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By J. L. C. Martin-Doyle (Auth.)

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T h e cornea is anaesthetic, and in rare cases a transient paralysis o f one or more cranial nerves occurs, lasting for m a n y weeks or e v e n months. T h e r e are three serious manifestations o f herpes ophthalmicus : — a. Iridocyclitis, w i t h all its attendant risks, especially t h a t o f increased tension. b. Anaesthetic cornea m a y persist for months, impairing its nutrition and rendering it liable t o further damage b y minute foreign bodies, abrasions, etc. c. Corneal scarring m a y be severe and permanent.

T h e cut edges of healthy conjunctiva should be a p p r o x i m a t e d . Care must be taken t o ensure complete r e m o v a l or a recurrence is inevitable. CONJUNCTIVAL CYSTS E x c e p t for small cysts due t o dilatation o f l y m p h space, conjunctival cysts are v e r y rare in E n g l a n d . I m p l a n t a t i o n cysts can occur following injuries, and v e r y rarely cysticerci or hydatids m a y be seen. TUMOURS OF CONJUNCTIVA INNOCENT TUMOURS 1. D e r m o i d s . — T h e s e usually occur at the junction o f the cornea and sclera and b o t h these structures m a y be i n v o l v e d .

R e m o v a l o f the overhanging edge ; this is essential. b. Cauterization w i t h the electric cautery. c. Covering w i t h a conjunctival flap or a tarsorrhaphy. d. R a d i u m t r e a t m e n t (beta r a y s ) in severe cases. 6. N e u r o p a r a l y t i c U l c e r . — T h i s condition can d e v e l o p as the result o f Gasserian ganglion lesions, including surgery of the ganglion. I t is v e r y rarely seen as a complication of fractured skull and o f intracranial tumours. T h e cornea becomes anaesthetic, hence reflex blinking no longer occurs and small foreign bodies remain unnoticed.

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