(From bent, and an eye-lid). A disease of the eye which closes the eye-lids.
This disorder derives its origin from glutinous discharges, such as attend most ophthalmies; chiefly in ulcerated eye-lids, and is prevented by warm milk, and absorbent or abstringent powders. If the coalition is a perfect concretion of the palpebrae with each other, or with the eye, there is sometimes a small aperture, which is generally in the great angle of the eye; if there should not be any, a perforation must be made in either angle, a probe with a groove then introduced, and with a fine edged knife let the parts be separated. If the eye-lids adhere to the globe, they must be carefully divided from each other; being more sparing of the eye-lid in the operation than sclerotica. If the adhesion is only to the conjunctiva, blindness is not the consequence; if on the cornea, the sight is generally lost. This may be supposed to happen when the disease has arisen from a cause that affects the whole eye, as a violent burn, hot lime, or any other acrid fluid in the eye. In this case the cornea adheres to the eye-lid, and the ball of the eye feels collapsed; a strong light cannot be perceived through the lid, and the motion of the ball of the eye cannot be distinguished. This kind of adhesion is sometimes called symblepharon, and it is often firm and fleshy. If the adhesion is not to the cornea, it may be separated by the knife; but the greatest caution is necessary not to injure the sight. No directions can assist the operator, who must be left to his own judgment and dexterity. If the adhesions are chiefly membranous, a blunt knife only will easily separate them, with little danger. Hildanus attempted the separation by passing a silk, with the assistance of a probe, into the eye at the external canthus, and out of it at the internal; the ends were joined, and a small bit of lead suspended, whose weight gradually, and with little inconvenience, separated the agglutinated parts. This method however is chiefly useful in the slighter cases, and would have little effect when the adhesions were general to the ball of the eye. The re-union is better prevented by injection, or lint placed between the eye-lid and ball of the eye, after dipping it in some mild liniment, than by a plate of lead, as recommended by Sauvages; as that might, from its hardness, bring on inflammation.
When the eye-lids adhere slightly, and the complaint has not been of long duration, they may be separated, according to Mr. Bell, by the end of a blunt probe insinuated behind them, so as to tear them asunder; but when they adhere firmly, or to the eye-ball, he advises slow dissection of every adhering fibre, and then the eye only to be covered with a piece of soft lint spread over with Goulard's cerate, or any other cooling emollient ointment; and after the first dressing, a small portion of the same to be daily insinuated between the eyelids. Perhaps, in preference to all others, one part of mercurial ointment, with four parts of axunge, may be introduced twice a day: the parts may be bathed twice a day, also, with a weak solution of the zincum vitriola-tum purificatum, or cerussa acetata. When the whole eye-lid is closed, a slight opening may be made at either canthus to introduce the probe and divide the eye-lid through its whole course, and the divided edges should be dressed with Goulard's cerate, or any other cooling application. The eyes should not be kept long shut; and, even after the first nap, they should be opened and the dressing renewed. See Wallis's Nosologia Methodica Oculorum, p. 51. Bell's Surgery, vol. iii. p. 297. Cullen's First Lines, vol. i. p. 271. edit. 4.