Cataract extraction : being a series of papers with discussion and comments read before the Ophthalmological section of the New York academy of medicine, 1907-1908 / edited by J. Herbert Claiborne.

Date:
1908
Catalogue details

Licence: Public Domain Mark

Credit: Cataract extraction : being a series of papers with discussion and comments read before the Ophthalmological section of the New York academy of medicine, 1907-1908 / edited by J. Herbert Claiborne. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    eye is closed by a dressing. Sterile towels are placed upon the patient's chest and around the head, which has pre- viously had a rubber cap put upon it; a dry towel is loosely arched over the patient's mouth, and I am ready to begin. For some years I have given up the habit of bandaging the eye for twenty-four hours previous to the operation, for I believe that not infrequently bandaging starts up secretion, probably by increasing the activity of the mucus formation and by dilating conjunctivae vessels through the warmth of the dressing and also in another manner which is well ex- plained by a statement in Fuchs (p. 74). He says: Not that we are to think of the tears as having any bactericidal properties, their action being, on the contrary, purely a mechanical one in that they continually bathe the conjunc- tiva, and after washing it off drain into the nose. Now when the eyes are bandaged, this action of the tears is much lessened, and any bacteria which may be present have a chance to multiply. The clinical fact is that bandaging alone will start up a conjunctival secretion in many eyes. I do not see the wisdom in the eye-bath which some oper- ators use for several days before operation, unless con- junctivitis is present, but always endeavor to interfere with the eye as little as possible, leaving it in what we may call its natural state. Of course, where there is blepharitis, conjunctivitis, or dacryocystitis, the question is a very different one, and treatment must be energetic and constant until the inflammation subsides. This is hardly the place to discuss the means of getting rid of infective scales among the lashes or conjunctival discharge, but a word in connection with dacryocrystitis may not be inappropriate. Any muco-pus in the sac, how- ever slight, may be fatal to the success of the operation, as every one knows, but the dangers of clear mucus or a very