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Diseases of the Tear Apparatus

inner, eye, sac and discharge

DISEASES OF THE TEAR APPARATUS.

Obstruction of the Tear p. 447 the nature of the apparatus for carry ing off the tears has been described. The canals in the inner portions of the lids are narrow, and the opening on the edge of the lid small. They are, therefore, very easily blocked. A swollen condition of the lining membrane is quite a sufficient cause of such a blocking; and, since the lining membrane is continuous upwards with that covering the inner surface of the eyelid and part of the eyeball, and down wards with that lining the nostrils and throat, it is liable to share in affections of these other parts. Cold-in-the-head, for this reason, readily extends up the tear passages, producing swell ing and increased amount of secretion from the membrane. The obstruction very often begins, not in the canals, but in the tear-sac (p. 447), which becomes affected by the catarrhal con dition (p. 214).

person is troubled with "a weeping eye." The tears gather at the inner corner of the eyelids and run down over the cheek. Especially is this troublesome in cold and windy weather. The nostril of the affected side is dry. Sometimes, owing to accumulation of discharge in the sac, a small swelling is formed at the inner angle of the eyelids. If the person

press with his finger over the swelling it may be emptied, discharge welling up through the tear passage into the eye. The discharge may be clear or mattery. But if the sac cannot be thus emptied the matter is apt to burst its way through the skin at the side of the nose, and a small opening is produced through which matter comes. This is a fistula of the tear-sac. Acute attacks of inflammation are not uncom mon. The inner part of the eyelids becomes red, dry, swollen, and acutely painful, and the inflammation may extend along both lids, so that the eye becomes almost or quite closed.

Treatment is most successful if begun early. Everyone with a "weeping eye" should at once seek competent advice, lest this affection be present. A probe is passed along the canal and, down through the sac into the nostril. When this is carefully done it is not so painful as would be expected. It clears the passage and restores the use of the part. But it must be done frequently, till the passage is made quite clear and remains so. Hot applications are the appropriate remedy in acute cases, the probing being delayed till the acute attack has passed.