The application of leeches

In this week's Nursing Standard, Jane Bates talks about receiving a nursing dictionary from the 1950's, and she mentions a little used ophthalmic treatment:

'One is straight from the horror films: for acute glaucoma, relief was given by applying leeches to the eyeball.'

Now I actually have in my possession Ophthalmic Nursing by P.Garland which was published in 1966. It has a whole section on The application of leeches.

'Leeching may be ordered for the relief of pain and congestion in cases of acute glaucoma and acute iritis. It is difficult to assess the efficacy as the treatment is so often combined with other measures, but patients with recurring attacks often welcome the apparently unpleasant application.'

The leech should actually be applied to the orbital ridge, and should be prevented from accidentally biting on the eyeball! The leech takes between 20 minutes to an hour to feed. They should never be pulled off:

'A little salt put around the spot where they are attached will cause them to vomit and so lose their hold.'

Explanation to the patient should be sensitively timed:

'He should not be told until the tray is brought to the bedside, and the jar of leeches will be kept out of his sight and also that of other patients.'

There's even a list of equipment:

'Leeches, Mackintosh cape, test tube plugged with wool, dissecting forceps to handle the leech, unscented soap and a small bowl of water, sweetened milk, salt and teaspoon, Carbolic 1 in 20 in a kidney tray, receiver, swabs, square of lint, eye pad, small pressure pad, large wool dressing, two inch bandage, adhesive strapping.
The top pillow should be protected by a jaconet pillow case.'

And let's not forget who'll be carrying out this procedure:

'The inexperienced nurse may feel apprehensive of handling a leech.'