This section is from the book "Massage And Medical Gymnastics", by Emil A. G. Kleen. Also available from Amazon: Massage and medical gymnastics.
An abnormal position of the eyelid, usually the lower lid, which does not touch the ball with the whole of its mucous membrane, but to a larger or smaller extent is turned outwards in mild cases so that a small space is found between the eyeball and the inner border of the edge of the lid, in worse cases so that the mucous membrane of the eyelid is visible even to the fornix. Ectropion arises from scars in the skin, in conjunctival catarrh and trachomatous conjunctivitis, in ulcerating blepharitis, anomalies in the tear-duct, and as a result of senile changes in the tissues.
Kiaer treated numbers of these cases by massage with marked success. Cicatricial ectropion, as can easily be understood, has a very much worse prognosis than non-cicatricial. Kiaer obtained complete recovery only in cases which were the result of blepharitis, chronic conjunctivitis, or eczema; in one case of senile change there was only a slight improvement in one eyelid (both had ectropion). In cicatricial ectropion Kiaer has in a few cases obtained some improvement after persevering work.
Massage is performed in long seances (five to ten minutes) and with vaseline, unless the disease seems to indicate the use of yellow precipitate ointment.
Abadie successfully massaged the orbicularis oculi in blepharospasm.
For cicatricial deformities in the eyelid Stedman-Bull has used massage preparatory to operation in order to make the tissues softer and more pliable.
* Schmidt-Rimpler advises cocaine ointment in marked infiltrations ("Lehrbuch d. Augenh.,"p. 50, 2).
+ Ciliary blepharitis, inflammation in the edges of the eyelids, which become hyperaemic and swollen. The skin between the cilia becomes covered with small scales (squamous blepharitis). Small abscesses are formed in the hair follicles and sebaceous glands, which cause ulcers (ulcerating blepharitis); the edges of the eyelids are often greatly thickened (tylosis). Blepharitis is combined with chronic conjunctivitis; the ulcerating form causes loss of the cilia (madarosis) or turns them in (trichiasis); the increased weight of the eyelid in the hypertrophic form causes it to droop (ptosis); as a result of scar contraction the lower eyelid may become everted (ectropion).
Ohlemann reports good results from massage in fissures of the canthus.
 
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