The student's guide to diseases of the eye . on.—(1) After in-troducing the speculum, take the fixation forceps inthe left hand, and pinch up a fold of conjunctivaover the lower border of the tendon (say of theright internal rectus) at its insertion. With thescissors make a small opening in this fold closeto the end of the forceps, and parallel with thetendon. A layer of fascia (capsule of Tenon) isnow exposed, and easily recognised ; it is to bepinched up, and an opening made in it correspond-ing to the conjunctival wound. By taking deephold with the forceps, both conjunctiva and fasciamay so
The student's guide to diseases of the eye . on.—(1) After in-troducing the speculum, take the fixation forceps inthe left hand, and pinch up a fold of conjunctivaover the lower border of the tendon (say of theright internal rectus) at its insertion. With thescissors make a small opening in this fold closeto the end of the forceps, and parallel with thetendon. A layer of fascia (capsule of Tenon) isnow exposed, and easily recognised ; it is to bepinched up, and an opening made in it correspond-ing to the conjunctival wound. By taking deephold with the forceps, both conjunctiva and fasciamay sometimes be divided at one stroke. As a rule,both conjunctiva and Tenons capsule are thicker inchildren than adults. (2.) Take the hook in the right hand (holdingthe wound open with the forceps in the left),and pass it, concavity downwards and point back-wards, through the opening in the fascia, as far as itselbow, keeping its end always flat against the sclero-tic. Next turn the end of the hook upwards, still OPERATIONS FOR STRABISMUS 333. a P^ ^> 0 <v rO <D ^*-\ A g -+? £ J4 ^» o o o o A ^-» GO ^ 0 a 5=1 00 O) QD ,fi O C3 u F4 Pn -4-3 <D (Tj Fh o CO guided by the sclerotic, between the tendon and theglobe, until its end is seen projecting beneath theconjunctiva, above the upper border of the tendon. 334 OPERATIONS On now attempting to draw the hook towards thecornea it will be stopped by the tendon. If Tenonscapsule have not been well opened the hook cannotbe passed beneath the tendon, nor swept round thesclerotic.—(3) Lay down the forceps, transfer thehook to the left hand, holding its handle parallelwith the side of the nose and tightening the tendonby traction forwards and outwards ; pass the scissors,with the blades slightly opened, into the wound, andpush them straight up between the hook and the eye ;the tendon is divided at two or three snips, with a crispsound and feeling. When the whole breadth of thetendon is divided the hook slips forwards beneath
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Keywords: ., bookcentury1800, booksu, booksubjecteye, booksubjectophthalmology
