DISEASES OF THE EYELIDS.
Skin Affections of the Eyelids.—Like the rest of the covering of the body the eyelids are liable to various skin affections. These are sufficiently discussed in Section XXI. One only need be mentioned here. It consists of an eruption of blebs, filled with clear fluid at first, but later with yellow matter. They spread from the inner part of the eyebrow over the forehead and up among the hair, and also downwards over the eyelids and the side of the nose. They are accompanied by severe pain and swelling and inflammation of the eye. The lids are so swollen that the eye is closed. This is an eruption quite similar to shingles, and properly called by the same name—herpes. It is treated iu a similar manner (p. 424).
Inflammation round the Eyelashes (Ble pharitis).—This is really an inflammation of the hair-sac from which an eyelash springs. It begins in little swellings on the edge of the lid round a hair, and rapidly spreads along the edge. Crusts form which stick to the lid, mat the hairs together, and produce a very unsightly appearance. The lids become thickened and red. Little points of matter often form. If the disease lasts long, the lashes fall out, so that the lids may be entirely deprived of lashes. Owing to the thickening the lids are turned outwards; the tears no longer readily escape into the opening of the tear passage, and the eyes are constantly overflowing. The inflammation may spread over the inner surface of the lids and reach the eyeball ; and the con stant irritation of the tears, discharge, &c., may also produce ulcers on the front of the ball.
Treatment, if early adopted and persevered in, will readily cure the affection in its first stages. The crusts must be thoroughly removed and the lids cleansed. This should be done by means of warm water. To the water bicar bonate of soda (baking soda) may be added, as much as can be lifted on a sixpence to an ordinary tea-cupful of water. When the lids are perfectly clean they should be smeared with ointment of the yellow precipitate.' This
must be kept up till the lids are quite restored, for the inflammation very readily returns. If the inflammation is very far advanced, the lids thickened and raw looking, &c., after crusts have been thoroughly removed the edges of the lids may be lightly touched all along by a stick of nitrate of silver. In such cases it is also necessary to pull out the hairs seriously affected. As this affection is apt to spread among badly-nourished children, and children not in vigorous health, good diet should be given, and exercise in the fresh air attended to. Cod-liver oil is of great benefit also.
The inflammation can apparently be con veyed to sound eyes by particles of the crusts or matter. Care must therefore be taken that towels, &c., used by the sufferer are not used by others, and that hands are well washed after bathing the eyes, &c.
Turning outwards or inwards of the eyelid is frequently a result of the above inflammation. The former is properly called ectropion, the latter entropion. Injuries, burns, &c., are causes, and the inward turning is frequent as a result of the general laxness of the lid in aged people. The inturned lid grievously irritates the eyeball, against which the lashes rub, and leads to serious inflam mation. In the case of the out-turned lid, the inner surface looks red and fleshy from the constant irritation of the air, dust, &c.; and the eyeball, being deprived of the protective covering of the lid, is also open to irritation by foreign particles, &c. Both conditions can be properly remedied only by surgical operation. The operation is not at all serious or dangerous.
Stye (Hordeolum) is a small boil formed on the edge of the eyelid, occupying the sac of an eyelash. Several are at to occur one after the other, probably because a bad state of health determines them. They form little red swell ings, accompanied by considerable heat and pain. When matter has formed, the pain usually ceases. The stye begins usually with an itchi ness, producing a tendency to rub the part.