SURGERY OF THE EYE 201 



hemorrhage is controlled quite easily by pressure 

 and a few drops of adrenalin solution. The cornea 

 is then seized with the rat-toothed forceps and the 

 eye pulled out as far as possible. 



The muscles are then divided one by one with 

 the scissors close to their sclerotic attachments, and 

 finally the optic nerve is divided as far back in the 

 orbit as possible. The hemorrhage is slight and 

 easily controlled by pressure, ligation being not 

 only unnecessary but harmful. The stumps of the 

 muscles are then trimmed and shortened, and the 

 orbit tamponed with the glycerinated gauze. The 

 glycerin prevents the tampon adhering and renders 

 its removal the next day easy and painless. 



After firmly packing the orbit the lids are closed 

 with the sutures already used in retracting them, 

 and a sterile gauze pad is applied over the orbit and 

 kept in position with an eye cap or bandage. The 

 tampon is removed in twenty-four hours and the 

 orbit swabbed out with sterile normal saline solu- 

 tion, taking care to remove all blood clots. The 

 orbit is then repacked with the glycerinated gauze, 

 care being taken to completely fill it so that the 

 eyelids are prevented from turning in. 



The orbit must be dressed after ,this manner every 

 day until healing takes place, otherwise the lids 

 will turn in from the contraction during the process 

 of healing and cause great irritation, in addition to 

 introducing infection. 



If careful attention is given to asepsis, pus for- 

 mation is either very slight or entirely absent. If, 

 however, infection does occur, the orbit should be 

 flushed out with a solution of chinosol at each 

 dressing. 



After healing is complete, a glass eye may be 

 inserted or the patient may be made more present- 

 able by the following procedure : 



