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By N. R. Galloway BA, MB, ChB, DO, FRCS, MD (auth.)

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Fig. 1. Subconjunctival haemo rrhage. 52 Common Diseases of the Conjunctiva and Cornea Conjunctivitis Inflammation of the conjunctiva is extremely common in the general population and the general practitioner is often expected to find out the cause and treat this condition. If we consider that the conjunctiva is a mucous membrane which is exposed during the waking hours to wind and weather more or less continuously, year in year out, then it is not surprising that this membrane is rather susceptible to inflammation.

Occasionally the presence of one of the two common acquired lid deformities, entropion and ectropion, may be the underlying cause. Sometimes the diagnosis may be missed, especially in the case of entropion when the deformity is not present all the time. Other lid deformities may also have the same effect. A special type of degenerative change is seen in the conjunctiva which is more marked in hot, dry, dusty climates. It appears that the combination of lid movement in blinking, dryness and dustiness of the atmosphere and perhaps some abnormal factor in the patient's tears or tear production may lead to the heaping up of subconjunctival yellow elastic tissue which is often infiltrated with lymphocytes.

Tear Film Break-Up Time Using the slit lamp, the time for the tear film to break up when the patient stops blinking is measured. This test is sometimes used as an index of mucin deficiency. Fig. 7. Schirmer's test. Common Diseases of the Eyelids 40 Management This, of course, depends on the cause of the dry eye, and the underlying systemic cause may require treatment in the first place. Artificial tear drops are a mainstay in treatment and may be prescribed hourly or more frequently if necessary.

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