542 
DEPARTMENT OF SURGERY. 
denuded areas may exist and pass unnoticed unless detected by 
the use of fluorescin. Fluorescin used for this purpose is a 2 
per cent, solution with sufficient carbonate of soda to give it an 
alkaline reaction. When this solution is dropped upon the cor¬ 
nea, the part divested of its epithelium will become greenish- 
yellow, while the portion which is only partly deprived of its 
epithelial covering, or entirely free from injury, will be unaf¬ 
fected. By this simple procedure a very thorough examination 
of the cornea will enable the inspector to detect the slightest in¬ 
juries that may involve the subepithelial structures. 
Superficial wounds may be caused in the same manner as 
perforating wounds, together with many other circumstances, 
which only cause slight or superficial injuries; the nature of 
these have already been mentioned. 
Incised Wounds of the anterior surface of the eyeball may be 
surgical or traumatic ; the surgical are usually made with asep¬ 
tic precautions and generally heal very readily, but traumatic 
wounds are often infected by the object that inflicted them ; and, 
unless rendered aseptic immediately, they are likely to termi¬ 
nate unfavorably. 
Lacerated Wounds require more attention ; they are more 
difficult to clean and may require excision of its ragged edges, 
which often makes it impossible to close the wound by sutures. 
Wounds caused by contusion or concussion are much the 
same in severity. Contusions of the eyeball usually result from 
blows with some solid or blunt object, such as a fork handle, club 
or “ twitch ” ; or a compression of the eyeball by some sudden 
force, such as a man’s weight upon an animal’s head when cast 
will occasionally cause such injuries. Contusions are bruises 
without breaking the external covering of the eyeball; they may 
bruise the underlying structures without any apparent laceration 
or may result in a solution of contiguity or continuity of these 
structures. Blows on the eye sometimes cause spasm of the iris, 
which is marked by a contraction of the pupil {myosis)\ paral¬ 
ysis of the ciliary muscle {cycloplegia) , which is often accom¬ 
panied by a dilatation of the pupil ( mydriasis ) ; temporary loss 
of sight without any perceptible anatomical alteration of retina 
{traumatic amblyopia ); and paralysis of the iris ( iridoplegia ). 
Concussions seldom cause superficial wounds, but the lesions 
following them are generally intraocular, with the exception of 
rupture of the eyeball. The lesions may be simple or multiple, 
and may consist of ruptures, detachments, lacerations, paralyses, 
spasms, or dislocation of the lens. 
