. A treatise on diseases of the eye . )atency, also the conditionof the canaliculi and of the lachrvnial sac should l)e determined. Rednessof the conjunctiva, particularly of the lower lid and globe to tiie nasalside, should direct attention to the lachrymal sac and to the should be made over the sac to determine the presence ofretained secretion. Pouting of the punctuni and swelling along the courseof a canaliculus, if present, should be noted. Conjunctiva.—For the purpose of examining the conjunctiva it is neces-sary to evert the upper lid (Fig. 82); this is done by seizi
. A treatise on diseases of the eye . )atency, also the conditionof the canaliculi and of the lachrvnial sac should l)e determined. Rednessof the conjunctiva, particularly of the lower lid and globe to tiie nasalside, should direct attention to the lachrymal sac and to the should be made over the sac to determine the presence ofretained secretion. Pouting of the punctuni and swelling along the courseof a canaliculus, if present, should be noted. Conjunctiva.—For the purpose of examining the conjunctiva it is neces-sary to evert the upper lid (Fig. 82); this is done by seizing the eyelashesbetween the thumb and forefinger at the middle of the lid; the patientshould then look downward, and gentle traction should be made on theeyelashes sufficient to draw the lid downward, and slightly away fromthe eyeball. The tissues of the brow may then be forced gently but Fig. 82. Eversion of the eyelid. firmly downward by means of a finger or thumb of the other hand;the margin of the lower lid is then turned (juickly backward over themass of tissue. An easier procedure is to ])lace the end of a small smoothinstrument (such as the end of a small pencil), on the upper lid justabove the upper margin of the tarsus, after the lid has been diawndownward and outward. The margin of the lid is then turned overthe small instrument, which is at once withdrawn. Tins exposes thetarsal conjunctiva, and the lid is held in the inverted position by meansof the finger or thumb. If no eyelashes are present the patient is directed to look downward,the tissues of the U])j)er lid are j)resse(l gently but (irmly downwani,the margin of the lower lid pushed under the margin of the up|>er lid,until the margin of the upper lid can be engaged on its conjunctivalsurface by the back of the thumb or finger nail, when it can be turnedup over the tissue of the lid or small instrument as be
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Keywords: ., bookcentury1900, bookdecade1910, booksubjecteyediseases, bookyear
