DEPARTMENT OF SURGERY. 
367 
attention, and from investigations made on this line, it is 
learned that in certain inhabited portions of the earth the dis¬ 
ease seldom occurs, while in others it is often epidemic. Do¬ 
mestic animals kept in overcrowded and poorly ventilated 
quarters, and those fed on poor non-nutritious food are prone to 
the disease. When granular ophthalmia is epizootic, it is very 
probable that a contagium must contribute to its development, 
but when the disease begins without an inflammatory stage the 
indications are that it is due to some constitutional debility of 
the patient, resulting from its environment. 
Diagnosis .—The veterinary practitioner will often find it 
difficult to differentiate trachoma from muco-purulent, and 
purulent conjunctivitis, folliculitis, lymphomata and fibroid or 
fungoid growths of the palpebral and ocular conjunctiva. The 
human practitioner recognizes a difference between each and 
trachoma, but the veterinarian does not have the same oppor¬ 
tunity to make a correct diagnosis. In most cases the history 
is very indefinite, and often no cause can be found for the dis¬ 
ease ; the patient is brought to him after the disease has devel¬ 
oped to the third or fourth stage, or probably has already ter¬ 
minated in some abnormality, such as pannus, corneal ulcers, 
trichiasis or entropion. Trachoma of the benign variety occa¬ 
sionally runs its course and terminates favorably without 
surgical attention, but in most instances it leaves some perma¬ 
nent abnormality of the eye or its appendages. In most cases, 
it is advisable to remove the granulation by surgical means, 
even if the disease assumes a benign form and is likely to make a 
favorable termination. The advantage of such treatment is 
observed by shortening the duration of the disease. 
Treatment .—The treatment of trachomatamay be divided into 
prophylactic, medicinal and surgical. Prophylactic measures 
are necessary in some instances, especially when the patient is 
kept among a number of animals and the surgeon has no assur¬ 
ance that it is not a contageous form of trachoma. The best 
method to adopt in every case is to isolate the patient during 
the first three stages or during the flow of discharges from the 
diseased eye, and to thoroughly clean the place, stall or kennel 
occupied by the patient before using it for other animals. 
Medicinal Treatment .—Before beginning the treatment the 
cause of the disease should be determined if possible ; if it is due 
to faulty alimentation, the regimen must be corrected ; and if 
caused by the environment, the surrounding conditions must be 
improved ; the internal medication will depend upon the indica- 
