By N. R. Galloway BA, MB, ChB, DO, FRCS, MD (auth.)
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Extra info for Common Eye Diseases and their Management
Eversion of the upper lid reveals the raised papillae which have been likened to cobblestones. Occasionally the cornea is also involved initially by punctate keratitis but sometimes it may become vascularised. It is often necessary to treat these cases with local steroids, for example prednisolone drops applied if needed every 2 hours for a few days to enable the child to return to school, then reducing this dose as much as possible to a maintenance dose over the worst part of the season. Less severe cases may respond well to sodium chromoglycate drops and these may be useful as a long-term measure (Fig.
Fig. 5. Acute dacryocystitis. (With acknowledgement to Mr R. ) The Watering Eye 37 proceed to undergo more radical surgery of the tear passageway. Sometimes, in adults, the obstruction is in the nasolacrimal duct and in these cases an effective cure can usually be achieved by performing an operation to connect the lacrimal sac directly with the nasal cavity (dacryocystorhinostomy). The initial investigation of lacrimal obstruction entails syringing and, if this does not give the information required, it is possible to display the tear duct by x-ray using a radio-opaque contrast medium which is injected into the lower canaliculus with a lacrimal syringe (Fig.
____ Opening of meibomian gland Cross-section of normal eyelid. Deformities of the Eyelids 41 supplied by the seventh cranial nerve, which closes the eyes, and the levator palpebrae superioris. Strictly speaking, it is the tendon of the levator which is present in the eyelid and this muscle opens the eyes and is supplied by the third cranial nerve. We must not forget that there is also some smooth muscle in both upper and lower eyelids which has clinical importance apart from its influence on facial expression when the subject is under stress.
Common Eye Diseases and their Management by N. R. Galloway BA, MB, ChB, DO, FRCS, MD (auth.)