SURGERY OF THE EYE 197 



impinging on the eyeball. The object sought by 

 the operation is the reduction of the superfluous 

 skin of the eyelid and the restoration of the lid to 

 its normal position. 



The following instruments and dressings are 

 sterilized by boiling and laid in sterile water in 

 sterile instrument trays : a scalpel, a pair of curved 

 scissors, entropion forceps, dressing forceps, needle 

 holder, six needles and sutures (silkworm gut), 

 swabs, ether, and iodized collodion. 



Place the patient in the abdominal position and 

 induce a general anesthesia. 



Technic. — The eyelid is shaved and cleaned in the 

 usual manner, and a fold of skin parallel to " the 

 direction of the eyelid seized with the entropion 

 forceps. Care must be taken to pick up skin only, 

 and only just enough of it to bring the eyelid back 

 to normal. The forceps are then clamped and the 

 fold of skin excised with the scalpel or scissors. 



The cut must be made close to the forceps. The 

 result is an elliptical wound, which, when the hemor- 

 rhage has been controlled by pressure, is sutured 

 by interrupted stitches placed one eighth of an inch 

 apart. The wound is then swabbed with ether, 

 which is allowed to evaporate, and . finally sealed 

 with iodized collodion. Sutures are to be removed 

 in about six days. 



If neatly executed, and if strict attention is paid 

 to asepsis, most excellent results are obtained by 

 this operation, and unless infected the wound pro- 

 duces no irritation and the patient shows no inclina- 

 tion to interfere with it. Should he do so, however, 

 an Elizabethan collar should be placed on him to 

 prevent him scratching it with his hind feet. 



In addition to the surgical treatment, any irrita- 

 tion of the conjunctiva or cornea must be treated 

 with mild astringent and antiseptic collyria. 



