Wounds of the Cornea are frequent from chips of steel, pieces of coal, &c. Pieces of coal are the worst, from their dirtiness. It is of the utmost consequence in such cases to know whether the chip that struck the eye has passed into the ball, or has simply cut the cornea. This is generally made out by shutting the eye and pressing gently but firmly all over the upper and lower lid. If pressure at a par ticular spot causes a sharp pain each time it is made, the chances are the piece that has struck the eye has passed inwards. If this is so, the eye almost surely will require removal, and that speedily, lest the sound eye becomes inflamed by sympathy (p. 485). Another danger of wounds of the cornea is that, if the cornea is completely cut through, the curtain of the eye—iris—may bulge forward into the wound. This not only delays healing, but serious inflammation may arise from the pinching of the iris in the wound. Wounds of the cornea may also lead Xi abscesses, ulcers, &c.
Treatment.--Till competent advice can be obtained the eye should be carefully bathed with warm water. A drop of solution of atro pine (2 grains to the ounce of water) should be inserted within the lids, which must be very carefully and gently opened for the purpose. A pad of lint should then be applied over the eye, and secured by a bandage pressing just sufficiently to prevent movement of the lids. If pain is great, apply hot cloths over the pad. The atropine may be droppel in twice a day. If inflammation of the sound eye threaten, no time must be lost in seeing an eye surgeon, lest both eyes be destroyed.
Inflammation of the white of the eye (the sclerotic, p. 447) appears in the form of a round red swelling, yellowish on the top. It may form a prominence of the size of a pea or small bean. It is to be treated with warm fomentations, and the eye is to be closed, a pad and bandage being applied.
Inflammation of the Iris iris, as explained on p. 448, is the curtain of the eye, whose line gives the colour to the eye. In its centre is the round opening or pupil. The iris regulates the amount of light admitted to the eye. By contracting it narrows the pupil to a very small opening ; and this it does under the influence of much light. By dilating it widens the pupil, and this it does when light is dim, so that more may be admitted. It is, therefore, easy to test whether the iris is in a healthy condition. Shacje the eye from light, the pupil should widen ; let the light fall full upon it, the pupil should narrow. This test may also be applied by simply shutting the lid of the person whose eye is being examined and then rapidly opening it. On the instant of opening, the pupil
is seen to be wide, and it immediately contracts. In dim light a taper may be used and brought near or held close to the eye.
The chief symptom of inflammation is the inability of the iris to act tinder the influence of various degrees of light, or it acts very slowly. This is due to the curtain becoming thickened by the inflammation. Perhaps the first symp tom is intense pain, worse at night, so that the sufferer gets no sleep. Light falling on the eye is painful, and the tears flow. But neither of these symptoms is so bad as in inflammation of the cornea. When the eye is carefully looked at, and compared with the sound eye, it is found to have changed colour, and is of a greenish, reddish, or yellowish line. Then the action of light should be tested as already explained. On carefully looking at the eye a circle of fine red vessels may be seen surrounding the transparent cornea.
The causes of this inflammation are various. Rheumatism is a very frequent On e and syphilis. In inflammation resulting from syphilis it is common to see one or more red fleshy points on the border of the curtain. Cold may also induce an attack.
The results of the disease maybe very seri ous. The iris may become attached to the lens behind so as to become permanently fixed. This is called posterior synechia. In some cases the pupil becomes altogether cloned, causing loss of sight.
Treatment.—Whether one is sure of the true character of the disease or not, the first thing to be done is to let fall a few drops of the solution of atropine into the eye, and to repeat this once or twice daily. This widens the pupil, so that if it becomes immovable it is fixed in the most favourable position Mr sight. If the case is advanced the pupil may not widen at all. This is a sure indication of the nature of the disease. Keeping the pupil wide also keeps it at rest and aids recovery. The eye should also be closed, the belladona paint (p. 480) applied, as well as a piece of lint and a bandage.
The patient should secure a free movement of the bowels by one or two of the compound blue and colocynth pills. This may be repeated every second night for several times. In severe leases a pill containing 2 grains of blue pill and 1 grain of quinine (for grown-up persons) may be given twice or thrice daily for a week or ten days, unless the gums become sore, when they should be stopped. A blister on the temple aids the purgative medicine in relieving the pain.