The conjunctiva lining the lids may be examined. The lower lid is drawn out and down, pressure being made at the same time below it, causing it to become prominent. The upper lid is turned back by grasping the edge slightly toward the outer canthus and raising the lid, while at the same time pressure is made upon it from above near the inner canthus. This inverts the tarsal cartilage and exposes the membrane. If while this lid is turned back the lower one is also treated as above, both together stand out more prominently and may be observed together.
Granulations appear as minute white or pale red elevations.
With the patient supine, direct pressure is made, with the palms of the fingers, upon the eye-balls, pressing them directly back into the orbits. This impinges nerves, blood-vessels, muscles and all the orbital structures. It presses excess of blood from the vessels, and tones the muscles, nerves and the structures of the intra-ocular mechanism. Tapping upon the eyeball has much the same effect. It is performed by placing the palms of one or two fingers over the closed eye, and lightly tapping them with the index finger.