Eye Speculum Research Articles

A NEW METHOD FOR TRANSPLANTING PTERYGIUM

Ophthalmologists have recognized for many centuries that the only treatment for true pterygium is surgical intervention. Many and various operations have been devised for the removal of the pterygium, either some form of excision or transplantation in the lower cul-de-sac being used. These operations are well known to all ophthalmologists. Transplantation of the entire pterygium beneath the upper bulbar conjunctiva has never been described. It has much merit and possesses advantages over all other operative methods. <h3>OPERATIVE TECHNIC</h3> After the usual surgical preparation of the conjunctival sac is carried out and local anesthesia is obtained, the lids are held apart with an eye speculum. The following steps are then performed : The neck of the pterygium, including the margins, is grasped with a strong, narrow tissue forceps. While gentle traction is exerted upward with the forceps, a sharp von Graefe knife is used to dissect carefully and accurately the head and

AN EYE SPECULUM FOR CATARACT OPERATIONS

To the Editor: —My attention has been called to a communication inThe Journal, Dec. 3, 1932, from Dr. Walter B. Lancaster commenting on an eye speculum for cataract extraction which I described and illustrated inThe Journal. Oct. 8, 1932, page 1252. Dr. Lancaster says that the eye speculum is a good illustration of how far one can go afield if one starts from an erroneous premise. I started from the premise that a patient with a cataract incision and an unsupported speculum in the eye can expel vitreous by a contraction of the orbicularis muscle. If that premise is erroneous, I have indeed gone far afield. I agree fully with Dr. Lancaster when he says, Expulsion of vitreous during cataract operations may come from either or both of two causes: pressure on the eyeball by the surgeon, or pressure on the eyeball by the patient through muscular action.

GUIST EYE SPECULUM

<i>To the Editor</i>.—The Guist eye speculum is a very great aid in operative procedures, especially in such operations as require section of the globe to any extent. There is, however, one feature of its application that adds danger in cataract operations. If the instrument is adjusted in such manner as greatly to lift the eyelids forward, with consequent pulling tension on the conjunctival folds, especially when a superior rectus stay suture is used, there is a marked tendency to collapse and recession of the anterior contents of the globe after section has been made. In other words, the lifting puts a pulling tension on the periphery of the globe forward from the equator and is likely to cause sinking backward of the lens and iris margin deeper into the globe immediately following the section, thus making it more difficult, or indeed impossible, to deliver the lens or do iridectomy.

A NEW EYE SPECULUM.

This improved eye speculum is made entirely of brass and is, therefore, non-magnetic. It is composed of only two parts, which are easily detached for cleansing. It has neither spring, setscrew, hinge or ratchet. It is very light, weighing less than three drams. It is introduced easily without changing hands, locking itself automatically. It can be removed very quickly without the resistance of a spring to overcome, a setscrew to loosen or the fear that it may slip from the hand. It takes but a moment to increase or to diminish the pressure on the lids. It has the advantage of the original Mellinger's speculum in that the blades open parallel. The blades are solid and conform to the curve of the lid margin. The pressure on the sensitive lid, therefore, is equally distributed, reducing the distress and reflex spasm to a minimum. The under surfaces of the blades are