Identifier: atlasepitomeofop00haab (find matches)
Title: Atlas and epitome of operative ophthalmology
Year: 1905 (1900s)
Authors: Haab, O. (Otto), b. 1850 De Schweinitz, G. E. (George Edmund), 1858-1938
Subjects: Ophthalmologic Surgical Procedures
Publisher: Philadelphia, New York (etc.) : W.B. Saunders and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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then divides the cornea and, close to it, theconjunctiva, picking up the latter with a straight conjunc-tival forceps (Fig. 101) and slightly stretching it, so thatit retracts; it is then divided and undermined. Theundermining is then continued around the entire eyeballbeyond the insertion of the muscles ; when there are manyold adhesions, this as well as the separation of the tendonsis often a somewhat troublesome procedure. The fourstraight ocular muscles are then divided in the same wayas in the operation for strabismus, each tendon being pickedup with the hook. In this way the quadruple tenotomycan be performed without inflicting much damage and with-out giving pain by pulling and twisting the globe. Itis best to begin with the external rectus, then, after thecapsule has thus been opened, the superior is attacked withscissors and hook; next the inferior, and, finally, theinternus, are separated from the globe, the latter beingdivided behind the hook—not between the hook and the
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ENUCLEATION OF THE GLOBE. 269 sclera—in order to leave a somewhat longer stump (3 to4 mm.) by which to hold and abduct the eyeball. Forthe latter purpose the heavy fixation-forceps shown inFig. 104 is used, and at this point of the operation thesurgeon takes up the heavy, curved scissors ; Fig. 105),the better and more surely to perform the last act of theoperation. With the globe in extreme outward rotation,the surrounding tissues are carefully dissected away withthe scissors, and the optic nerve is found by palpatingcarefully with the closed scissors. It is very important tosee that the globe is accurately rotated outward—that is,brought into a position of >imple abduction without eitherelevation or depression (Plate 9), and if this has been care-fully attend to the optic nerve is found without any trouble.The operator then opens the scissors so that the nerve slipsbetween the two blades, and cuts it off short at the globewith one snip. The eyeball at once advances, the twoob

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