Transactions . whether anything further could be done inpreference to using the knife. He had had no experienceof injections of alcohol for the condition. 3. The diag7wsis and treatment of osteoma of tlie orhit. By C. Wray. The diagnosis of orbital osteomata may be a verysimple matter or one of no small difficulty and uncer-tainty ; indeed, Weil had a case of osteochondroma underhis care for five years before he was able to make acertain diagnosis. Bony growths of the orbit as theyoccur in ophthalmic practice are generally obviouslyorbital, but to be more exact they are nearly all sinus DIAGNO
Transactions . whether anything further could be done inpreference to using the knife. He had had no experienceof injections of alcohol for the condition. 3. The diag7wsis and treatment of osteoma of tlie orhit. By C. Wray. The diagnosis of orbital osteomata may be a verysimple matter or one of no small difficulty and uncer-tainty ; indeed, Weil had a case of osteochondroma underhis care for five years before he was able to make acertain diagnosis. Bony growths of the orbit as theyoccur in ophthalmic practice are generally obviouslyorbital, but to be more exact they are nearly all sinus DIAGNOSIS ANM1 TKIiATM KNT OF OSTEOMA OF OKBIT. 191 growths, though a few arise from the periosteum and sub-periosteal tissue of the orbital margin. The diagnosis in the earliest stages is sometimesimpossible, as shown by the case of orbital osteoma in theMuseum of the Royal College of Surgeons. It wassuccessfully removed by Sir Victor Horsley from theneighbourhood of the optic foramen, where it was attached Fig. Exostosis of left frontal sinus. (Mnseixm of Eojal Collegeof Surgeons.) by a narrow pedicle. Although the dura was exposed thepatient made a perfect recovery, but its successful removalis of less interest than the fact that the subjective wouldprecede the objective signs, i. e. proptosis would be a latersymptom and not, as is so common in other situations, theearliest. As the first step in the investigation of orbitaltumours is by palpation, the following remarks may be ofinterest. The orbit may be examined by means of thefinger, the probe, or the spatula, but the probe is adangerous instrument and can only be used with safety ifthe extremity is blunt and bent to the shape of a 192 DISEASES OF THE OEBIT. strabismus hook. Nothing need be said as to examinationby means of the fingers. As regards the spatula, it canbe used more efficiently than the straight probe and shouldbe of flexible metal, 10 mm. wide, with the extremities 2mm. thick. Here it may be stated that the av
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