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Chalazion Technic
487
NEUROEPITHEL.IOMA OF RETINA
5. Acute suppurative hyalitis. The rapid course of the disease, the pres ence of hypopyon, scleral perforation, and the discharge of pus may clear the diagnosis. 6. Cysticercus in the vitreous, giving a bluish-white mass in the vitreous and unvascularized, is uncommon in this country. 7. Congenital abnormalities. Per sistent vascularity of the lens capsule, and a hyaloid artery with posterior polar cataract may be mistaken for a neoplasm. 8. Retinitis circinata, when occur ring in children, may be mistaken for this condition.
Neuroepithelioma of the retina is al ways a serious condition and without prompt treatment always causes death. Early operations are followed by 13% of recoveries. With perforation of the eyeball, especially posteriorly, death is certain, but operation will prolong life. It is said that if the disease does not recur in four years the patient is safe. The treatment is early and radical. Any suspicious growth in the eye of a child calls for immediate enucleation and removal of the optic nerve as far back as possible. If microscopic ex amination reveals true neuroepithel ioma, exenteration of the orbit should be performed.
CHALAZION TECHNIC.
has escaped the spoon, come out. It stops the bleeding and thus avoids the formation of a hematoma which often makes the patient doubt, for some days, whether he has gotten rid of his tumor. Finally, one can not infrequently feel, while squeezing out the original cyst, that there is another much smaller one close to, but not opening into the first one; which it is well to empty even tho one may have to make several stabs before hitting its center. While the squeezing method gives its most striking results in fairly large cysts, it is equally useful in the very small ones which form and often cause a persistent irritation at the edge of the lids. Also it often evacuates pus from neighboring glands and thus prevents apparent recurrences. If our cave dwelling ancestors bothered with such trifles as meibomian cysts, they prob ably employed some such method, but as I have seen no inscription or tablet to that effect, I make this report after testing it for twenty-five years.
NOTES, CASES, INSTRUMENTS
H. GIFFOED, M. D., F. A. C. S. O M A H A , NEBR.
First, tell the patient that as such cysts sometimes go away of themselves, or with a little massage; he need be in no hurry about having it removed. This is the truth and he generally has it done anyway. Get a good anesthesia. If you want to retain the affection of your chalazion patients don't operate after merely dropping in any local anesthetic. In ject 2% cocain all around it (not into it) and touch inner surface once or twice with 10% cocain. Then wait four minutes. Open freely thru conjunctival surface by incision at right angle to lid margin. Scrape out with sharp spoon. Then squeeze the tumor region be tween thumb and forefinger, with latter on conjunctival surface. Or if it be in the lower lid, squeeze between butt end of forceps on the inner side and finger on the outer side. Have patient hold his finger firmly pressed against outside of tumor region for a few minutes. Dismiss him with the injunction that as there are many meibomian glands, another tumor may show up apparently at the same spot; but that if it does so, you will remove it for nothing. This squeezing performance has three distinct advantages. It evacuates the cyst better; one can almost always feel or see some chalazion stuff, that
STEEL SPLINTER PENETRATING LENS W I T H O U T CATARACT FORMATION. GEORGE H. CROSS,
M.D.
CHESTER, PA.
Mr. T. A. U., age 32, white, foreman, while cutting salt glazed brick with a new steel chisel, was struck in the left
NEUROEPITHEL.IOMA OF RETINA
5. Acute suppurative hyalitis. The rapid course of the disease, the pres ence of hypopyon, scleral perforation, and the discharge of pus may clear the diagnosis. 6. Cysticercus in the vitreous, giving a bluish-white mass in the vitreous and unvascularized, is uncommon in this country. 7. Congenital abnormalities. Per sistent vascularity of the lens capsule, and a hyaloid artery with posterior polar cataract may be mistaken for a neoplasm. 8. Retinitis circinata, when occur ring in children, may be mistaken for this condition.
Neuroepithelioma of the retina is al ways a serious condition and without prompt treatment always causes death. Early operations are followed by 13% of recoveries. With perforation of the eyeball, especially posteriorly, death is certain, but operation will prolong life. It is said that if the disease does not recur in four years the patient is safe. The treatment is early and radical. Any suspicious growth in the eye of a child calls for immediate enucleation and removal of the optic nerve as far back as possible. If microscopic ex amination reveals true neuroepithel ioma, exenteration of the orbit should be performed.
CHALAZION TECHNIC.
has escaped the spoon, come out. It stops the bleeding and thus avoids the formation of a hematoma which often makes the patient doubt, for some days, whether he has gotten rid of his tumor. Finally, one can not infrequently feel, while squeezing out the original cyst, that there is another much smaller one close to, but not opening into the first one; which it is well to empty even tho one may have to make several stabs before hitting its center. While the squeezing method gives its most striking results in fairly large cysts, it is equally useful in the very small ones which form and often cause a persistent irritation at the edge of the lids. Also it often evacuates pus from neighboring glands and thus prevents apparent recurrences. If our cave dwelling ancestors bothered with such trifles as meibomian cysts, they prob ably employed some such method, but as I have seen no inscription or tablet to that effect, I make this report after testing it for twenty-five years.
NOTES, CASES, INSTRUMENTS
H. GIFFOED, M. D., F. A. C. S. O M A H A , NEBR.
First, tell the patient that as such cysts sometimes go away of themselves, or with a little massage; he need be in no hurry about having it removed. This is the truth and he generally has it done anyway. Get a good anesthesia. If you want to retain the affection of your chalazion patients don't operate after merely dropping in any local anesthetic. In ject 2% cocain all around it (not into it) and touch inner surface once or twice with 10% cocain. Then wait four minutes. Open freely thru conjunctival surface by incision at right angle to lid margin. Scrape out with sharp spoon. Then squeeze the tumor region be tween thumb and forefinger, with latter on conjunctival surface. Or if it be in the lower lid, squeeze between butt end of forceps on the inner side and finger on the outer side. Have patient hold his finger firmly pressed against outside of tumor region for a few minutes. Dismiss him with the injunction that as there are many meibomian glands, another tumor may show up apparently at the same spot; but that if it does so, you will remove it for nothing. This squeezing performance has three distinct advantages. It evacuates the cyst better; one can almost always feel or see some chalazion stuff, that
STEEL SPLINTER PENETRATING LENS W I T H O U T CATARACT FORMATION. GEORGE H. CROSS,
M.D.
CHESTER, PA.
Mr. T. A. U., age 32, white, foreman, while cutting salt glazed brick with a new steel chisel, was struck in the left