Clinical lectures on some of the principal diseases of the eye. Cataract, continued / by Isidor Glück.

  • Glück, Isidor.
Date:
[1854]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on some of the principal diseases of the eye. Cataract, continued / by Isidor Glück. 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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    ing the patient’s head to his chest. The surgeon depresses with the index and middle finger of one hand^ the lower lid, and fixes the globe by press- ing it, and holds the instrument in the other. The light must be allowed to fall obliquely upon the patient’s eye. Or the patient is seated in an arm chair,f and leans his head back- wards, the operator stands in front or behind the patient; or the patient lays comfortably on a couch, and the surgeon is seated behind the patient, and rests his elbow on the head of the couch.J Suppose the patient to be seated in a chair without a back, and the op- eration for extraction has to be performed on the left eye §; the surgeon holding the knife in his right hand, between the thumb and the first three fingers, fixes his little finger on the malar bone, and proceeds to incise the cornea, after having touched the cornea with the flat surface of the knife, to steady the eye. The incision may be made in three different points of the cornea; or it may be pierced about its middle, close to the junction with the sclerotica at its outer side, and a semicircular flap of the cornea may be formed parallel with its margin (superior section), or the flap may be formed on its lower half (inferior section), or on its lower and outer side (exterior and inferior section), I prefer the superior section : if this be adopted, the cornea has to be pierced with Beer’s, Wenzel’s, or Jaeger’s cataract knife, directly (and not obliquely) close to its junction with the sclerotica, about the middle of the cornea, at its temporal side, the knife, with its cutting edge turned upwards and the flat part parallel to the iris, has to be pushed rapidly, but steadily, across the anterior chamber; the cornea then is punctured again on the opposite (nasal) side as near as possible to its junction with the sclerotica; the knife is now carried upwards very slowly,|| parallel with the circle formed by the junction of the iris and sclerotica, and thus the semi-circu- lar flap is completed. The aqueous humor escapes when the section is completed. The upper lid must now be dropped, and the eye allowed to rest for a few moments ; when the lid should be raised again. The iris will be found to bulge forward together with the cataract against the concavity of the cornea. * The left hand for the right eye, and right for the left eye. f Guthrie. Bowman, Dixon, and others. § The pupil is to be dilated by atropine: although it contracts quickly when the anterior chamber is opened, still the iris is less in the way of the knife while it is pushed across the chamber. II If the knife is carried quickly, an irregular, mostly triangular flap is formed, often too small to allow the lens to escape.