The Head and Neck 57 



The Eyelids 



CONGENITAL MALFOBMATIONS. 



At birth the margins of the lids are united and they do not 

 separate for some ten days thereafter. When separation fails to take 

 place, the condition is known as Ankyloblepharon. It is also some- 

 times seen in after life occurring as a result of inflammation of the 

 lids. 



Treatment. In the partial form a grooved director is inserted 

 in the opening remaining and made to pass to the opposite canthus 

 in a line with the ciUary border; the tissue is then divided with a 

 bistoury or scissors. In the complete form, a primary incision is 

 made in a fold of skin gathered up with forceps and the operation 

 completed in like manner. To prevent reunion of the severed edges, 

 they must be frequently stretched apart and oil dropped in. 



TBAUMATIC LESIONS. 



The lids sometimes sustain lacerations which, if not attended 

 to, may result in deformity, entropion, ectropion, etc. Edema of 

 the lids often follows a blow, and abscess formation is an occasional 

 termination. 



Treatment. The edges of wounds must be carefully approxi- 

 mated with fine silk sutures. 



BLEPHARITIS. 



Inflammation of the lids occurs as an idiopathic trouble con- 

 fined to the free border, often as a manifestation of eczema or 

 follicular mange. It has been known to terminate in ankyloble- 

 pharon. Suppurative inflammation sometimes results from con- 

 tusions and wounds and leads to abscess formation which may dis- 

 charge spontaneously into the conjunctival cul-de-sac. 



Treatment. In blepharitis confined to the free border remedies 

 must be used to combat the condition present, whether eczematous 

 or parasitic, always, however, with the precaution to avoid irritating 

 applications. In abscess formation, the pus should be evacuated by 

 an incision made just external and parallel to the free border. 



