INFLAMMATION OF THE CONJUNCTIVA. 357 



membrane from the eye. The incision does not require any further 

 treatment except to bathe it with cold water. The author has 

 never seen any bad results from this operation, which has been 

 especially recommended by Frohner, MoUer, and others. 



The influence of cocaine upon the conjunctiva and cornea renders 

 these parts insensitive and permits a number of small operations 

 without producing any feeling of pain or convulsive irritation of 

 the eyelid. We pour a little 5 per cent, solution of cocaine into 

 the eye and obtain in this manner, from two to three minutes, an 

 absolute insensibility to pain, both in the cornea and conjunctiva. 

 This does not, as a rule, last more than ten minutes, and must 

 therefore be renewed every five minutes if necessary. In order 

 to reduce blepharospasm, as a consequence of violent conjunctivitis, 

 we should apply solutions of cocaine every two or three hours. 



Theeapeutics. In ophthalmic blennorrhoea we must endeavor 

 to prevent it before it goes too far. We must treat it with anti- 

 septic agents, and it is especially important to keep the conjunctiva 

 clean with water or some non-irritating antiseptic fluid, such as 

 boric acid, 3 per cent. ; corrosive sublimate, 0. 02 per cent. ; per- 

 manganate of potassium, 0.05 per cent.; creolin^ 1 per cent.; 

 salicylic acid, 1 per cent. These must be introduced into the 

 pouch of the lid by means of a syringe, brush, or sponge. When 

 it is necessary we must irrigate the eye with strong solutions of 

 nitrate of silver (1 to 3 per cent.), taking care to observe the rules 

 mentioned on page 356. We may also use diluted alcohol (equal 

 parts), covering the conjunctiva with calomel ointments or oxide 

 of mercury, or blowing on it powder of iodoform or calomel. 

 Aniline (pyoktanin) is also advised by some authors. 



The treatment may also be materially altered by complications 

 of the cornea, for which we would refer to page 359 for further 

 details. 



Besides the inflammatory condition which has just been de- 

 scribed, we may have tumors of the conjunctiva, but, as a rule, 

 these occur on the membrana nictitans. Their treatment depends 

 on general rules which have been already described. It may be 

 advisable to remove them in the manner described. 



