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
As you will remember, the strength of ordinary crystallized sodium
citrate in water should be from 4.05 to 5.41 per cent. Of this five to
fifteen minims are injected, the eye having been previously cocainized
and adrenalinized. With frequent injections the weaker of the two
solutions is mixed with 2 to 4 parts of physiologic salt solution. These
authors in no sense claim to cure glaucoma, but to ameloriate it and
reduce the tension. Weekers has used the salts of calcium, 3 grams a
day, with success in so far as lowering of tension is concerned,
although it must be stated, as a reviewer of his work has said, that his
recommendation of this drug in these respects is poorly supported. On
the other hand, Tristiano seems to have proved that calcium chlorid is
capable of lowering ocular tension and clinically may be used as an
adjuvant in the treatment of glaucoma for this purpose, largely because
he believes that he has proven that it facilitates the absorption of
edema. Darier has reported that a single subconjunctival injection of a
milligram of iodate of sodium has cleared the cornea and lessened the
intra-ocular pain in glaucoma.
What shall be said in regard to certain medicinal agents which stimulate
the lymphagogue activity of the eyeball in their relation to the
reduction of intra-ocular tension, notably of dionin? Toczyski's
experiments with this drug on the normal eye indicate that it produces
first a rise of tension, which shortly falls to the normal and sometimes
below it, the tension being high as long as the primary narrowing of the
pupil is maintained, but more than one author, particularly A. Senn,
holds an opposite view and reports acute glaucoma following its
instillation into a chronic glaucomatous eye. He believes that dionin
not only does not reduce the tension but hinders the filtration through
the anterior lymph channels by the pressure of the edema which is
produced on the veins and by the increased secretion of the ciliary
processes. In spite of this statement, most of us must agree with Karl
Grossman's observations that certainly in acute and particularly in
chronic secondary glaucoma, this is a most valuable agent, especially if
it is combined with holocain, which Paul Knapp in his well-known
research has proved can reduce the tension even of the normal eye. I
cannot think that anybody who has systematically used dionin with
holocain, the former in gradually increasing strength, beginning with 2
per cent and going up to 8 per cent, in various types of acute glaucoma,
particularly of the secondary variety, can fail to have noted a
favorable influence.
Public-domain text, read in full here on John Shaqi.
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