Atlas of the external diseases of the eye : including a brief treatise on the pathology and treatment / by O. Haab ; Authorized translation from the German, edited by G.E. de Schweinitz.

Haab O. (Otto), 1850-1931.

Date:: 1899

Credit: Atlas of the external diseases of the eye : including a brief treatise on the pathology and treatment / by O. Haab ; Authorized translation from the German, edited by G.E. de Schweinitz. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$It may be stated, in general, that myopie eyes almost never become atfeeted with inflammatory glancoma, but jnay be attacked by the simple form. Arterial sclerosis and cardiac weakness are predisposing causes. The mechanism of glaucoma is not well understood. The rise in tension is thought to be caused by increased secretion of fluid within the eye (von Gracfe’s serous choroiditis) and by obstruction to the normal outflow from changes in the eye (obstruction to the outflow in the anterioi’ chamber in the form of circular adhesions between the ])crij)hery of the iris and the cornea, Knies and Weber theory). Dilatation of the pupil with atropin is positively known to bring on glaucoma if the eye is predisposed to the disease or has alreadv suffered an attack. Diagnosis.—Inflammatory glaucoma is very apt to be confounded with iritis; and the differential diagnosis is of the highest importance, as the two conditions demand radically different treatment. It should be made a rule of practice never to use atropin until the tension has been accurately determined. In iritis the pupil is contracted ; in inflammatory glaucoma, dilated. The recognition of .simple glaucoma depends on an oj)hthalmoscopic ex- amination. A fatal error is to mistake infantile glau- coma for parenchymatous keratitis; the two conditions are very similar in their external a])])carances during the initial .stage. The distinction is made by observing the tension. The prognosis is always grave. Simple glaucoma is more difficult to cure than the inflammatory variety; but the hemorrhagic form is the most hopeless of all. The more precarious the conditioii of the heart and blood- ve.s.sels, the more dubious will be the prognosis in a given case of glaucoma. The treatment comsists in the local u.sc of myotic.s, physostigmin or pilocarpin, and in most cases surgical operation. Medicinal treatment must be begun at once : 3 to 5 drops of a \ per cent, solution of physostigmin (eserin), or 5 to 10 drops of a 2 per cent, solution of pilocarpin, 14$