I 



SECTION III 



SURGERY OF THE EYE 

 Injuries 



NJURIES to the orbit are fairly frequent from 

 blows, kicks, collisions, and other causes, and 

 may involve the surrounding soft tissues, bones, or 

 contents. Treatment will vary naturally with tfie 

 extent and particular nature of the injury, either 

 coming under the head of general surgical principles 

 or special operative considerations. One of the com- 

 mon results of severe traumatism of the orbital re- 

 gion is dislocation of the eyeball, which may or 

 may not be a very serious condition, depending 

 entirely upon the injury inflicted on the eye itself. 



If the injury is recent, with no laceration of the 

 globe or interocular hemorrhage, there is every 

 chance of the eye being saved and vision unimpaired. 

 However, in cases where the globe is lacerated, 

 cold, or shows evidence of interocular hemorrhage, 

 enucleation is the only proper procedure. 



In attempting to replace a dislocated eyeball, the 

 chief difficulty encountered is the inversion of the 

 eyelids and the swollen condition of the parts. 



The simplest and most effectual procedure is as 

 follows : 



Place the patient in the abdominal position and 

 induce a general anesthesia. Have ready for use 

 a small scalpel, a small-pointed bistoury, dressing, 

 swabs, sterile gauze, fine needles, silk sutures, band- 

 age or eye cap, and collodion (all the instruments 

 being sterilized by boiling). 



Technic. — The skin around the outer canthus is 



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