Here are some of the other eye problems you may meet.
OTHER EYE PROBLEMS If he has a BLIND, PAINFUL EYE, it may be better removed. See Section 24.14.
If CANNOT OPEN HIS EYE he has PTOSIS. This may be congenital (refer him), traumatic (refer him), acute as the result of an oculomotor palsy (refer him), or the result of myasthenia gravis (treat him).
If he has A SMALL YELLOWISH-WHITE LUMP adjacent to his cornea in the region exposed by his palpebral opening, he has a PINGECULA. It is harmless, reassure him.
If he has a wing-shaped vascular THICKENING OF HIS CONJUNCTIVA which grows on to his cornea, usually from the medial side (common), this is seldom serious. If his vision is good, leave it. If it is advancing over the centre of his cornea and impairing his vision, refer him. If you cannot refer him, under local anaesthesia excise the pterygium off his conjunctiva, and dissect it off his cornea. Leave his sclera bare, and gently diathermy it. Up to 50% recur.
If an old person has a complete or incomplete WHITE RING ENCIRCLING HIS CORNEA about 1 mm within the limbus, he has ARCUS SENILIS. It is harmless, reassure him.
If A PATIENT IS WORRIED ABOUT HIS EYES, they are both white, they have good visual acuity, and he is under 40 years old (that is, he is not presbyopic), and there is nothing obviously abnormal, you can reassure him that his eyes are normal.
25 The ear, nose, and throat