For eczema yellow oxide of mercury 1, to vaseline 10, has an excellent reputation. It may be alternated with pyoktannin.
When abscess has formed it should be excised in a line parallel to the free border and the resulting cavity injected with the silver or the pyoktannin solution.
In all cases the patient must be fastened as for wounds of the lids so that he cannot rub the eye.
For eczema and other skin diseases the special treatment appropriate to the disease should not be omitted.
ŒDEMA OF EYELIDS.
In anthrax, malignant œdema, disease of heart, kidney or liver, distomatosis, trichiniasis, wasp stings, urticaria, petechial fever. Treatment: correct general disorder, remove local irritant, antiseptic astringents.
An œdematous condition of the eyelids with or without inflammatory conditions may be due to local disease or it may be the result of more general disorder. In anthrax districts any of the herbivora, but especially cattle and sheep, are liable to a diffuse anthrax of the eyelid with a special petechial or brownish condition of the palpebral conjunctiva. Malignant œdema and other local bacteridian affections affect the loose textures of the eyelid in a similar manner, but with extrication of gas and crackling under pressure. Such cases are complicated by local inflammation. When in the absence of inflammation the lids pit on pressure, one should seek for some disease of the heart, kidney or liver, also for indications of similar dropsical effusions in other parts of the body. Distomatosis and, to a less extent, pulmonary and duodenal strongylosis are especially common factors in sheep. In distomatosis (liver rot) a simultaneous dropsy is often present in the intermaxillary space, the chest or the abdomen. The puffiness of the eye is especially marked in the palpebral conjunctiva, and is exposed by everting the eyelid over the tip of the finger. In trichinosis in man and less frequently in swine, dropsy of the eyelid is often present at the end of the first week. Other swellings of the lids partaking more of the nature of inflammation, result from the stings of wasps, hornets and other insects, from urticaria (in horses especially) and from petechial fever in solipeds.
In treating such cases the general disorder, if present, must be first attended to, then the removal of any local irritant, and finally the antagonizing of any local inflammation or infection. Astringent and antiseptic lotions are especially called for.
EMPHYSEMA OF THE EYELIDS.
This has been already referred to as occurring in malignant œdema, black quarter and other gas producing infections. It may also come from lacerations made in puncturing the lachrymal sac, and from fracture of the margin of the orbit—the air entering the connective tissue in this case from the cavities of the nasal sinuses. The lid feels puffy and crackles when pressed and apart from a general infection it requires only soothing and antiseptic dressings.