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To the Editor.—The Guist eye speculum is a very great aid in operative procedures, especially in such operations as require section of the globe to any extent.
There is, however, one feature of its application that adds danger in cataract operations. If the instrument is adjusted in such manner as greatly to lift the eyelids forward, with consequent pulling tension on the conjunctival folds, especially when a superior rectus stay suture is used, there is a marked tendency to collapse and recession of the anterior contents of the globe after section has been made. In other words, the lifting puts a pulling tension on the periphery of the globe forward from the equator and is likely to cause sinking backward of the lens and iris margin deeper into the globe immediately following the section, thus making it more difficult, or indeed impossible, to deliver the lens or do iridectomy.
Chapman VA. GUIST EYE SPECULUM. Arch Ophthalmol. 1932;7(2):307. doi:10.1001/archopht.1932.00820090147016