Bell's paralysis or Bell's Palsy (paralysis of the seventh cranial nerve or 'facial nerve') occurs in both sexes equally and at all ages, though it is commonest in early adult life. It comes on rapidly, generally after exposure to wet or cold, or to draughts on the side of the face. An exactly similar type of facial paralysis may occur in cases of acuteinflammation of the middle ear, or after operations on the mastoid. The onset is usually sudden, and the paralysis is generally complete from the first. If it is incomplete, the lower part of the face is more affected than the upper. The first symptom is that the patient feels one side of the face to be stiff when he attempts to move it. The paralysed side of the face shows a striking contrast with the normal side. It is smooth and free from wrinkles, and devoid of any form of expression, so that the patient cannot laugh or weep or frown or express any feeling or emotion, while the features of the normal side are in fullplay. The eye cannot be closed because of the drooping of the lower eyelid, and the mouth cannot be moved on the affected side so as to expose the teeth. Speaking becomes difficult, and fluids may escape from the mouth on drinking, and saliva dribbles away. The duration of the paralysis varies within wide limits. Quite slight cases may recover in ten to fourteen days. Others remain unaltered for many weeks or months, but recovery always occurs finally, and as a rule within two years. The recovery always appears first in the upper part of the face. In cases associated with some underlying disease of the brain or bones of the ear, recovery may be uncertain. Research Bell's Paralysis
The conjunctiva is a thin, transparentmembrane that surrounds the sclera of the eye and lines the inside of the eyelid. The cells of the conjunctiva produce a fluid similar to tears that lubricates the lids and the cornea making it easier to blink. Conjunctivitis, often called pink-eye, is a common infection of this area. Conjunctivitis can be bacterial or viral in nature. The infection causes the area to become red and irritated, hence the name 'pink-eye'. Research Conjunctiva
The eye is the organ of vision of animals, consisting in man of the globe of the eye, the muscles which move it, and of its appendages, which are the eyelids and eyebrows, and the lachrymal apparatus. The walls of the globe of the eye are formed principally of two fibrous membranes; one white and opaque - the sclerotic (from the Greek skleros meaning hard) - which envelops two-thirds of the globe posteriorly; and the other transparent, and resembling a horny plate, whence its name, cornea (from the Latin. corneus, meaning horny). The sclerotic is a tough fibrous coat, and is the part to which the phrase 'white of the eye' is applied. In the front of the globe the sclerotic is abruptly transformed into the transparent portion (the cornea), which is circular, and which forms a window through which one can see into the interior.
A mucousmembrane, the conjunctiva, so named because it unites the eye to the lid, spreads over the anterior portion of the globe, and then folds back on itself and lines the internal surface of the, eyelids. On the internal surface of the sclerotic is a vascular membrane called the choroid. This is essentially the blood-vessel coat of the eyeball. The front part of the choroid terminates about the place where the sclerotic passes into the cornea in a series of ridges, the ciliary processes. The circular space thus left in front by the termination of the choroid is occupied by the iris, a round curtain, the structure seen through the cornea, differently coloured in different individuals. In its centre is a round hole, the pupil, which appears as if it were a black spot. The iris forms a sort of transverse partition dividing the cavity of the eyeball into two chambers, a small anterior chamber filled with the aqueous humour, and a large posterior chamber filled with vitreous humour. The iris consists of a framework of connective tissue, and its posterior surface is lined by cells containing pigment which gives the colour to the eye. In its substance are bundles of involuntary muscular fibres, one set being arranged in a ring round the margin of the pupil, the other set radiating from the pupil like the spokes of a wheel. In a bright light the circular fibres contract and the pupil is made smaller; but in the dark these fibres relax and cause the pupil to dilate more or less widely, thus allowing only that quantity of luminous rays to enter the eye which is necessary to vision.
Just behind the pupil is the crystalline lens, resembling a small, very strongly magnifying glass, convex on each side, though more so behind. The greater or less convexity of the surfaces of the lens determines whether the vision is long or short. The internal surface of the choroid, or rather the pigmentary layer which covers it, is lined by the retina or nervous tunic upon which the objects are depicted that we see.
The ocular globe is put in motion in the orbit by six muscles, grouped two by two, which raise or lower the eye, turn it inward or outward, or on its antero-posterior axis. In these movements the centre of the globe is immovable, and the eye moves round its transverse and vertical diameters. These three orders of movements are independent of each other, and may be made singly or in combination, in such a manner as to direct the pupil towards all points of the circumference of the orbit.
Each eye is furnished with two eyelids, moved by muscles, which shield it from too much light and keep it from being injured. They are fringed with short fine hairs called eyelashes; and along the edge of the lids is a row of glands similar to the sebaceous glands of the skin. The eyebrows, ridges of thickened integument and muscle, situated on the upper circumference of the orbit and covered with short hairs, also regulate to some extent the admission of light by muscular contraction. In reptiles, some fishes (sharks, etc), in birds, and in some mammals a third eyelid or nictitating membrane is present, and can be drawn over the surface of the eye so as to clear it of foreign matters, and also to modify the light.
The lachrymal apparatus is composed of, firstly, the lachrymal gland, which lies in a depression of the orbitalarch; secondly, of the lachrymal canals, by which the tears are poured out upon the conjunctiva a little above the border of the upper lid; thirdly, the lachrymal ducts, which are destined to receive the tears after they have bathed the eye, and of which the orifices or lachrymal points are seen near the internal commissure of the lids; fourthly, the lachrymal sac, in which the lachrymal ducts terminate, and which empties the tears into the nasalcanal.
The tears, by running over the surface of the conjunctiva, render it supple and facilitate the movements of the globe and eyelids by lessening the friction. The influence of moral or physical causes increases their secretion, and when the lachrymal ducts do not suffice to carry them off they run over the lids.
The retina renders the eye sensible of light, and we may therefore consider it as the essential organ of vision. The function of the other portions is to converge the luminous rays to a focus on the surface of the retina, a condition necessary for distinct vision and the clear perception of objects. The visual impressions are transmitted from the retina to the brain by means of the optic nerve. The two optic nerves converge from the base of the orbit toward the centre of the base of the skull, where there is an interlacement of their fibres in such a manner that a portion of the right nerve goes to the left side of the brain, and a part of the left nerve to the right side; this is called the chiasma or commissure of the optic nerves. The principal advantage of having two eyes is in the estimation of distance and the perception of relief. In order to see a point as single by two eyes we must make its two images fall on corresponding points of the retinas; and this implies a greater or less convergence of the optic axes according as the object is nearer or more remote.
According to one estimate, four-fifths of everything we know reaches the brain through our eyes. The eyes transmit constant streams of images to the brain by electrical signals. The eyes receive information from light rays. The light rays are either absorbed or reflected. Objects that absorb all of the light rays appear black, whereas those that reflect all the light rays appear white. coloured objects absorb certain parts of the light spectrum and reflect others. When you look at something, the light rays reflected from the object enter the eye. The light is refracted by the cornea and passes through the watery aqueous humor and pupil to the lens. The iris controls the amount of light entering the eye. Then the lens focuses the light through the vitreous humor onto the retina, forming an image in reverse and upsidedown. Light- sensitive cells in the retina transmit the image to the brain by electrical signals. The brain perceives the image the right side up.
To accommodate the eye to different distances the lens is capable of altering itself with great precision and rapidity. When we look at a near object the anterior surface of the lens bulges forward, becoming more convex the nearer the object; the more distant the object the more the lens is flattened. When the transparency of the cornea, the crystalline lens, or any of the humours, is destroyed, either partially or entirely, then will partial or total blindness follow, since no image can be formed, upon, the retina; but although all the humours and the cornea be perfectly transparent, and retain their proper forms, which is likewise necessary to distinct vision, yet, from weakness or inactivity of the optic nerve, or injury of the central ganglia with which it is connected, weakness of sight or total blindness may ensue. Defective vision may also arise from the crystalline lens being so convex as to form an image before the rays reach the retina (a defect known as short sight or myopia), in which case distinct vision will be procured by interposing a concave lens between the eye and the object of such a curvature as shall cause the rays that pass through the crystalline lens to meet on the retina; or the lens may be too flat, as is the case in old age, a defect which is corrected by convex lenses.
In the lower forms of life the organs of sight appear as mere pigment spots. Ascending higher, simple lenses or refracting bodies occur. Insects, crustaceans, etc, have large masses of simple eyes or ocelli aggregated together to form compound eyes - the separate facets or lenses being optically distinct, and sometimes numbering many thousands. In the molluscs well-developed eyes approaching in structure those of the highest animals are found; and in all vertebrate animals the organ of vision corresponds generally to what has been described, though they vary much in structure and adaptation to the surroundings of the animal. Research Eye
The eyelashes fringe the border of each eyelid. The lashes help protect the eye from dust and other foreign particles and protect the eye from glare. Each eye has about 200 lashes. They consist of three series of short hairs. Those of the upper lid are more numerous and longer than the lashes of the lower lid. The lashes of the upper lid curve upward and the lashes of the lower lid curve downward. They extend from about one-fourth of an inch from the inner canthus to near the outer canthus. The lashes last between three and five months. New lashes are continually growing. Research Eyelashes
The eyelids are two folds of skin that shield the eyeball. The upper lid is larger and more movable. It regulates the opening and closing of the eye with the help of the orbicularis palpebrarum muscle. Lower-lid movement is slight. The eyelids sweep dirt from the surface of the eye, protect it from injury, and help distribute the tear fluid. When the eye is closed, the lids unite at the lid-slit in a downward curve. The corners of the eye are called the inner canthus, which is near the opening of the lachrymal duct, and the outer canthus, which ends in the crease where the upper lid overlaps the lower lid. The eyelid is lined with a mucousmembrane called the conjunctiva. This lining also covers the front of the eyeball. This covering, when washed with tears, gives the eye its glossy appearance. Research Eyelid
The lachrymal duct is one of two channels that secretes the sterile tear fluid that constantly bathes the front of the eye and its thin protective covering membrane, the conjunctiva. Although tear flow is continual, only about 1/2 to 2/3 of a gram of fluid is produced per day. The lachrymal duct is located in the inner corner of the lower eyelid. Research Lachrymal Duct
Abbreviations
Research Abadie's Sign
