Transactions . this year, when thechild was 4 years and 10 months old. Since she hadbeen first seen the bridge of her nose had developed tosome extent, and the epicanthus had become less marked,in other respects the condition of her eyelids remained justthe same. On January 14th, 1915, the child being under the in-fluence of a general anaesthetic, a wedge-shaped piece ofthe whole tliickness of the right lower lid was cut out alittle way internal to the outer canthus. The base of thewedge was at the free margin of the lid, and measuredabout 6 mm. in length. A stitch was inserted throughthe two
Transactions . this year, when thechild was 4 years and 10 months old. Since she hadbeen first seen the bridge of her nose had developed tosome extent, and the epicanthus had become less marked,in other respects the condition of her eyelids remained justthe same. On January 14th, 1915, the child being under the in-fluence of a general anaesthetic, a wedge-shaped piece ofthe whole tliickness of the right lower lid was cut out alittle way internal to the outer canthus. The base of thewedge was at the free margin of the lid, and measuredabout 6 mm. in length. A stitch was inserted throughthe two raw surfaces left, just inside the line of the lashes, 230 DISEASES OF THK EYELIDS AND CONJUNCTIVA. and by means of it they were drawn together and this way the length of the lower lid was shortened andit was drawn up into a better position. No operation hasyet been performed on the left side. Fig. Photo by J. Bender ^ Co. Microscopical examination of sections of the piece ofthe lower lid which was removed show the orbicularismuscle to be well-developed The group of its fibresnear the free border of the lid, which are termed themuscle of Riolani, are exceptionally numerous, showing CONGENITAL ECTROPION OK THE LOWER LIDS. 231 that the defect cannot be attributed to any defect in theirdevelopment. As the function of Riolanis muscle is tokeep the border of the lids in contact with the eyeball, ithad occurred to me that its absence might accountfor the ectropion, but this was evidently not the epithelium of the palpebral conjunctiva was several Fig. 41.
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Keywords: ., bookcentury1800, bookdecade1880, bookpu, booksubjectophthalmology
