The student's guide to diseases of the eye . Fig. 116.—Desmarres lid elevator. knees, its body and legs being on the nurses lap; ifan adult, the same as for 1. If the lids cannot be easily separated by a fingerof each hand, enough to allowa view of the cornea, retrac-tors should be used (a con-venient pattern is shown inPig. 116), by which one lid,or both, can be raised andheld away from the this instrument be gentlyused we avoid all risk ofcausing perforation of thecornea should a deep ulcer bepresent; an accident whichmay happen in cases attendedby much swelling or spasmof the lids
The student's guide to diseases of the eye . Fig. 116.—Desmarres lid elevator. knees, its body and legs being on the nurses lap; ifan adult, the same as for 1. If the lids cannot be easily separated by a fingerof each hand, enough to allowa view of the cornea, retrac-tors should be used (a con-venient pattern is shown inPig. 116), by which one lid,or both, can be raised andheld away from the this instrument be gentlyused we avoid all risk ofcausing perforation of thecornea should a deep ulcer bepresent; an accident whichmay happen in cases attendedby much swelling or spasmof the lids if the fingers areused. 5. Entropion.—Spasmodic entropion of the lower lid,with relaxed skin, in old people. Position as for :—T forceps (Fig. 117), scissors (), toothed forceps. (1.) With the T forcepspinch up a fold of skin as close as possible to theedge of the lid, and of width proportionate to the. Fig. 117.—Entropionforceps. OPERATIONS ON THE EYELIDS 323 degree of inversion, and cut it off close to the for-ceps ; (2) with the toothed forceps pinch up theorbicularis muscle now exposed, and cut out a smallpiece. Sutures need not be used. 6. Organic entropion and trichiasis.—When thewhole row of lashes is turned inwards, and the innersurface of the lid much shortened by scarring, theradical extirpation of all the lashes is the quickestand most certain means ofgiving permanent relief,but it leaves an unsightlybaldness and exposes thecornea to unnatural riskfrom dust, &c. Position:recumbent; the surgeonstands behind the seldom neces-sary. Instruments : a hornor bone lid-spatula (, s), or a lid clamp (), a Beers knife (), and forceps. Makean incision from end to end(beginning just outside thepunctum) between thehair-follicles and Meibo-mian ducts, as if to split the lid into two make a second incision through the skin andti
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Keywords: ., bookcentury1800, booksu, booksubjecteye, booksubjectophthalmology
