear and kept in place by a bandage; second, when all inflamma- 

 tion has passed by a blister on the same region, or by rubbing it daily 

 with a mixture in equal proportions of olive oil and strong aqua 

 ammonia. Improvement is usually slow, and it may be months before 

 complete recovery ensues. 



In paralysis from blows above the eyes the same treatment may be 

 applied to that part. 



Thickening of the lid may be treated by painting with tincture of 

 iodine, and that failing, by cutting out an elliptical strip of the skin 

 from the middle of the upper lid and stitching the edges together 



