Glaucoma : $b A symposium presented at a meeting of the Chicago Ophthalmological Society, November 17, 1913
Science
Glaucoma : $b A symposium presented at a meeting of the Chicago Ophthalmological Society, November 17, 1913
Glaucoma
distributed to the epithelium, the compression probably occurring along
the course of the long ciliary nerves, from which the corneal nerves are
derived, as they pass between the choroid and the unyielding sclera
(Collins & Mayou).
In advanced cases of glaucoma after the congestive period has subsided
the cornea becomes somewhat condensed, the lymph spaces contracted; a
condition of sclerosis obtains. Alteration in the shape of the cornea
occurs only rarely in adult life. When it does occur it takes place in
corneae that have suffered from keratitis. The alteration is usually in
the form of ectasiae. In infancy and early youth (buphthalmia) the cornea
may become uniformly enlarged and globular. Often, however, the
enlargement of the cornea is irregular. Increase in tension may produce
fissures in Descemet's membrane. These occur more frequently in the
cornea that have suffered a change in shape, as in buphthalmos. Gaps
occur in the elastic membrane which become covered by endothelium. Some
cloudiness may be seen in the corneal lamellae adjacent to these
fissures, in some cases due evidently to the filtration of aqueous humor
through defective endothelium. Prolonged high intra-ocular tension may
be accompanied, particularly in cases of secondary glaucoma, by
vesicular and bullous keratitis.
In acute glaucoma the sclera appears to be edematous and slightly
thickened. As the disease progresses the sclera becomes denser than
normal. The oblique openings--passages for the venae vorticosae--are
said to be narrowed. The openings for the passage of the anterior
ciliary vessels are enlarged in many, particularly in advanced cases.
Minute herniae at these openings are sometimes present. Dilatation and
tortuosity of the anterior ciliary veins are due apparently to excessive
flow of blood through them on account of the abnormally small amount
carried off by the venae vorticosae. In the stage of degeneration,
ectasae of the sclera occur most frequently near the equator of the
globe. Spontaneous rupture may take place.
_Anterior Chamber._ The anterior chamber is shallow, as a rule. This is
almost without exception in primary glaucoma in adults. In secondary
glaucoma in which occlusion of Fontana's spaces occurs as a result of
the deposition of fibrin or other inflammatory products the anterior
chamber may be of normal depth, or deeper than normal. Very deep
anterior chamber may occur in glaucoma, due to retraction of lens and
iris following fibrinous or plastic exudation into the vitreous, or
when it occurs in congenital glaucoma, due to enlargement of the globe.
Public-domain text, read in full here on John Shaqi.
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