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he conjunctiva. If the papillse are much swollen and very-prominent, like cauliflower excrescences, it may be necessary to snip themoff with a pair of scissors. 4._G0X0KEH(EAL OPHTHALMIA. [Syn. GonorrhcTeal conjunctivitis.—B.] Gonorrhceal ophthalmia is one of the most dangerous and virulent diseasesof the eye. In the majority of cases it presents the symptoms of a verysevere purulent ophthalmia, accomj)anied sometimes by marked constitu-tional disturbance. Shortly after the infection, the patient experiences a feeling of tinglingand smarting in the eye, as if a little grit or sand had become lodged be-neath the lids. The eye becomes red, watery, and irritable, and the edgesof the eyelids somewhat glued together by a slight grayish-white discharge.These symptoms rapidly increase in severity, and the disease quickly assumesthe character of purulent ophthalmia of an aggravated type. The eyelidsbecome greatly swollen, hot, red, and cedematous [Fig. 62], the conjunctiva [rig. 62. Tm. 63.

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After Dalrymple.] very vascular, swollen, and villous; the chemosis is also very considerable[Fig. 63], enveloping and overlapping the cornea, and protruding betweenthe lids. The discharge is thick and creamy, and perhaps so profuse that itoozes out between the lids, and when they are opened streams over the cheek.There is always great danger of the cornea becoming affected with deep andextensive ulceration, which frequently quickly leads to perforation. Theconstitutional symptoms are often severe; the patients being generally in afeeble and weakly condition, their general health having, perhaps, sufferedfrom the existence of the gonorrhoea. Sometimes, the disease shows from the outset a marked tendency to assumethe character of diphtheritic conjunctivitis, and this proves especially dan- 154 DISEASES OF THE CONJUNCTIVA. gerous to the eye. In such cases, we notice that the conjunctiva, instead ofpresenting the usual red, vascular, succulent appearance common to purulentophthalmia, bec