Atlas and epitome of operative ophthalmology / by O. Haab ; edited by G. E. de Schweinitz.

  • Haab, O. (Otto), 1850-1931.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Atlas and epitome of operative ophthalmology / by O. Haab ; edited by G. E. de Schweinitz. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    to determine whether the injected fluid, which should be a bichlorid-of-mercury solution of 1 : 5000, is turbid or not, it is best to collect it in a clean black receptacle, as, for example, one made of hard rubber. In this way the faintest suspicion of cloudiness can be detected. I con- sider this a very important point. If the fluid is not clear, the lachrymal apparatus should first be treated for a time with irrigation, using preferably a freshly prepared 1-2 per cent, protargol solution, which is to be injected once a day for several days. [For this purpose a 20 per cent, solution of argyrol is most efficient.—Ed.] It is needless to say that the syringe—which ought always to be of glass—must be carefully sterilized before it is used for these diagnostic or prophylactic injections. The sterilizing is done by placing the glass syringe, with the canula, in a bichlorid solution of 1 : 1000 for a few minutes, or by boiling. If the patient is sensitive, a few drops of a 2-5 per cent, solution of cocain are injected into the lachrymal sac as a preliminary measure. The lower canaliculus, which is a little wider and more con- veniently situated, is for obvious reasons selected for mak- ing the injections; it must be somewhat dilated with a conical probe, to facilitate the introduction of the delicate Anel syringe. Both the probe and the syringe are intro- duced into the canaliculus at first vertically and then horizontally, as the canal at first runs vertically from the lachrymal punctum ; unless this precaution is observed, there is danger of making a false passage. The entire procedure must be executed with a light hand and with great caution. At the same time the operator should observe how the patient reacts to the interference, as it will guide his actions later during the operation. If the patient takes the injection quietly, it is most probable that he will be equally quiet during the operation. If marked or complete stenosis of the lachrymonasal duct be discovered, the condition may be treated by intro- ducing the probe or by extirpating the lachrymal sac if it is secreting. The latter procedure is absolutely necessary