CHAPTER V.
OPERATIONS ON EYE.
Operations on the Eye and its Appendages.
Operations on the Lids.—
Fig. vii. [81]
1. For Entropium or Inversion of the Lids, often Combined with Trichiasis, irregularity of the Ciliæ.—As in many cases the entropium seems to depend partly on a too great laxity of the skin of the lid, combined occasionally with spasm of the orbicularis, the simplest and most natural plan of operation is (a) to remove (Fig. vii. a) an elliptical portion of skin, extending transversely along the whole length of the affected lid, including the fibres of the orbicularis lying below it, and then to unite the edges with several points of fine suture. (b) An improvement on this in obstinate cases is proposed by Mr. Streatfeild (Fig. viii.) He continues the same incision, but in addition removes a long narrow wedge-shaped portion of the tarsal cartilage, grooving it without entirely cutting it through, in such a manner that the retraction of the skin bends the cartilage backwards, thus everting to a very considerable extent the previously inverted ciliæ.[83]
