DEPARTMENT OF SURGERY. 
831 
it is necessary to resort to all possible means to determine the 
nature of the condition and the danger of metastasis. 
2. Suppurative Corneitis .—Any condition of the cornea 
which will not yield to treatment and which is surrounded by a 
state of things that will engender sepsis, may require a removal 
of the eyeball or evisceration. Perforations of the cornea whether 
due to trauma or disease are most invariably followed by loss of 
sight; and in many instances leave an unsightly eyeball, unless 
treated by proper surgical means. If the septic portion of the 
eyeball can be removed without resecting too much of the eye¬ 
ball, evisceration is the proper operation to adopt; but, if too 
much of the globe is involved, it is safer to remove it. Such 
surgical interference must never be undertaken unless all pal¬ 
liative measures have failed. 
3. Suppurative Choroiditis .—All the conditions in suppurative 
corneitis, such as extension of inflammation to the other eye, 
the meninx,. or meninges, are contraindications for evisceration 
in choroiditis. In general, choroiditis is a more serious condi¬ 
tion than a corneitis of the same pathological nature ; that is, a 
septic choroid coat is more dangerous than a septic cornea, when 
evisceration is the operation in question. 
4. Accidental Wounds .—Accidental wounds to the eyeball 
are always more or less serions. Slight wounds that simply 
perforate the cornea and open the auterior and posterior cham¬ 
bers are often followed by grave conditions. The complications 
in such instances are generally due to the infection of the eye 
by the object which inflicted the wound. These wounds may 
not injure any part of the inner structures of the eye and yet 
terminate very unfavorably. If the eye is treated from the time 
of the injury, it is necessary to learn the nature of the object 
which produced the wound, and if there is any danger of in¬ 
fection, it must be controlled from the beginning; but, if the in¬ 
fection cannot be prevented or the septic process arrested, it is 
a wise plan to eviscerate before the eyeball has become too badly 
involved. 
Wounds that penetrate the eyeball are always more serious 
than those above mentioned. The danger of infection is greater; 
and, the damage may be so great that it is impossible to repair 
the injury done to the structures within the ball. In wounds of 
this nature, evisceration should be the surgical treatment selected 
before septic infection has made any progress. 
Rupture of the eyeball may also be an indication for the 
operation, especially if accompanied by prolapse of the iris and 
