Clinical lectures on diseases of the eye. Lecture III. Squint / by Charles Bell Taylor.

  • Taylor, Charles Bell, 1829-1909.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on diseases of the eye. Lecture III. Squint / by Charles Bell Taylor. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    operated upon thousands of patients at this institution: it is a rule that each shall return within a few months, so that we may note the ultimate result. One easily forgets faces in a large practice, and it frequently happens, as you know, that we fail to recognise them, so completely has the ocular defect been removed. Here is a young man—Chaeles Fitch, from Staveley—on whom you saw me operate three weeks ago. He had for eighteen years suffered from a very marked deformity caused by internal strabismus, and was restored to his present condition without anaesthetics, by an operation that did not take five minutes. It was not so in former times: Dieffenbach and his followers used to divide the belly of the muscle some distance from its insertion into the sclerotic, outside the capsule of Tenon, which was frequently lacerated in the process, and the result was that the muscle did not become re-attached to the globe, but fell back, so that the unopposed rectus externus roUed the eye outwards, producing a worse deformity than before. Here is a patient,—at present coachman to Mr. Unthank, surgeon, of this town,—on whom you saw me operate five weeks ago, for a frightful deformity of this kind, occasioned by an operation for internal squint—performed at St. Bartholomew’s hospital twenty-six years ago. His eyes are now, as you see, perfectly straight; but the effects of the original operation are still manifest by a retracted caruncle in both eyes. [The three patients, Janet S. and the two L.’s, were then placed under the influence of a mixture of chloroform and ether, and operated upon in succession in the manner described.] Eemaeks aftee Opeeation.—The results of the operation you have just seen upon the younger L. and Janet S., so far as I can judge, leave nothing to be desired; there is, however, a slight residual convergence in the case of the elder L., which may or may not require correction by shght tenotomy of the internal rectus of the sound eye. We shall not, however, attempt this untH we see what is the result in a few week’s time. I am asked whether all cases of internal squint depend upon hyper- metropia; and what is the cause of divergent strabismus ? Well, I should say that 90 per cent, of the cases of internal strabismus are caused by hypermetropia. It is true that there are odd cases for