The first thing we notice in looking at the eye may be the lids and at
each edge are the eyelashes. When this edge becomes inflamed it is called
Blenharitis Marginalis or inflammation of the margin of the eyelids. It is
called thus from the name of the eyelid "Blepharon;" It is always means
inflammation.
If we turn down the lower lid and turn up the upper, we see a red membrane
called the conjunctiva (connecting). This is the mucous membrane of the
eye. It lines the inner surface of both lids and is reflected over the
fore part of the Sclerotic and Cornea--two other coats of the eye, The
palpebral or eyelid portion of the conjunctiva is thick, opaque, highly
vascular (filled with blood vessels) and covered with numerous papillae.
It turns back (reflects) over the Cornea, but it consists only of a very
thin structure (epithelium) forming the anterior layer of the cornea and
is, in health, perfectly transparent. Upon the sclerotic it is loosely
attached to the globe. When the conjunctiva becomes inflamed it is called
(Conjunctiv(a)itis) conjunctivitis. The sclerotic-cornea forms the
external tunic (coat) of the eyeball, the sclerotic being opaque and
forming the posterior five-sixths of the globe; the cornea, which forms
the remaining sixth (the front white part that is plainly seen) being
transparent. The sclerotic (means dense and hard) serves to maintain the
form of the globe, the eyeball.
[EYE AND EAR 347]
The cornea.--This is almost circular in shape. It is convex anteriorly and
projects forward from the sclerotic in the same manner that a watch glass
does from its case. This layer covers what we call the pupil.
The second tunic or coat (membrane) is formed from behind forward by the
Choroid, the ciliary body and the Iris. The choroid is the vascular and
dark coat covering the posterior five-sixths of the globe. The ciliary
body connects the choroid to the circumference of the iris. The iris is
the circular muscular septum (division) which hangs vertically behind the
cornea, presenting in its center a large rounded opening, the pupil.
The choroid is a thin highly vascular membrane of a dark brown or
chocolate color and is pierced behind by the optic nerve and in this
situation is firmly adherent to the sclerotic.
The ciliary body comprises three muscles for its make-up and connects the
choroid to the circumference of the iris.
The Iris (rainbow) has received its name from its various colors in
different individuals. It is a thin, circular shaped, contractile curtain,
suspended in the aqueous (watery) humor behind the cornea and in front of
the lens, being perforated a little to the nasal (nose) side of its centre
by a circular opening, the pupil, for the transmission of light. By its
circumference it is continuous with the ciliary body, and its inner or
free edge forms the margin of the pupil. The anterior surface of the iris
is variously colored in different individuals and marked by lines which
converge toward the pupil.
The Retina.--This is a delicate membrane, upon the surface of which the
images of external objects are received. Its outer surface is in contact
with the choroid; its inner, with the vitreous (glass) body. Behind it is
continuous with the optic nerve; it gradually diminishes in thickness from
behind forward. The retina is soft, semi-transparent and of a purple tint
in the fresh state. Exactly in the centre of the posterior part of the
retina corresponding to the axis of the eye, and at a point in which the
sense of vision is most perfect, is an oval yellowish spot, called after
its discoverer, the yellow spot or Macula lutea of Sommering.
Refracting Media.--The aqueous humor completely fills the anterior and
posterior chambers of the eyeball. The anterior chamber is the space
bounded in front by the cornea; behind by the front of the iris. The
posterior chamber is a narrow chink between the peripheral part of the
iris, the "suspensory ligament" of the lens and the "ciliary processes."
[348 MOTHERS' REMEDIES]
The vitreous body forms about four-fifths of the entire globe, It fills
the concavity of the retina and is hollowed in front, forming a deep
cavity, for the reception of the lens. It is perfectly transparent and of
the consistency of thin jelly. The fluid from the vitreous body resembles
nearly pure water. The crystalline lens enclosed in its capsule is
situated immediately behind the pupil, in front of the vitreous body. The
lens is a transparent, double-convex body. It is more convex on the
posterior than on the anterior surface. The rays of light go through this
body and converge to a point at the back of the retina.
BLEPHARITIS MARGINALIS.--This means a chronic inflammation of the margin
or edge of the eyelids accompanied by congestion, thickening and
ulceration of the parts and the formation of scales and crusts.
Causes.--The underlying cause is often an inflammation of the conjunctiva
where the proper care is not taken in cleansing the roots of the lashes
when the discharge collects.
Other causes are keeping late hours, smoke and dust.
Symptoms.--The red swelling along the roots of the lashes is often the
only symptom. This comes and goes at the least excuse, such as eye strain,
late hours, dust and wind. Scales and dust form in the severe forms, of
the disease. It is most common in children, extends over many years and
may finally result in the loss of the lashes, with the edge of the lid,
thickened, reddened and turned out.
Treatment.--This is tedious. Fit glasses if there is eye strain, reform
the mode of life and attend to any constitutional disease that may tend to
make it worse.
Local treatment.--Keep the parts thoroughly clean. The edges of the lids
should be washed carefully with soap and warm water or mild solution of
borax or soda until the crusts are all cleaned off and then use at night
an ointment composed of the following ingredients:
Yellow oxide of Mercury 2-1/2 grains
Petrolatum 2-1/2 drams
Mix and make an ointment and rub on the edge of the lids every night,
first cleaning them. The conjunctivitis must be cured.
STYE (HORDEOLUM).--This is a swelling beginning in a gland or glands at
the edge of the lid and pus forms finally.
Causes.--Inflammation of the edge of the lid, stomach trouble, run down
condition, poorly fitted glasses, when glasses should be worn to relieve
the eye strain.
Symptoms.--Itching and burning feeling followed by a red swollen area
(lump) at the edge of the lid. Later it comes to a point and discharges.
Cause.--Styes usually run their course in a few days or a week; another
frequently follows. When it does not reach the pus stage, it often leaves
a hard swelling (blind stye).
[EYE AND EAR 349]
MOTHER'S REMEDY. 1. Stye.--Home Method to Kill.--"To hasten the pointing
of a stye apply hot compresses for fifteen minutes every two hours. As ill
health may be the cause, a tonic may be needed; glasses properly fitted
should be worn and a boric acid eyewash used until long after the stye has
disappeared." Applying hot compresses will relieve the congestion and
gives much relief. Ill health produces a poor circulation of the blood and
a good tonic will be found beneficial. Styes are frequently produced by
need of glasses.
Treatment.--Treat the stomach and system if necessary. Ice or cold cloths
against the stye may abort it. If it goes on, hot fomentations will hasten
it. It should then be opened up and scraped out. It will soon heal then
and will not leave a lump.
ACUTE CATARRHAL CONJUNCTIVITIS (Pink Eye).--Definition.--This is an acute
inflammation of the mucous membranes under the eyelids, and there is
congestion (too much blood), swelling and a discharge of mucus and pus.
Causes.--Exposure to wind, dust, smoke, or irritating foreign substance,
cinder, sand, etc. It may occur in epidemic form and then is contagious
and is called "pink eye."
Symptoms.--The lids appear stiff to the patient, the light causes
discomfort and the patient fears it. Burning feeling as if there was some
dirt, etc., under the lid, not much pain, but discomfort especially in the
evening. The lids look swollen and red. The conjunctiva on the cornea is
reddened and that on the lid is thickened, reddened and rough. The
discharge collects at the roots of the lashes or lies on the conjunctiva.
The lids are stuck together in the morning. The sight is slightly affected
by the discharge on the cornea, which is otherwise clear. Sometimes little
(minute) ulcerations are seen.
Course.--It may run into a chronic conjunctivitis. One eye is usually
attacked a few days before the other. The first stage lasts a few hours or
a day and then the discharge follows which may last a few days or a week
or more.
Treatment.--First: Use gauze or cotton and dip in ice or cold water and
apply to the eyelids. A wash of hot water can be used to cleanse the eye
or ten to sixty grains (one teaspoonful) of boric acid to an ounce of
water can be used as a wash also.
The following remedies are good in combination as follows:
Alum 3 grains
Sulphate of Zinc 2 grains
Distilled Water 1 ounce
Mix and drop one drop into the eye two or three times daily. A weak
solution of tea can be used also as a wash. Anoint the lids at night with
white (tube) vaselin.
[350 MOTHERS' REMEDIES]
INFLAMMATION OF THE EYE OF NEWLY BORN (OPHTHALMIA NEONATORUM).--This is a
severe inflammation of the conjunctiva in the new born infant, usually due
to a discharge from the mother and it is characterized by a discharge of
pus.
Causes.--Mild cases may come from a less violent form of infection from
the mother's discharge from the vagina, or from outside causes. The
majority of the severe cases is due to a poison (the gonococcus
infection).
Symptoms.--The first symptoms are swelling and redness, usually of both
eyes, usually occurring a few days after birth. Soon the discharge appears
and shortly becomes creamy pus, which runs from the eyes when the swollen
lids are partly opened. As the disease continues to advance, the membrane
of the lid is thickened, red and velvety looking and the conjunctiva
(membrane) in the eye is swollen, puffy and watery.
The disease may last from two to six weeks or longer.
If the pus is not cleaned from the eye, the cornea may look dim and ulcers
may appear. If the ulcer eats through the cornea the iris is apt to be
caught in the opening and in the scar resulting from the ulcer. The cornea
may later bulge and protrude or the disease may involve the whole eye in
an inflammation which may destroy it.
The result generally depends upon how soon treatment is begun. If attended
to early the great majority of cases recover. It is serious to neglect
early treatment for this disease. It causes a great many cases of
blindness and generally the cases are neglected too long. Treatment must
begin before the disease begins. Immediately at the birth of the child,
when if there is any poison in the eye due to a discharge in the mother's
vagina, it can be immediately cleansed.
TREATMENT PREVENTIVE. What to do first.--As soon as the child is born and
before its eyes are opened the discharges should be carefully wiped away
from the lids with small squares of cotton or gauze, pieces wrung out of a
weak solution, three per cent (three parts to one hundred of warm, boiled,
water) of boric acid. The eyes should not be exposed to the light. At the
first both the eyes should be bathed and the same piece of linen should
not be used for both eyes.
As soon as any redness appears the eye should be frequently bathed with
this warm, weak solution of boric acid and sometimes cold compresses
should be used by taking squares of folded gauze or masses of absorbent
cotton. Take them cold from a block of ice and lay them over the eyes, and
keep constantly changing to keep them cold. This relieves the congestion
and prevents a great amount of blood from flowing and settling
(congestion) there. When pus appears in the eye it should be cleansed
every half hour at least. You can do this by letting the solution run over
it from a medicine dropper. After being allowed to trickle from the outer
to the inner angle (corner) of the eye, it will then run down beside the
nose and can be caught in a piece of absorbent cotton or sponge. If there
is a great amount of pus in the eye, the eye may have to be washed out in
this manner, every fifteen minutes, day and night, so that the cornea will
be kept clean. If this must be done a small fountain syringe with a glass
tube (eye-dropper) attached will cause a steady flow of the solution. The
boric acid can be increased to five or ten grains to the ounce of water.
If only one eye is diseased the other eye may be covered.
[EYE AND EAR 351]
All cloths, etc., should be burned at once and the basin which has held
them, filled with carbolic acid solution of the strength of one part acid
to twenty parts water. The nurse's hands should be thoroughly scrubbed in
hot water and soap and disinfected in the same strength of carbolic acid
solution, as the disease is very contagious and dangerous to adults. An
attendant should not touch her face or hair with her hands unless they
have been washed quite clean. The conjunctiva should be brushed with a
solution of nitrate of silver of two per cent strength (two parts to one
hundred of distilled water) and then neutralized with a salt solution, not
strong enough to burn.
When the cornea is diseased one per cent solution of atropine may be
necessary once or twice a day.
Caution.--In the cities this disease is disastrous in its results to the
sight of babies. This is due to the want of necessary care. Persons who
must be with the patient should be very careful not to get any of the
discharge upon their clothes or person, as it is very contagious.
ULCER OF THE CORNEA.--Causes.--Poor general health is an underlying cause
or the cornea itself may be poorly nourished. Ulcers are common among the
poor classes. They often begin through a rubbing of the cornea by a
foreign body. They also come from diseases of the conjunctiva. Weakly
babies are easily affected.
Symptoms.--The light hurts the patient; there is a feeling of something in
the eye. When the ulcer is over the pupil the sight is impaired. The
eyeball shows a ring of pink congestion about the cornea, with congestion
of the conjunctiva. The form of the ulcer may be irregular, circular, etc.
Course.--The simple ulcers heal in a week or two. Infected ulcers may
spread, or they may sink deeply into the substance of the cornea and eat
through. The danger to the sight depends upon the kind and severity of the
ulcer. There is apt to be more or less film over the eye for some time and
if the ulcer eats through it may destroy the sight.
Treatment. Preventive.--When the cornea has been injured and there has
been some rubbing off of its tissue (abrasion) mild antiseptic solution in
the form of eye drops should be used. Boric acid, as much as will dissolve
in warm, distilled water and some dropped in the eye three or four times a
day. If there is a foreign body in the cornea, clean instruments should be
used to remove it. The cocaine used to render the eye painless must be
pure.
[352 MOTHERS' REMEDIES]
General Treatment.--If the patient is "run down" the general system should
be built up.
Local Treatment.--One to two per cent solution of Atropine should be put
into the eye three to six times a day to keep the pupil dilated and
prevent it from adhering to the cornea. Hot fomentations repeated
according to the severity of the case and the amount of "easing" they
give. A three per cent solution of boric acid should be used for cleansing
purposes. The bowels should be regular. The patient should remain in one
room.
FILM ON THE EYE PTERYGIUM.--This is a growth beginning near the inner or
outer corner and extending with its point towards the center of the
cornea.
Symptoms.--The patient only complains when it has advanced toward the
center of the cornea and the vision is lessened or cut off. It occurs more
often from the inner corner. It keeps growing for many years and may cease
advancing at any time.
Treatment.--Surgical treatment is often necessary. Dr. Alling says:
"Dissect off the growth from the cornea and sclera coats, leaving the base
attached (toward the corner of the eye) and bury its point under the
undermined conjunctiva below. If the growth is dissected off the cornea,
which may readily be done, and then cut off (towards its base) it would
recur."
IRITIS. (Inflammation of the Iris.)--This is an inflammation of the iris,
characterized by congestion, small pupil and posterior synechia.
Causes.--It occurs in the second stage of syphilis, second to eighteenth
month, from rheumatism, diabetes, gout, injury, and without any known
cause (idiopathic).
Symptoms.--More or less severe pain in the eye, forehead and temple, worse
in the night and early morning especially. There is fear of the light and
the eyes water very much. The sight is affected and there may be some
fever. On examination the lids are found swollen and red, the eyeball
shows congestion in the cornea and ciliary body, with some congestion of
the conjunctiva. The cornea looks hazy. The anterior surface of the iris
looks muddy and does not look so fine and delicate. The pupil is small and
the light does not make it contract readily. If atropine is put in the eye
(one per cent solution) the pupil will not dilate regularly, because at
different points the pupillary edge of the iris is held to the lens by an
exudate that lightly holds it.
Course and Recovery.--The disease may occur at any age, but it is most
common in children. It may last from one to six weeks.
Chances of recovery are good if treatment is begun early. There is a
tendency to recurrence.
[EYE AND EAR 353]
MOTHER'S REMEDY.--1. Iritis.--Sensible Remedy for.--"Doctor the blood with
sulphur and lard, a teaspoonful three times a day. Refrain from using the
eyes. This disease is said to be brought on by rheumatic fever, and
rheumatism is a disease of the blood." This is a very serious disease and
a physician should be called.
Treatment. What to do first.--Confine the patient in a darkened room and
if the attack is severe in bed.
Local Treatment.--Dry or moist heat should be applied, according to the
ease they give. Leeches are good in severe cases placed near the outer
corner of the eye. Atropine usually made of about the strength of two to
four grains Atropine to an ounce of water; or one per cent (1 to 100) may
be used, and it should be dropped into the eye from three to six times a
day. The pupil must be dilated and kept so from the beginning to keep the
adhesions from forming between the iris and lens. If too much is used the
throat and tongue will feel dry, face will flush, and there will be
dizziness and a rapid pulse. Stop it until that effect is gone and then
cautiously use it again. The bowels should be kept open.
The diet should consist of milk to a great extent. Water of course can be
taken freely. Soups, broths, gruels, etc., can be used if desired; but
meats should be withheld for a time unless the patient runs down.
Caution.--If a person has any of the special symptoms above mentioned it
would be prudent to begin treatment at once. The great danger is permanent
adhesion of the iris to other parts, especially the lens, and the dilating
and contracting power may be lost.
INJURIES OF THE IRIS.--Concussion of the eyeball may produce an irregular
dilation of the pupil. This is due to paralysis of the sphincter muscle of
the pupil, but it generally disappears. The edge of the pupil may be torn
in the form of one or more rents, or the iris may be separated from its
root at its circumference, leaving a clear space, or it may be entirely
torn from its attachment.
Perforating wounds are accompanied by injury to the lens and other
structures; when the cornea is wounded it is often complicated by falling
of the lens. When a small foreign body passes through the cornea and iris
a small opening may be seen. The greatest danger from wounds is due to
infection and if it reaches the iris, it may produce violent iritis. If
the lens is displaced or absent the iris being without support, will
tremble with every movement of the eye. In some cataract operations, if
there is a loss of the "Vitreous" body a part of the iris may be folded
upon itself, thus enlarging the pupil in that point.
[354 MOTHERS' REMEDIES]
CATARACT.--This is an opacity of the crystalline lens or its capsule. The
lens is not clear and bright and keeps the light from going through it.
Then it is called opaque.
SENILE CATARACT.--The vast majority of these cataracts are found after the
age of fifty. They simply come without any known cause. Of course, injury
can cause a cataract and it is then called traumatic cataract.
Symptoms of Senile (Old Age) Cataract.--Blurred vision, flashes and
streaks of light, dark spots, double vision. There is no pain. Eye strain
due to imperfect sight. Sometimes the first symptom is ability to read
without glasses (second sight). This is due to the increased refractive
power of the lens from swelling. The lens looks a little whitish through
the pupil opening and looks more so as time goes on.
Course.--The progress is slow. It usually takes a number of years before
it is "ripe" for operation. They may remain in the same condition
sometimes. In this kind of cataract both eyes are affected sooner or
later, although one eye may be fully matured before the other is much
changed.
The result of an operation depends upon the condition of the eye. The eye
should be free from evidence of disease. "The anterior chamber should be
of normal depth. The pupil should react to light. There should be a
homogeneous (all alike) white or gray opacity immediately back of the
pupil, with no shadow from the edge of the pupil (except in cases of
sclerosis, already mentioned). A candle carried on all sides of the
patient while the eye is fixed, should be properly located by him. The
tension of the eyeball should be normal."
The operation is very frequently done and it is very successful. The
patient should be ready and willing to place himself in the charge of the
operator and do as he says.
SYMPATHETIC INFLAMMATION OF THE EYE.--(Sympathetic Ophthalmia.)--A
condition in which the healthy eye becomes the seat of a destructive
inflammation transferred from the other eye which has been the subject of
a similar inflammation usually following a perforating injury of the
eyeball. The injured eye is called the exciting eye; the other, the
sympathetic eye.
This is a rare disease, but it may occur when one eye is injured or
diseased and on the first indication of trouble in the injured eye the
other eye should be closely watched for symptoms of sympathetic trouble so
that if can be removed.
Symptoms in the Exciting Eye.--This is more or less congested and painful;
when pressure is made upon the upper lid, it shows tenderness. The tension
is not as strong; the pupil may be blocked with an exudate.
In the Sympathizing Eye.--There is an inflammation involving the choroid,
ciliary body and iris. There is pain, tenderness, small blocked pupil and
sight is poor.
[EYE AND EAR 355]
Course.--It usually appears between the third week and the sixth month
after the original injury. "The extreme limits are two weeks and twenty
years." The sound eye is likely to be attacked when the exciting eye is in
a state of active inflammation.
Treatment.--The "exciting eye" should be enucleated (taken out) before any
signs of sympathetic inflammation appears in the healthy eye. If it has
appeared, enucleation will be of no value; at all events if there is
vision in the exciting eye, the operation should not be done then.
INFLAMMATION OF THE RETINA FROM BRIGHT'S DISEASE (Albuminuric
Retinitis).--The retina is a very delicate structure and we are often able
to diagnose Bright's disease from the peculiar effect it produces upon the
retina.
Causes.--The cause is usually Bright's disease, (nephritis) and usually
the chronic Interstitial variety. Pregnancy causes it sometimes.
Interference of the vision, sight, is what the patient complains of. This
may be very slight, when you consider the great changes occurring in the
retina. Such patients are subject to attacks of temporary blindness of
uremic origin. The vessels of the retina are swollen and tortuous.
Bleeding and shining white patches are scattered through the back part of
the eye and a peculiar arrangement of glistening white dots around the
yellow spot. This disease shows itself late in Bright's disease and the
patient is not likely to live more than two years after the appearance of
this eye lesion.
Treatment.--It sometimes occurs during pregnancy. Then the question of
inducing premature labor arises. There is no local treatment that can be
of any use when it is caused by Bright's disease.
FITTING GLASSES.--This is done by lenses and prisms, etc.
Lens.--A lens is made of glass and prisms graded in strength, one surface
curved, and has the power of refracting or changing the direction of the
rays of light. A prism is wedge-shaped and bends rays of light towards its
base. A great many people are troubled with their eyes, much more than
years ago. We even see little children wearing glasses. It is unfortunate,
but true, that even more children and grown people should wear them.
Fitting glasses is an art in itself. It takes more ability to fit glasses
well than it does to operate well. Poorly-fitted glasses are not only
annoying to the wearer, but dangerous. Glasses rest the eyes, not tire
them. When the eyes water and feel tired or strained, even after using
them but little, glasses are needed. Headaches are frequently caused by
the eye strain. When glasses are needed it does not pay to put off getting
them and the person needing them should go to one competent to properly
fit them. A great many eyes are hard to fit, and they need not only
ability to fit them well, but time and attention must be given to fitting
them properly.
[356 MOTHERS' REMEDIES]
SQUINT OR STRABISMUS.--Both lines of sight are not directed towards the
same object of fixation.
Internal or Convergent Squint.--Where one eye is turned inward toward the
nose.
External or Divergent Squint.--One eye turns outward toward the temple.
Squinting upward and downward are uncommon.
Causes of Convergent (Internal) Squint.--It generally appears between two
and five years; at first periodically, later constantly. The patient is
generally far-sighted.
Treatment.--Internal squint in very young children may be treated by
covering the well eye and forcing the child to use the other. When the
child is old enough, proper glasses should be worn. Operation can be done
when needed and is generally successful.
External (Divergent) Squint.--This may appear at any age and is often
associated with near-sightedness. An operation is necessary and the
tendons on both sides must generally be cut and properly placed. Parents
should always attend to a child who has this trouble. The operation is not
difficult to perform and it will not only, as a rule, give the child good
sight, but better looks. Parents who are able to have an operation or
glasses fitted when needed, and who neglect their children, should be
punished; they are guilty not only of neglect, but cruelty.
MOTHERS' REMEDIES. Inflammation of the Eye. 1. Chickweed a Relief for.--
"The juice of chickweed is good for inflammation of the eyes, when dropped
into them."
2. Inflammation of Eyes, Sassafras, Excellent Remedy for.--"Take sassafras
bark and make into a tea. Apply this externally to the eyes, and it will
be found very beneficial for this trouble." This is a very good remedy, on
account of its oily soothing nature.