The commoner diseases of the eye : how to detect and how to treat them . become more pronounced. On everting thelids their conjunctival surfaces will be foundcovered with a number of irregularly scatteredgranulations, more abundant in the upper lidand particularly in the retro-tarsal folds. Thesegranulations are grayish white, somewhat re-sembling sago grains, are embedded in the con-junctiva and project above its surface. The base of the granulation consists of con-nective tissue which eventually constitutes thecicatricial degeneration of the conjunctiva andindicates its localitv. The disease
The commoner diseases of the eye : how to detect and how to treat them . become more pronounced. On everting thelids their conjunctival surfaces will be foundcovered with a number of irregularly scatteredgranulations, more abundant in the upper lidand particularly in the retro-tarsal folds. Thesegranulations are grayish white, somewhat re-sembling sago grains, are embedded in the con-junctiva and project above its surface. The base of the granulation consists of con-nective tissue which eventually constitutes thecicatricial degeneration of the conjunctiva andindicates its localitv. The disease, in the course 172 COMMONER DISEASES OF THE EYE of months or years, finally involves the tarsalcartilage, the granulations disappear and deform-ity of the lids is a frequent result. This is dueto the cicatricial contraction, producing- entro-pion. The bulbs of the eyelashes become af-fected, so that they grow irregularly and a con-dition known as trichiasis results. After thisatrophy of the granulations, the under surfaceof the lids again becomes smooth, but is shiny. Typical Granular Lid and Beginning Scars, with Pannus. and intersected by a number of whitish lines showing that the conjunctiva has been replaced by connective tissue. As the disease still further advances othercomplications arise. The ocular conjunctiva be-comes congested and a vascular condition of thecornea occurs, bringing about a condition calledpannus, which is nothing more or less than theextension of the trachoma to the cornea. Theupper portion of the cornea is generallv the first COMMONER DISEASES OF THE CONJUNCTIVA 173 to suffer and is covered with vessels derivedfrom the conjunctiva, which run between theepithelial layer and Bowmans membrane. Theportion of the cornea affected is usually coveredwith a diffuse opacity, which may clear up en-tirely if the course of the disease is arrested. If the disease progresses the whole corneamay present this same picture of vascularizationand opacity and its surfac
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