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Of Children

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Pustules, the size of a pie's head or millet seed, are often found in the eyes of ill-nourished children. Usually they are on the edge of the cornea, the transparent part of the eyeball, and look like little raised ulcers. They are called in medical language phiyctenm. Sometimes they surround the edge of the cornea like beads. The lining membrane of the eyeball in their neighlmurhood is deeply inflamed, and there is usually considerable pain.

Treatment consists in inserting a piece of yellow ointment (see note at p. 475) into the eye and rubbing it over the pustule by a move ment of the lids. To get the ointment into the eye, take it on the end of a smooth piece of wood, say the thickness of a match ; gently turn out the lower lid and smear it on, then rub the lid over the eyeball. The person's general health ought also to be attended to.

Thickening of the Lining of the Lids (Granular Lids—Egyptian Ophthalmia—Trach onta).—After prolonged inflammation of the eyelids their inner lining becomes studded by shaggy little elevations, which appear like sago grains, and make the surface very rough. The irritation maintained by the rough lids, as they move over the eyeball, encourages inflammation. The transparent cornea becomes affected, blood vessels are formed over it, and in the end it becomes so thickened and covered with vessels that the person cannot see with the affected eye. The eye is extremely sensitive to light, and scalding tears are constantly flowing from it.

The treatment is of considerable difficulty. The inner surface of the lids should be scarified to destroy the elevations, and then glycerine of tannin should be dropped on the lids, which should be taken between the fingers and vigor ously rubbed together. Only a surgeon can do this properly. All the patient can do is to keep the eyes clean and use one of the washes already noted.

Burns of the inner surface of the eyelids, that is of the conjunctiva, should be treated by dropping into the eye a little castor-oil in each ounce of which 2 grains of sulphate of atropia have been dissolved. When the burn is deep,

the danger is of the inner surface of the lid becoming attached to the surface of the eyeball in the process of healing. In this way the lid may become so attached to the eye as to cover up the ball and prevent sight, and at the same time bind the eyeball and prevent it being moved about to any extent. This condition is called symblepharon. Sometimes, as the result of burns, the margins of the two lids grow to gether. This is called anchylobiepharon.

An openktign is required to remedy either condition, Foreign Bodies within the eyelids.— Everyone knows the annoyance and pain caused by getting something into the eye which has no business there, and which is consequently called a "foreign body." Everyone should be able to look for and turn out such an intruder. First cause the person to open his eye as wide as possible, and turn his eye up as far as possible. Let a finger be placed on the outside of the lower lid to pull it slightly downwards. By this means the lower lid is turned out and the searcher can see if anything is there. If the person turns the eye to one side and another, when directed, the whole surface is readily examined. If any particle is seen it is readily removed by the corner of a soft cloth. If a camel-hair pencil is at hand it is the best to brush out any particles. Next examine the upper lid, which also must be turned out,' though that is not so easily done. The person having turned his eye downwards, catch hold of the edge of the lid by the eyelashes, and pull it well downwards and forwards. Put the point of one finger on the top of the lid, well under the eyebrow, and turn the lid over on to it. A little practice makes this very easy, but at first it is difficult. If the searcher cannot do this, then let him turn the lid over on the point of a pencil or on the wrong end of a match, &c. If the foreign body is on the lid, remove it as already advised. Foreign bodies on the eyeball are spoken of on p. 481. In every case of prolonged irritation of the eyelids a foreign body should be looked for.

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