File:The student's guide to diseases of the eye (1884) (14592471389).jpg

Identifier: studentsguidetod1884nett (find matches)
Title: The student's guide to diseases of the eye
Year: 1884 (1880s)
Authors: Nettleship, Edward, 1845-1913
Subjects: Eye Color blindness Ophthalmology Ophthalmology Eye Diseases Color Perception Color Vision Defects
Publisher: London : J. & A. Churchill
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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f it stands forwards from the brow itis usually in a false passage. C. OPERATIONS FOR STRABISMUS. Tenotomy.—The object is to divide the tendon closeto its insertion into the sclerotic. In this countrythe operation is usually done subconjunctivally,but in the operations of Graefe and Snellen thetendon is more or less exposed to view. The internaland external recti are the only tendons commonlydivided, the internal far the more frequently.Anaesthesia is seldom necessary except for chil-dren. Position recumbent.—The operator usuallystands on the patients right whether for rightor left eye; but some prefer to stand behind,using curved scissors. Instruments : Stop speculum(Pig. 127 shows a convenient and common pattern),straight scissors, with blunted points (Pig. 128),toothed fixation forceps (Fig. 129), strabismus hook(Pig. 130). There are several forms of hook, differ- 332 OPERATIONS ing in the length and sharpness of the curve,1 andthe shape of the tip. In some the tip is bulbous ;
Text Appearing After Image:
Fig. 127.—Stop spring speculum. in others the hook is flattened sideways, but not en-larged at the end. Operations.—CritcheWs operation.—(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

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