. A treatise on the diseases of the eye. ival tissue beneath the tendon, soas to catch up the latter, and render it tense. The points of thescissors (but slightly opened) are then to be introduced into theaperture, and one point passed along the hook behind the tendon,the other in front of the tendon between it and the conjunctiva,and the tendon is then to be divided close to its insertion by suc-cessive snips of the scissors. A small counter-puncture may bemade at the upper edge of the tendon, to permit of the escape ofany effused blood, and thus prevent its diffusion beneath theconjunctiva (
. A treatise on the diseases of the eye. ival tissue beneath the tendon, soas to catch up the latter, and render it tense. The points of thescissors (but slightly opened) are then to be introduced into theaperture, and one point passed along the hook behind the tendon,the other in front of the tendon between it and the conjunctiva,and the tendon is then to be divided close to its insertion by suc-cessive snips of the scissors. A small counter-puncture may bemade at the upper edge of the tendon, to permit of the escape ofany effused blood, and thus prevent its diffusion beneath theconjunctiva (Bowman). [In this operation the tendon, owing to the cutting action of the scissors, is apt to slip off the hook before it has been completely divided. To remedy this. Dr. TheobakF has devised the crochet hook (Fig. 224). With the exception of the crochet point, it is similar to Von Graefes strabismus hook. The tendon being secured by it, it is not necessary to force the point up against the conjunctiva, as is ordinarily done, rig. a. Crochet hook, natural size. h. Magnified view of crochet point. SO as to throw the tendon into the angle of the hook, while it is being divided,but simply to hold the handle at right angles to the muscle.—H.] Mr. Liebreich^ has lately introduced a modification of the operation ofstrabismus, based upon a different view of the anatomical relations of theconjunctiva, subconjunctival tissue, and the capsule of Tenon to the musclesof the eye. He considers the capsule of Tenon as divided into two portions—an anterior and a posterior—the division being formed at the point wherethe recti muscles pierce it from without inwards; the capsule being at thispoint so closely connected with the muscles as to render any displacementbetween the two impossible. The posterior half of the capsule, with itssmooth, firm, inner surfi^ce, forms a cup, in which the eyeball moves as freelyas the head of a joint in the socket. The close connection between themusc
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Keywords: ., bookcentury1800, booksubjecteye, booksubjecteyediseases, bookyear
