The commoner diseases of the eye : how to detect and how to treat them . The Lachrymal Gland and Its Relations. (Schwalbe.)a, superior portion of gland; b, inferior portion; d,lachrymal ducts; e, upper eyelid, skin partiallyremoved; p, p, puncta; c c, canaliculi; s, lach-rymal sac; /;, nasal duct. latter (about 21 mm. long and 4 to 6 mm. wide)passes downward, outward and backward andempties into the inferior meatus of the nose atits anterior third. The bony duct and sac arelined with fibrous tissue covered with columnarepithelium. The former is by no means uniform DISEASES OF THE LACHRYMAL APP


The commoner diseases of the eye : how to detect and how to treat them . The Lachrymal Gland and Its Relations. (Schwalbe.)a, superior portion of gland; b, inferior portion; d,lachrymal ducts; e, upper eyelid, skin partiallyremoved; p, p, puncta; c c, canaliculi; s, lach-rymal sac; /;, nasal duct. latter (about 21 mm. long and 4 to 6 mm. wide)passes downward, outward and backward andempties into the inferior meatus of the nose atits anterior third. The bony duct and sac arelined with fibrous tissue covered with columnarepithelium. The former is by no means uniform DISEASES OF THE LACHRYMAL APPARATUS 271 ill its diameters, being contracted where it leavesthe sac and just before it enters the nose. Epiphora is the name usually employed todesignate a flow of tears over the lower lid mar-gin. Lachrymation refers more particularly toan increase in the supply of tears. Anythingwhich interferes with the drainage of the ex-. Lachrymal Apparatus. (Juler.) ternal eye will produce epiphora; any causewhich stimulates the formation of tears produceslachrymation. Among other causes of epiphora,besides lachrymation, may be mentioned : (I)Those that produce misplacement of the puncta,such as surgical and other wounds in the neigh-borhood, paralysis of the facial nerve (by which 272 COMMONER DISEASES OF 1HK EYE the orbicularis loses its tone) and laxness ofthe palpebral tissues dependent upon senilechanges; (2) obstruction at some point in thelachrymal canal or nasal duct. The last is tin-commonest and most important cause of epi-phora, which will hereafter be considered merelyas a symptom of this class of diseases. Chronic dacryocystitis is a chronic infectiveinflammation of the mucous membrane lining thecanaliculi and tear sac. This disease is usuallychronic from the beginning and generally resultsfrom an obstruction of the nasal duct. There isa certain resemblance between inflammation ofthe urethra and the same


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