sub-retinal fluid, and of creating a watertight adhesion between the choroid and the
retina. A frequently used operation involves the use of electrocautery. The surgery
may be performed using general or local anesthesia.
1-14. PROCEDURES FOR REMOVAL OF INTRAOCULAR FOREIGN BODIES
a. General. The presence of an intraocular foreign body usually represents a
serious ocular problem. Disturbance of the function of the eye results from several
sources, including the destruction of or damage to the tissues caused by the entrance of
a missile; infection introduced by the missile; and destruction of or damage to the
delicate intraocular tissues caused by reactions to the intraocular intruder, such as
siderosis caused by iron or inflammation caused by wood particles.
(1) Before surgery is undertaken, the size and location of the foreign body
must be determined. This is done by special X-ray procedures of the skull with special
bone-free X-ray using dental film and other techniques.
(2) In addition, metal-locating instruments and ultrasonic probes are
employed to locate the foreign bodies.
b. Operative Procedures. The operation performed depends upon the size,
location, and magnetic property of the embedded object. Local anesthesia is used
(1) The magnet tip may be directed to the eye and the foreign body
removed without incision into the eye if the size and location of the object makes this
procedure feasible.
(2) If the size, shape (jagged edges), or the location of the foreign body is
such that passage of the object would endanger structures vital to vision, the sclera is
incised and the magnet tip is advanced into the vitreous, humor for removal of the
object.
(3) A nonmagnetic foreign body is removed by incision and extraction, but it
must be seen to be removed.
1-15. PROCEDURES IN THE TREATMENT OF CATARACT
a. General. Cataract is a clouding or an opacity of the crystalline lens, its
capsule, or of both. A cataract may result from local or systemic disease, from eye
injury, or the cataract may be congenital. Cataracts seen in the elderly are referred to
as primary or senile cataracts. Medical treatment of cataracts is not available. Only
surgical removal of the lens is of any significant assistance and this is indicated when
the patient's vision is sufficiently depressed.
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