. A treatise on diseases of the eye . advised opening the lachrymal sac by a verticalincision between the commissure of the lids and the caruncle, enteringthe sac behind the inner canthal ligament. This point is renderedeasier of access by the swelling of the surcharged sac. . Youthen may empty the sac without difhculty and avoid an external wound,nor does your procedure injure the canaliculi or damage any appendageof the eye or interfere with after treatment. In cases of partial stenosis of the lachrymal duct, the nasal cavityshould be examined and measures instituted to correct any abnormalc
. A treatise on diseases of the eye . advised opening the lachrymal sac by a verticalincision between the commissure of the lids and the caruncle, enteringthe sac behind the inner canthal ligament. This point is renderedeasier of access by the swelling of the surcharged sac. . Youthen may empty the sac without difhculty and avoid an external wound,nor does your procedure injure the canaliculi or damage any appendageof the eye or interfere with after treatment. In cases of partial stenosis of the lachrymal duct, the nasal cavityshould be examined and measures instituted to correct any abnormalcondition that may be present. In hypertrophic rhinitis it is oftensufficient to use a cleansing spray (of which Dobells solution is a goodexample) twice daily and to interdict smoking if that is indulged in. Anhypertrophied inferior turbinated body compressing the inferior portionof the canal should be reduced in size or partly removed. In addition tothese measures it is often of value to treat the sac and partly closed Fig. 129. Anels lachrymal syringe. canal by the introduction of medicated solutions by means of an Anel(Fig. 129) or other canaliculus syringe. Before the nozzle of thelachrymal syringe will pass into the punctum it maybe necessary to dilatethe opening; this may be done by means of an instrument made forthat purpose. The solutions employed may be of boric acid(saturated solution), bichloride of mercury (1 to 5000 to 1 to 10,000),argyrol (15 to 25 per cent.). The introduction of these solutions shouldbe preceded by a solution of cocaine, 2 to 4 per cent., to which a very,little adrenalin chloride has been added. Solutions of the nitrate ofsilver are sometimes employed. Solutions of this salt should be veryweak, not stronger than per cent. If stronger solutions areemployed, an adhesive inflammation may be set up which mayresult in obliterating the canaliculi. This treatment may be supplementedby passing small probes through the canaliculi and through the canal
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Keywords: ., bookcentury1900, bookdecade1910, booksubjecteyediseases, bookyear
