ADHESION OF THE EYEI.ID TO THE BUIvB. SYM- 

 BLEPHARON. 



Causes : Conjunctivitis, bums, operation and other wounds. In front of 

 or behind the reflection of the mucosa from eye to lid. Prevention. Treat- 

 ment : section of adhesion, and vaseline, etc. Two edges of healthy mu- 

 cosa sutured together over the sore. When fornix is implicated mucosa is 

 transplanted. 



This is liable to occur to a greater or less extent, in all animals, 

 in connection with violent conjunctivitis, burns and operation 

 and other wounds. It has been divided into anterior and pos- 

 terior symblepharon, the former being an union in front of the 

 normal reflection of the conjunctiva from the lid upon the bulb 

 (fornix), and the latter involving the fornix in the substance of 

 the adhesion. The anterior form by anchoring the lid to the 

 eyeball _is much more likely to induce blindness, but it has the 

 compensation that the union may be broken up and the parts 

 healed without subsequent reunion. In the posterior form the 

 eye can be better exposed and vision retained, its repair is much 

 more difficult demanding transplantation of skin or mucous mem- 

 brane on to the sore, and even then the granulation tissue being 

 continuous from bulb to eyelid may so contract in healing as to 

 leave matters no better than before. 



These adhesions not only restrict the movements of the lids, 

 preventing their opening and the exposure of the bulb, but they 

 also anchor the bulb itself, and hamper its movements, neces- 

 sitated for vision. In all cases therefore of wounds, burns, abra- 

 sions and ulcers, of the palpTebral and bulbar mucosae it is highly 

 important to take precautions against the formation of such con- 

 nections. Any forming adhesions must be broken up day by day 

 and the surfaces must be kept apart in the intervals by borated 

 or iodoformed vaseline. 



In a small anterior symblepharon the connections may be cut 

 through and subsequent adhesion prevented by the frequent in- 

 troduction of iodoformed vaseline, and if need be, by the daily 

 separation of the surfaces by a probe. When this fails a plastic 

 operation may be resorted to, the mucosa on the inner side of the 



341 



