Screw eye

“ If the lens changed during accommodation, the iris, which rests upon it, would change also.
Fig. 30. Images on the Side of the Sclera R, rest; A, accommodation. The image in A is the larger, indicating a flattening of the side of the sclera as the eyeball elongates. My, Myopia. The eye is straining to see at the distance and the image is larger, indicating that the eyeball has elongated, resulting in a flattening of the side of the sclera. Hy, Hypermetropia. The eye is straining to see at two inches. ”

“ The severing of the optic nerve has not disturbed the sympathetic vision between the companion eyes, so this curious double sight results. In a quarrel arising from this peculiar situation, the first man kills the second, and sees on his left eye the hideous image of his own face distorted with murderous rage, as his friend saw it, which is never to be effaced, because the companion eye is dead and will see no more. ”

“ In looking at a distant object the two visual axes must be parallel, and in looking at an object at a less distance than infinity, which for practical purposes is less than twenty feet, they must converge to exactly the same degree. The absence of this harmony of action is known as squint, or strabismus and is one of the most distressing of eye defects, not only because of the lowering of vision involved, but because the want of symmetry in the most expressive feature of the face which results from it has a most unpleasant effect upon the personal appearance. ”

“ Frequently all endeavours to avert untoward results are unavailing, and the functions of the organ are more or less impaired—the cornea may become opaque, the iris may protrude, the pupil may become irregular, contracted, or obliterated—the crystalline lens may lose its transparency, amaurosis may occur from injury of the retina, the humours may be evacuated, and the eye sink in its socket. The entrance of a large foreign body into the orbit may displace the globe, and cause it to protrude between the eyelids: in such a case the body should be removed and the ball gently replaced ”

“ The commonest visual defects are, first, inflammation of the cornea, or imperfections of the lens—the cornea is often so scarred as to make vision imperfect; second, myopia, or progressive shortsightedness, a condition in which the axis of the eye gradually grows longer. This lengthening is accompanied by stretching of the eyeball, and such children always run the risk of the inner and most important part of the wall of the eye, the retina or nerve layer, being torn away, and blindness resulting. ”

“ Mental strain may produce many different kinds of eyestrain. According to the statement of most authorities there is only one kind of eyestrain, an indefinite thing resulting from so-called overuse of the eyes, or an effort to overcome a wrong shape of the eyeball. It can be demonstrated, however, that there is not only a different strain for each different error of refraction, but a different strain for most abnormal conditions of the eye. ”

“ Statistics indicate that in this country, at the present time, external injury is the most frequent cause of loss of vision between the ages of twenty and thirty-four. I believe that a great part of this blindness could be relieved, for, as I have already stated, I have never seen an eye so badly injured that its vision could not be improved. To cite only one of many similar cases, a patient injured in an automobile accident became suddenly and completely blind, either from hemorrhage into the orbit, or from injury to the optic nerve. ”

“ After he has demonstrated these facts he is told that persons with imperfect sight always attempt to hold their points of fixation too long, even when the lowering of vision is caused by an injury, or by a foreign body in the eye. ”

“ Why should a man strain his accommodation when no advantage is thereby gained?
In most cases the squinting eye has also an available power of vision and is on that account used for fixing objects which lie in the direction of its visual axis; it can also be made to fix objects in front, this occurs as soon as the other eye is covered; it remains as the fixing eye till the next blinking of the lids, or movement to another object for fixation, or till both eyes are closed for a short time, when it returns to its former deviation. ”

“ No matter what their degree or their duration their cure is accomplished just as soon as the patient is able to secure mental control. The cause of any error of refraction, of a squint, or of any other functional disturbance of the eye, is simply a thought - a wrong thought - and the cure is as quick as the thought that relaxes. In a fraction of a second the highest degrees of refractive error may be corrected, a squint may disappear, or the blindness of amblyopia may be relieved. ”

“ In convergent strabismus, however, no one, at least no ophthalmologist, thinks of entertaining such fears for the eye used in fixation, and where is the physiological basis of this whole idea to be found? Is the visual purple more active in monocular than in binocular vision, or what physiological activity is thereby taxed in increased degree? ”

“ That frightful scar running all the way down one side of his clean-shaven face, from his eye to his chin, must have been made with a knife; but no one knew how it had been done, and that made it all the more mysterious. ”

“ Others again, on the contrary, place the book or object they are looking at, at a greater distance from the eye than that named. Such people are called long-sighted, and the defect results from the too great flatness of the cornea and the crystalline lens. ”

“ In infants, where processes of repair go on very rapidly, the whole lens may be freely broken up. In diabetic cataract, or indeed in all cases of solution, where the patient is adolescent or adult, or the eye at all weak, only a small portion of the lens should be attacked at one sitting.
The needle should then be withdrawn gradually and with great care, that the broad axis of the blade be in exactly the same position in which it entered, i.e. flat and parallel with the iris, lest the iris be wounded, entangled, or prolapsed. ”

“ This will remove the preserving and hardening fluid from the surface, and will save the hands a little from the effects of the fluid. Next remove all the muscles and fatty tissues from the sclerotic. After that has been done, puncture the cornea with the pointed jaw of the scissors about 2 mm. from the corneo-scleral junction. (Fig. 22.) Then proceed to cut the cornea away, being [63] careful not to lacerate the choroid or the iris. (Fig. 23.) The escaping aqueous humor will flow over the eye and make it very slippery, and, therefore, difficult to hold. ”

“ Still another way to see the interior is to cut out a piece of the sclerotic about the size of a twenty-five-cent piece; then pinch up and tear out the choroid and the retina under the opening made in the sclerotic. (Fig. 57.) Hold the eye, the cornea forward, close to a bright light, and the image of the light will be seen upon the retina. The closer the light is to the eye, the greater the illumination will be in the [111] interior of the eye. If the opening or “window” is close enough to the optic nerve, the optic papilla can be seen easily. ”

“ The aqueous humour is either secreted in greater abundance than it usually is, or absorption is diminished. The cornea gradually accommodates itself to the increase of the fluid behind, and becomes wider and more prominent, but retains its transparency; in looking at the eye, the anterior chamber is seen evidently enlarged, and occasionally the aqueous humour is of a turbid appearance. There is little or no pain in the eyeball, but the patient complains of an annoying sense of fulness and tension in the part. ”

“ The editor is practically alone in advocating central fixation. A small number of physicians, including a few eye specialists, who have been cured or seen members of their families cured of eye troubles, without glasses, operations, or medication, have been convinced that the old theories about the eye and the treatment of defects of vision are wrong ”

“ If our theory be correct, the distribution of pain nerves must have much bearing upon the coexcitation of pain with other sensations. If there were no pain fibres in the optic sheath, but only in proximity to sight regions, this would explain why sensations of bodily pain do not accompany ordinary sight; only rare excitations of light, those violent enough to cause influences radiating to adjoining nerve terminals, or some mechanical disturbances upon the eye, as a blow, or some pathological irritation of the eye, would then cause optic pains. ”

“ In most cases of eccentric fixation, on the contrary, the eye quickly tires, and its appearance, with that of the face, is expressive of effort or strain. The ophthalmoscope reveals that the eyeball moves at irregular intervals, from side to side, vertically or in other directions. ”

“ Whenever he came across any one with a peculiar eyeball, sometimes bright and clear, and at others covered with a filmy gauze, or a double pupil, ringed twice, or a larger eye on the left than on the right side, he would hold the thumb, fore and middle fingers in a peculiar manner, so as to ward off the evil effect of the eye. ”

“ These movements are often so extensive as to be manifest by ordinary inspection, and are sometimes sufficiently marked to resemble nystagmus.2 Nervous movements of the eyelids may also be noted, either by ordinary inspection, or by lightly touching the lid of one eye while the other regards an object either at the near-point or the distance. The visual axes are never parallel, and the deviation from the normal may become so marked as to constitute the condition of squint. ”

“ Later, when the patient becomes accustomed to the situation, this strain is often relieved, and the eye becomes able to focus accurately upon near objects. Some rare cases have also been observed in which a measure of good vision both for distance and the nearpoint was obtained without glasses, the eyeball elongating sufficiently to compensate, to some degree, for the loss of the lens. ”

“ If the foreign body be sharp, as a piece of steel or flint is likely to be, it may be driven right into the eyeball.351 Seek a physician who will drop medicine into the eye to deaden the pain and then if it cannot be gently rubbed off the eyeball, a magnet will promptly remove it. ”

“ But just as the invalid may gradually increase his strength until the Marathon has no terrors for him, so may the eye with defective sight be educated until all the rules with which we have so long allowed ourselves to be harassed in the name of "eye hygiene" may be disregarded, not only with safety but with benefit. ”

“ Fortunately for the victims of this distressing condition, their eyes often become straight spontaneously, regardless of what is or is not done to them. More rarely the vision of the squinting eye is restored. ”

“ The variability of the refraction of the eye is responsible for many otherwise unaccountable accidents. When people are struck down in the street by automobiles, or trolley cars, it is often due to the fact that they were suffering from temporary loss of sight. Collisions on railroads or at sea, disasters in military operations, aviation accidents, etc., often occur because some responsible person suffered temporary loss of sight. ”

“ The bores of the eyes should be set as true as possible one with the other before the plates are tightened upon the eyes, for if it is attempted to set the eyes true by hammer blows afterwards, the pressure of the plates would cause the arm or hub of the double eye which received the hammer blow to move more than the other, or, in other words, to spring out of its normal position, and the eye will be distorted. ”

“ My wound had received no attention, and my right eye was hopelessly mutilated. The optic nerve of my left eye was damaged beyond repair, and the eye itself was obscured by an enormous swelling. My sense of smell was gone, and my cheeks, nose, and mouth were swollen and numbed to a painful degree. ”

“ When the eye is inflamed, great light becomes eminently painful, owing to the increased irritative motions of the retina, and the consequent increased sensation. Thus when the eye is dazzled with sudden light, the pain is not owing to the motion of the iris; for it is the contraction of the iris, which relieves the pain from sudden light; but to the too violent contractions of the moving fibres, which constitute the extremities of the optic nerve. ”

“ The eye with- normal sight never attempts to hold a point more than a fraction of a second, and when it shifts, as explained in the chapter on "Central Fixation," it always sees the previous point of fixation worse. When it ceases to shift rapidly and to see the point shifted from worse, the sight ceases to be normal, the swing being either prevented or lengthened, or (occasionally) reversed. These facts are the keynote of the treatment by shifting. ”

“ DISEASES OF THE EYES Albugo, or Spot in the Eye, Opacity of the Cornea In consequence of a blow, stroke of a whip, or similar injury, an inflammatory action is set up in the eye, the result of which is an effusion of serum between the lamina of the outer coating of the eye, which renders the cornea or clear part of the eye, whitish or opaque in spots, interfering materially with the sight and usefulness of the organ. ”

“ Whether the state of refraction or the condition of the muscular equilibrium is held to be the chief cause of squint, defective vision of one eye will always have to be acknowledged as one of the most important favouring circumstances; in order to cure squint it is important to have regard to the visual acuity of both eyes, and not only to the defective condition. ”

“ Some of these arise directly from causes inherent in the design or structure of the eye itself, and may be broadly classified as physical; others are of psychological origin, and result from the erroneous interpretations placed by the mind upon the phenomena presented to it through the medium of the optic nerve and the brain.
Among the numerous physical defects [Pg 85] of the eye none is more remarkable than the absence of means for properly correcting chromatic aberration. ”