This is a condition in which the mucous membrane of the eyelids becomes rough in consequence of the formation of little round prominences, known as granulations. The lids are deep red, and generally have a velvety appearance. The mucous membrane is very much thickened; and in consequence of the constant friction of the rough surface upon the cornea, it is generally congested, often ulcerated, and in bad cases, opaque, occasioning great pain, sensitiveness to light, and even diminution of sight.

This condition is generally the result of neglect of proper treatment of inflammation of the eyes. It is in most cases largely dependent upon disorders of the stomach and liver, or both, which have been occasioned by improper diet, particularly the use of condiments, fats and excessive quantities of meat.

The Treatment of Granular Lids - Trachoma

The patient must carefully regulate his diet and all his habits of life. The food should be simple, but unstimulating in character. Tea, coffee, tobacco, and condiments should be scrupulously avoided. Fat meats and pastry, and excessive quantities of animal fat, should also be avoided. Attention should be given to the general health, especially to improvement of the digestion and increasing the activity of the liver and skin by eliminative baths. The eye should be kept very clean by bathing in tepid water two or three times a day. It should also be protected from bright lights by wearing a hat with a broad rim, or using colored glasses. The best kind of glasses for this purpose, especially in the winter season when the reflection of the sunlight from the snow is often very painful and injurious, is the kind known as "London smoke." An alum wash, consisting of a teaspoonful of powdered alum to the pint of water, or a solution of sulphate of zinc, two grains to the ounce, should be applied to the eyes after careful bathing two or three times a week. The application to the eyes of the hot spray, or hot fomentations, for five or ten minutes once a day, will often accomplish much more than astringents or irritants of any sort. Care should be taken, however, not to employ these methods of treatment longer than the time specified, as the congestion and inflammation may be increased. The astringent solution should be applied directly to the affected surface. The mucous membrane of the lower lid may be easily exposed by causing the patient to look upward, while the lid is drawn down by pressing upon the skin just below it. The upper lid, however, must be inverted by means of the fingers. This is best done as follows: Seize the edge of the lid by the thumb and finger of the right hand, and stretch it outward and downward. Then place the end of the fore-finger of the other hand upon the upper surface of the lid just below the eye-brow, pressing somewhat firmly upon the eyeball, and turn up the outer edge of the lid. By a little practice, the lid can be easily folded over. It is often very convenient to be able to perform this simple operation, as it can be brought into service very often in removing dirt and other foreign bodies from the eye. The operation may also be performed by rolling the lid over a pencil or knitting needle, as shown in Fig. 444. The edges of the lids should be anointed twice a day with vaseline or some other good ointment. A long time will be required in most cases to effect a cure, as the disease is very chronic. The disease rarely if ever recovers of itself, and often requires the services of a very skillful oculist.

Fig. 444. Rolling Eye Lid Over Pencil.

Fig. 444. Rolling Eye Lid Over Pencil.