GRANULAR CONJUNCTIVITIS. or Trachoma, pop ularly known as 'granular lids.' This is a con tagious affection of the eye, conveyed by means of the secretion. The contagion is most fre quently carried by towels. etc., used in common by many persons, and so the disease is found chiefly in crowded and dirty houses, in schools, barracks, etc. It occurs very frequently in Arabia, Egypt, and the lowlands of Europe. In this country the negro race is comparatively seldom affected by it. The disease has been called Egyptian ophthalmia on account of its importa tion into Europe from Egypt during the wars of Napoleon. The Irish and Jews are especially liable to the affection. It is accompanied by a varying degree of dread of light, itching and burning of the lids, pain, flow of tears, and trouble with sight. The lids are swollen, the upper drooping: there is a variable amount of muco-purulent discharge. The conjunctiva of the lids and fornix. or fold between lids and eye balls, is red, thickened, and covered with many small papillie, or velvety elevations, or by gran ules which are round. translucent, and yellow or grayish. After a time, scar tissue forms and the papilla' and granules disappear. The disease may be acute, but usually begins gradually and lasts for years. It is believed by some that the
cases in which .the granulations give few or no symptoms, and there are no signs of inflamma tion, are not contagious. The dangerous com plications are ulceration of the cornea alone or accompanying a condition known as pannus. In the latter, new tissue containing blood-vessels gradually forms until the upper half of the cornea is covered, occasionally the whole. If this disappears later, sight will be restored; otherwise, the new tissue causes permanent opa city, an accident which may also result from corneal ulceration. Entropion (q.v.), trichiasis (q.v.), or ectropion (q.v.), or symblepharon, a eieatrieial adhesion of the conjunctiva of the lid to that of the eyeball. may follow trachoma.
The treatment of trachoma may require either local applications or surgical interference. Pre vention is most important. Persons having the disease should exercise great care that others may not use their to eels or other toilet articles, which might serve to convey it and in public institutions cases should be carefully watched for and isolated.