ENOPHTHALMUS 551 



(boric acid, 2 per cent.). Try replacement by picking 

 up the eyelids, retracting them as much as possible, at 

 the same time gently but firmly pressing the eyeball back 

 into its socket. It may be necessary to enlarge the palpe- 

 bral slit by cutting the outer canthus. After replacement 

 two or three stitches will retain the eyeball in position. 

 The after-treatment consists in fomenting the eye with 

 warm water and keeping it lubricated with dilute glycerin 

 or liquid vaselin. Should panophthalmitis or hydrophthal- 

 mitis develop, or the luxation reappear, enucleation of the 

 eyeball should be practised. The operation is as follows: 

 The patient should be given a general anesthetic and the 

 eyeball thoroughly washed with an antiseptic. The lids 

 are held apart by a retractor, or with dressing forceps 

 held by an assistant. Make an incision through the con- 

 junctiva at the corneal margin, dissect back to the muscles, 

 cutting them off close to their attachment to the eyeball. 

 Keep as close to the eyeball as possible. When all of the 

 muscles have been cut away pull the eyeball downward and 

 excise the optic nerve. Control hemorrhage, pack the 

 socket with sterile gauze, or iodoform gauze, put retaining 

 sutures in the lids, and cover the whole with an antiseptic 

 pack held in place with a head bandage. In twenty-four 

 hours remove the pack and treat with antiseptic dusting 

 powder. Healing is usually prompt. 



ENOPHTHALMUS. 



Definition.— An abnormal sinking of the eyeball into the 

 orbit. It is rare in animals. 



Etiology.— It may be congenital. Most cases, however, 

 are acquired and due to an atrophy of the retrobulbar fat 

 cushion, general emaciation, spasms of the muscles of the 

 eye. 



Symptoms.— The eyeball appears retracted into its socket. 

 It should be distinguished from normal eyes which are 

 unusually small. The general condition of the patient 

 suffices for differentiation. 



