LACHRYMAL ORGANS, DISEASES OF THE. The lachrymal gland Is very rarely the seat of disease. It sometimes suppurates from acute Inflammation, but it is more commonly affected with a chronic enlargement and induration, forming a prominent tumour under the upper eyelid, which pushes the eye downwards and inwards.
In this state it may be removed without difficulty and with perfect safety from beneath the eyelid.
The most frequent disease of these organs is that commonly called fistula lachrymal's, which consists of inflammation of the lachrymal sac. [EYE, NAT. HIST. Dry.] When the inflammation is acute, it forms a tumour of about the size and shape of a horsa-bean at the inner side of the eye, which is firm, red, hot, and extremely painful. The nasal duct being closed, the tears, which should pass through it into the nose, flow continually over the cheek, and produce redness and excoriation. The eyelids swell, and the pain and tension are sometimes so severe as to excite considerable fever and even delirium. If the inflammation be not early checked, suppuration takes place, and the matter may escape by an opening, which sometimes remains for a long time fistulous, at the corner of the eye. The treatment must be actively reducing, and when suppuration has taken place an early opening should be made into the sac at its most prominent part.
In the chronic inflammation of the lachrymal sac, which often succeeds to the acute, the nasal duct continuing obstructed, the sac becomes frequently distended with its secretion, and a mixture of mucous and purulent matter may be pressed out of it through the puncta lachrymalia. In some cases no other inconvenience is pro duced than that of the necessity of pressing out the contents of the sac once or twice a day ; but in others, attacks of acute inflammation are apt to supervene, and excite very painful affections both of the lachrymal apparatus and the eye itself. In the first instance, leeches and other antiphlogbtic remedies should be employed ; but if they are unsuccessful, astringent lotions should be applied to the eye, that they may be imbibed by the puncta lachrymalia, and conveyed through them to the nasal duct. But if these means fail, the lachrymal sac must be punctured near the inner angle of the eye, and a probe passed through it into the nose. A portion of bougie must be introduced into the passage thus restored; the canal will enlarge around it so as to permit the tears to pass through, and after a few days the bougie may be exchanged for a nail-headed style, which must be worn iu the canal and sac for a considerable time.