The Project Gutenberg eBook of Technique of Eye Dissections
Title: Technique of Eye Dissections
Author: Frederic A. Woll
Release date: July 2, 2020 [eBook #62544]
Most recently updated: October 18, 2024
Language: English
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—Wordsworth.
Brain, showing eyes with muscles removed, optic nerves, and chiasm.
TECHNIQUE
OF
EYE DISSECTIONS
BY
FREDERIC A. WOLL, Ph.D.,
Associate Professor, Department of Hygiene, College of the City of New York; Optometry Courses, Columbia University; Member of New York State Board of Examiners in Optometry; Honorary Member: American Optometric Association; State Societies—Alabama, California, Connecticut, Kentucky, Maine, Massachusetts, North Carolina, Rhode Island; Local Societies—Lehigh Valley Society of Optometrists, Mahoning Valley Optometrists’ Society, and Optometrists’ Club of Brooklyn.
SECOND EDITION
NEW YORK
FREDERIC A. WOLL
1924
Copyright, 1914, by
FREDERIC A. WOLL
Printed in the United States of America
First Edition, July, 1914
Second Edition, April, 1924
SCHLUETER PRINTING CO., NEW YORK
DEDICATION
THIS LITTLE BOOK IS DEDICATED WITH AFFECTION
AND ESTEEM TO MY FIRST TEACHER
IN OPTICS, MY FRIEND FOR YEARS
ANDREW JAY CROSS
WHOSE RESEARCH IN THE FIELD OF APPLIED
OPTICS HAS WON FOR HIM RECOGNITION
AND HONOR
CONTENTS
| PAGE | |
|---|---|
| Preface | 13 |
| Introduction | 17 |
| Removal of Hyaloid Membrane with Contents and Attachments Intact | 25 |
| Canal of Petit, The | 35 |
| Interior of the Eye, The | 38 |
| Posterior Half, The | 40 |
| Optic Nerve, The | 47 |
| Anterior Half, The | 49 |
| Iris, The | 51 |
| Cornea, The | 52 |
| Crystalline Lens, The | 53 |
| Choroid, The | 62 |
| Retina, The | 74 |
| Sagittal or Vertical Section of the Eye, The | 86 |
| Papilla, Puncta Lacrimalia, and Nasal Duct, The | 92 |
| Meibomian Glands and Ducts, The | 96 |
| Enucleation of the Orbital Contents, The | 97 |
| Ophthalmoscopic Examinations | 106 |
| Lacrimal Ducts, The | 112 |
| Lacrimal Gland, The | 114 |
| Capsule of Tenon, The | 115 |
| Superior Oblique Muscle and its Pulley | 117 |
| Other Extrinsic Muscles, The | 118 |
| Three Tunics of the Eye, the Hyaloid and its Attachments, The | 120 |
ILLUSTRATIONS
| PAGE | ||
|---|---|---|
| 0. | Brain showing eyes with muscles removed, optic nerves, and chiasm | Frontispiece |
| 1. | Glassware and tools | 22 |
| 2. | The first cut | 28 |
| 3. | How the point of the scissors is kept away from the underlying tissues | 29 |
| 4. | Half of the sclerotic separated | 30 |
| 5. | Picking up the choroid | 31 |
| 6. | Emptying the eye of its contents | 32 |
| 7. | Isolated hyaloid, contents and attachments intact | 33 |
| 8. | Petit’s Canal | 36 |
| 9. | Cutting eye into anterior and posterior sections with safety-razor blade | 39 |
| 10. | Posterior half showing retinal vessels and choroid | 40 |
| 11. | Showing network of vitreous | 42 |
| 12. | Tearing retina away from posterior half of eye | 44 |
| 13. | Posterior half of eye with retina removed | 45 |
| 14. | Excavated posterior half of eye | 46 |
| 15. | Split optic nerve | 47 |
| 16. | Ciliary processes and the lens | 48 |
| 17. | How to pull off vitreous | 50 |
| 18. | Processus Zonuloe | 54 |
| 19. | Onion-like layers of lens removed | 56 |
| 20. | Cross section of lens | 57 |
| 21. | Lenses showing the results of different kinds of treatment | 60 |
| 22. | Puncturing the cornea | 63 |
| 23. | Removing the cornea | 64 |
| 24. | How to separate the choroid from the sclerotic | 65 |
| 25. | Cutting away the separated sclerotic | 67 |
| 26. | Scraping the choroid free from the sclerotic | 68 |
| 27. | The isolated choroid | 69 |
| 28. | Inserting scalpel to loosen lens and cut through vitreous | 70 |
| 29. | Taking out lens and “core” of vitreous | 71 |
| 30. | Squeezing out remaining part of vitreous | 72 |
| 31. | Cutting through the iris | 75 |
| 32. | Cutting around the ciliary ring | 76 |
| 33. | Lens, iris, and part of vitreous removed | 77 |
| 34. | How to force blowpipe into the vitreous | 78 |
| 35. | Bulging out of vitreous caused by blowing air through glass blowpipe | 79 |
| 36. | Showing vitreous removed | 80 |
| 37. | Folding the retina by blowing air at it through blowpipe | 81 |
| 38. | Suspended retina. Sclerotic ready to be cut away | 82 |
| 39. | Showing sclerotic nearly all cut away | 83 |
| 40. | Isolated retina | 84 |
| 41. | The beginning of the cutting of the eye for sagittal sections | 87 |
| 42. | Method of cutting through the crystalline lens | 88 |
| 43. | Cutting through cornea to complete the sagittal sections | 89 |
| 44. | Sagittal section enlarged | 90 |
| 45. | Part of calf’s head showing knitting needles inserted in puncta | 93 |
| 46. | Course of knitting needles showing the course of the canaliculi | 94 |
| 47. | Initial cuts to be made in the skin | 98 |
| 48. | First cut in bones of orbit | 99 |
| 49. | All the cuts to be made in bones of orbit | 100 |
| 50. | How to pry bone loose | 101 |
| 51. | Dissecting close to bones of orbit | 102 |
| 52. | Excavated orbit | 103 |
| 53. | Anterior view of enucleated eye | 104 |
| 54. | Side view of enucleated eye. All parts in situ | 104 |
| 55. | Enlarging pupil for ophthalmoscopic inspection | 107 |
| 56. | How to get rid of the pucker in the cornea | 108 |
| 57. | Window cut in the eye | 110 |
| 58. | Pins inserted in lacrimal ducts | 112 |
| 59. | Capsule of Tenon blown up | 115 |
| 60. | Showing the extrinsic muscles of the eye | 118 |
| 61. | Cutting through the iris | 120 |
| 62. | Scraping ciliary processes free. Choroid cut around ciliary ring | 121 |
| 63. | Cutting away choroid | 122 |
| 64. | Three tunics, hyaloid, and lens | 123 |
PREFACE
The aim of this booklet is to present to the eye-specialist, the teacher, the student, and others interested in the study of the anatomy and physiology of the eye, some definite methods to follow in the dissection of that organ.
Most dissections of the eye are not made with the same degree of care and skill used in the dissections of other organs. In following the usual method of dissecting eyes, much of the important detail is lost. Often certain membranes are confounded with others, and wrongly demonstrated. Furthermore, an eye is merely divided by some demonstrators into an anterior and a posterior half, a very short time is spent by the students scrutinizing each half; then the text-book is turned to, and the anatomy is studied descriptively.
Not enough time has been given to thoroughly dissecting all parts of the eye. As much time should be given as is necessary to bring out prominently all its parts. Other organs of the body are more thoroughly dissected, and, therefore, the student has better opportunity to gain a clearer comprehension and better understanding of the anatomy and physiology of those organs. Also, as much time should be given, proportionately, to the learning of the technique of the dissection of the eye as is given to the learning of the technique of dissecting other organs of the body.
Many now make a direct specialty of ministering to those suffering from errors of ocular refraction, ocular diseases, and ocular reflexes, and for those specialists, principally, this book is written. It is to fulfil its mission to them by acting as a guide and as a complement to the descriptive matter in the text-book. It is sent forth in the hope that it will tend to create more interest in the study of the practical anatomy of the eye. It is written with a desire to stimulate the ability to make careful and intelligent observation. It carries with it, as a final end, an earnest wish that it may, in some small way, be the means of opening up to the original researcher, a larger field for the further study of the most important of the senses—the eyesight.
Most of the dissections explained in the following pages are original; some, however, are only revisions of old methods.
This opportunity is taken to acknowledge the many helpful suggestions that were made by Dr. Ivin Sickels, of the College of the City of New York, and by the late Dr. Edward C. Spitzka, of New York. Thanks are due Mr. E. F. Howes, of Messrs. Swift & Co., for furnishing the necessary supply of beef eyes; to Messrs. Lee & Beach, photographers, of New York, for their painstaking efforts in producing good photographs of the actual dissections; and to Schlueter Printing Company, of New York, for their many courtesies and interest in the production of the book.
Frederic A. Woll.
New York, July 21, 1914.
INTRODUCTION
In eye dissections it is unnecessary to have either a large equipment of instruments or a special room. To have a laboratory at one’s disposal is but a small added convenience. Not to have it, is no serious hindrance. The work may be carried on and successfully done in one’s office or in the home, as well as in class-room or laboratory. If it is true that the atmosphere of a laboratory adds zeal to the efforts of a worker, but there is no laboratory available, then reverse the order; let the zeal of the worker add to the atmosphere of the place in which he is doing his work.
Two things, among others to be mentioned later, are essential; a table of convenient height, and a good light, natural or artificial. Both are but modest needs. Compared with other dissections, there will be found an absence of offensive odors. Neither are there any repulsive sensations experienced. Such experiences are quite common when making other kinds of dissections. This work is clean and attractive. Indeed, one may even develop a rather keen sense of the æsthetic. Many of the various parts of the eye, when separated and properly preserved, then viewed and inspected, are bound to bring forth exclamations of appreciation and wonderment. One can then better understand the statement: “When Nature perfected the first eye she took a day off so she could admire the result of her finest piece of handiwork.”
This does not imply that dissections of the eye tend to develop art appreciation. Appreciation of the wonderful in Nature’s construction of the special organs is not, however, to be relegated to a distant point. Such appreciation is concomitant with the knowledge that comes from having seen, handled, and examined the object studied.
The orchestra leader must have a good listening and hearing ear. This is developed in him because he has to exercise constantly his power of listening and hearing. The dissector who would become proficient in eye dissections and in anatomical investigations must have a good seeing eye and a dextrous hand. To acquire these two most valuable aids necessary to carry on careful inquiry or research, it is essential to practise using the eye and the hand. Combined with the expertness of these two, must be the ability to continue one’s efforts in the face of failure; to redouble one’s efforts to attain success despite the shortcomings of eye or hand. This simply means practise and patience. And the one who is without that wonderful virtue, patience, will never stay long enough with his problem to gain either an observing eye or an expert hand, or to achieve his end, and thereby reap the full and pleasing results of his efforts. In order of importance, patience really precedes dexterity, skill, and observation; and persistence of effort is a factor not to be entirely outshone by any other virtue. With these attributes, knowledge of the subject in hand naturally follows.
One reason why eye dissections are easily carried on is because material can always be readily procured. Any butcher will furnish sheep, pig, or beef eyes. Or, if one has the time to visit the manager of a slaughter-house, and make known to him one’s needs, he will supply enough eyes to carry through a host of interesting dissections and experiments, and give sufficient material for careful, orderly, and fruitful study. Perhaps in no other kinds of dissections will the investigator find so much of interest, or have his efforts crowned with such abundant and satisfactory results, as in the dissections of the eye. But no one should try to study all parts of the eye with only one specimen. To try to do so is an error, and a common one often committed by both teachers and students. Specimens cost little or nothing, and it is no more trouble to prepare a half-dozen eyes for dissection than one. The cost of preparation, too, is but little more for a number of eyes than it is for one, and may be no more in some instances. Besides, having enough material on hand saves time in case of a failure. Also, one can quickly repeat a dissection, and so procure any number of desired specimens of specific parts, or do over again the same dissection on another eye just for the purpose of practise, and thus add to one’s dexterity. It is, therefore, strongly advocated to have plenty of material on hand before beginning work. Economy here is not even “penny wise.”
The tools, or instruments, needed are but few in number; an ordinary scalpel, a pair of blunt tweezers, or forceps, as they are sometimes called; a pair of sharp-pointed tweezers, a pair of small, sharp-pointed scissors of about three to three and a half inches in length, and a pair of large scissors, about four or five inches in length, having one jaw sharp-pointed and one jaw blunt.
For glassware, any wide-mouthed jar or bottle, such as the ordinary fruit or jelly jar, will do for preparing material. For clarifying tissues, or for preserving and keeping them, small, wide-mouthed bottles or vials should be used. And for temporary keeping, or for purposes of “running through” various fluids, the regular Stender dishes are most convenient. A glass graduate is almost indispensable if accuracy in measuring fluids is desired. (Fig. 1.)
Fig. 1.
The chemicals needed are few in number and small in quantity: Alcohols in varying strength, which can be made by diluting a 95 per cent. alcohol, and keeping an absolute alcohol on hand. A few ounces of formaldehyde will make enough solutions of different strengths to be sufficient for the preparation and keeping of many specimens. Of other chemicals, such as xylol and cedar oil, only small quantities are needed; enough to cover a specimen. Fifteen to twenty cents worth of each will be an ample supply to keep on hand. All of these may be procured at any large drug store, and are the only chemicals required for doing the dissections as explained in this book.
Before further advance is made, it will be best to state that this work deals only with methods for dissecting the various parts of an eye, and is primarily intended to aid in the study of the anatomy and physiology of the eye by being used in conjunction with such books as “Gray’s Anatomy,” “A Text-Book of Physiology,” by Howell, “The Anatomy and the Physiology of the Eye,” by Brown and Zoethout, and similar other works of authority. However, if it is desired to acquire only specimens, then, of course, no other works are necessary, and the matter contained herein is sufficient to enable one to procure just what is wanted.
It is also wise to state here that since human eyes are hard to procure, and not available in large quantities, one must resort to the use of the eyes of animals, which are procurable in large quantities, and which may be used without “feelings” in the matter. Though there is a difference between the eyes of human beings and the eyes of other animals, the difference is slight and of minor importance when compared with the similarity of the more important parts.
TECHNIQUE
OF EYE DISSECTIONS
REMOVAL OF THE HYALOID MEMBRANE WITH CONTENTS AND ATTACHMENTS INTACT[1][2]
One of the easiest and most satisfactory dissections to attempt is the isolating of the hyaloid membrane with its contents and its attachments. The success one meets with in making this dissection will surely prove a strong incentive for making all the rest. For these reasons this has been placed first in this arrangement.
In eye dissections it is quite customary, in giving directions for dissections, merely to mention the hyaloid membrane and its relations with other parts of the eye. Rarely is there any attempt made to isolate it. Often, too, the retina is mistaken for the hyaloid, and the retina then wrongly demonstrated as being attached to the choroid. Of course, it is impossible to separate the hyaloid from the vitreous; but a dissection can be made which, when placed in a glass of some kind, will show the hyaloid. If the following simple technique is carefully observed, the membrane, with all its connections, can be easily separated from certain other parts of the eye. Opportunity for thorough study and observation will then be made extremely easy.
Procure the eye of either a sheep or a bullock. Instead of following the usual procedure of hardening in any one of the several solutions used for the purpose of toughening the ocular tissues, place the eye in a cool place and permit it to collapse a trifle. Usually two or three days is a sufficient length of time to accomplish the result.
Experiments have shown that if an eye is too fresh the ciliary processes will not be easily detached from the hyaloid (zonular processes), and if the eye has been in a preserving fluid, the same result will follow. A sheep’s eye will make a better specimen even if it is small, because the ciliary processes are more easily separated from the zonular processes. If a bullock’s eye is used, it must be left in a cool place a day or two longer than in the case of a sheep’s eye, in order to permit a long enough time to elapse to allow disintegration of the eye to take place sufficient to have the two processes separate easily and cleanly.
Fig. 2—Making the first cut. (Page 27.)
Fig. 3—Showing how the point of the lower jaw of the scissors is to be kept away from the underlying tissues. (Page 27.)
Fig. 4—Showing about half of the sclerotic separated. (Page 29.)
With a pair of dissecting forceps pinch up the sclerotic about 5 mm. anterior to the equator. With a pair of small, fine-pointed scissors, make an incision. (Fig. 2.) Next hold the eye in the left hand without exerting any pressure. Insert the point of the scissors into the incision which has been made, and cut. Be careful to keep the point of the scissors close to the sclerotic or an untimely puncturing of the choroid will occur. (Fig. 3.) Continue the cutting on a line parallel to the equatorial meridian and about 5 mm. anterior to it until about half the sclerotic has been separated. In cutting, always move the point of the scissors forward with a slight oscillating lateral movement. (Fig. 4.) While doing this, partly suspend the eyeball from the point of the scissors. Doing these things will tend to loosen the choroid from the sclerotic and prevent puncturing too soon the former mentioned membrane. Now apply pressure in such a manner that the lips of the cut sclerotic will gap. Into this put the point of the scissors and very carefully pick up the choroid and the retina with the point of the scissors and cut them. (Fig. 5.) If the choroid alone has been picked up and separated, the retina will show milky white or yellowish white underneath. The retina must then also be separated. Care must be taken not to go deeper than the retina or the hyaloid may be damaged. Continue the cutting of the choroid and the retina for a distance of about 20 mm. Apply enough pressure occasionally so that the vitreous will be forced upward and above the cut choroid and the retina. This will show whether any strands of the two membranes have been left uncut. If the separation is complete for the distance specified above, invert the eyeball, squeeze and shake gently over some receptacle, such as a Stender dish, three-fourths filled with a 2½ or 5 per cent. solution of formaldehyde, and the hyaloid membrane containing the vitreous, its attachments, suspensory ligament to the lens capsule, and lens, will drop out intact, as when one empties the contents of an egg. (Fig. 6.)
Fig. 5—Picking up the choroid with the point of the scissors.
Fig. 6—A. Hyaloid, vitreous, and lens ready to drop out of the eyeball.
Fig. 7—Photograph of dissected hyaloid membrane (A), with pigmented indentations of the ciliary processes, the suspensory ligament (B), and the crystalline lens in its capsule (C). (Page 34.)
Many times a considerable amount of pigment from the second tunic will remain attached to the processus zonuloe. This pigment may be easily removed by scraping it off with the sharp edge of the scalpel or by brushing it off with a soft, wet tooth-brush.
It is unwise to use alcohol as a preservative because it produces an almost immediate opaqueness and hardness which spoils the specimen for further study.
This description may give the impression that the dissection is a lengthy one; however, it can be done by an expert in two or three minutes; by a beginner in five or six minutes.
For purposes of demonstration or study the specimen should be placed in a small bottle or a vial containing a 5 per cent. solution of formaldehyde. It can then be examined with hand lens or microscope. (Fig. 7.)
[1] Approved as an original article in The Anatomical Record, September, 1912.
[2] This dissection, and several of the following, appeared in The Optical Journal and Review, beginning with the issue of January 16, 1913.
THE CANAL OF PETIT
The canal of Petit is a “triangular space around the circumference of the lens.” That it can be “inflated through a fine blowpipe inserted through the suspensory ligament,” is the usual direction given. However, the ordinary “fine blowpipe” is much too large and too dull to be inserted through the suspensory ligament. Take a long medicine-dropper (5 or 10 cents at a drug store), or a pipette, and heat it until it is red hot over an alcohol lamp or a Bunsen burner; hold one end with one hand and the other end with a pair of tweezers. As the glass becomes white hot pull the tube apart. This will leave the places of separation pointed and sharp-edged. Use the larger of the two pieces. Sometimes the point or tapering end of the tube is too long and the bore too small. All that is necessary is to first mark off with a file the length to be broken off, and then that length may be snapped off, leaving a sharp-edged, tapering point.
Fig. 8—A. Glass blowpipe. B. Petit’s canal.
After having completed the first dissection (the hyaloid, contents and attachments), and the specimen has been in the formaldehyde solution for ten days or two weeks, it will have become hard and tough enough to stand a considerable amount of rough handling. If the specimen has been kept in a large receptacle, such, for instance, as a jar, remove it with a spoon; if in a small jar or vial, empty out the fluid, then slide the specimen out on whatever has been prepared to receive it. Turn it so that the lens will be uppermost. Find the suspensory ligament in the Zone of Zinn. Insert the pointed end of the glass tube, close to the lens, and blow gently until the canal shows its sacculated construction by filling with air, giving the appearance of a lot of little bubbles surrounding the periphery of the lens. (Fig. 8.) It may be necessary to move the blowpipe in and out in order to find the canal, all the while blowing steadily through the tube.
THE INTERIOR OF THE EYE
For the study of the interior of the eye and its contents in situ either a fresh or a hardened eye will do; a hardened eye is preferable. In the dissection for isolating the hyaloid membrane, vitreous, lens, and other parts, the anterior and posterior halves of the evacuated eye may be separated entirely, and each half studied. However, the choroid and the retina will be more or less mutilated, and the vitreous and other parts will be removed. The absence of these parts will prevent one from receiving a definite idea of their anatomical relationships. Therefore, it is better to work with an entire and complete eye.