Transactions of the American Ophthalmological Society Annual Meeting (Volume 13) (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1915. Excerpt: ... a tendon hook is passed under the tendon of the muscle, and one of the needles is passed through the tendon and out again so as to include its middle f. The suture is now firmly tied around this middle f, and that part of the tendon cut from its attachments to the globe and the incision extended upward until a narrow ribbon of muscle about 12 mm. long is isolated. With a dull pointed scissors a channel is now dissected from the margin of the tarsus where the conjunctival incision ended and between the tarsus and the skin to the ciliary margin. One of the needles is now passed through the channel and made to emerge through the skin just above the cilia near the center of the lid, and the second needle is passed likewise, piercing the skin 3 mm. from the first. Gentle traction is now made on the sutures, and the muscle slip is pulled into the channel in the lid until finally its end is drawn quite down to the ciliary margin, when the sutures are tied over a small piece of folded gauze. The incision in the conjunctiva is now sutured with great care with fine silk, that of the globe over the remaining superior rectus muscle and that of the lid over the muscle slip now attached in the lid. Especial care should be taken to carefully coapt the conjunctiva at the fornix, as a disregard of this precaution has led to prolapse of the fornix conjunctiva. The immediate effect should be a considerable overcorrection. After both operations, the eyes could not be completely closed for several days and precautions should be taken to avoid an exposure ulcer. In neither of these eyes was there any injury to the corneal epithelium, and the final result, as can be seen from the photographs, is quite satisfactory. The patient, J. H. H., aged six, had a congenital ptosis of bot...