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In an operation for removal of cataract it is a serious situation if the patient suddenly attempts to close the eye while the speculum is still in place under the lids. Many an eye has been lost by this accident after the corneal section has been completed; for the lens may be forced out, followed by a serious loss of vitreous. Some of our most skilful and experienced operators have entirely done away with the use of the speculum for this reason, and in its place use the thumb and fingers to keep the lids open, or they have a trained assistant to do this, or use a lid elevator. But not all operators can have such an assistant and at all times. Others remove the speculum as soon as the corneal section is finished and the capsule opened.
To avoid this source of danger as far as possible, and
SWASEY E. A LID ELEVATOR FOR CATARACT OPERATION.. JAMA. 1907;XLIX(20):1673-1674. doi:10.1001/jama.1907.25320200031003c