Since the matter to which Dr. Bissell has referred, I have many times made this immediate capsulotomy, and have had no reason to regret it. I believe it to be in entirely safe operation. So long as we have the iris in proper position, we may open the posterior capsule allowing the vitreous to go into the anterior chamber with no serious results. When the support is taken off, then an element of danger is introduced. There has sometimes been a little loss of vitreous, a loss not sufficient to imperil the operation, but to make me feel like going no further.
A.B. NORTON, M.D.: I would like to add a suggestion as to what to do with those medium cases of exophoria. I want to reiterate the benefit, the improvement of leaving off your convex glasses in those cases of exophoria. I find, over and over again, cases where they have been wearing glasses, and have been treating for it. Leave off convex glass, and the exophoria soon disappears. In other cases, where they are not wearing those glasses, I think they should put on prisms. Let them have a prism to wear.
Treat the muscles, strengthen the internal recti up to 70 degrees power, and if that does not correct the power, let them wear prisms, and later, in the higher degrees. If necessary, I am willing to operate. The operation which Dr. Wilson spoke of, for squint, seems to me to be like that of sub-conjunctivitis in the text-books. In regard to one of the Doctor’s questions about tannin, I will say that I do frequently use it, one to two hundred or five hundred. I use it very frequently drop it into the eye every hour or two hours, and believe the essential value of it is found very frequently.
DR. BISSELL., in closing the discussion, said: The question has been asked me regarding the special preparation of cocaine. I have had no special connection with it, and have not seen it used in our work. I do not think it is superior to any other anaesthetic agents that we have, and it is unpleasant to use, in soiling the clothing and staining, although it may be used. I think in one or two cases it has acted unfavorably, seemingly aggravating the case, and was probably used too strong; but I immediately discarded it and took something else.
Regarding the operation for strabismus spoken of by Dr. Wilson I should have given him the credit for it if I had known that it was peculiar to him. The first operation that I ever saw of the kind was not done by Dr. Wilson, and the only modification I make is a suture I put in, which has certainly given me wonderful results. In that respect it differs from Dr. Wilson’s if he is really the originator of it.
