Glaucoma, and its cure by iridectomy : being four lectures delivered at the Middlesex Hospital / by J. Soelberg Wells.

  • Wells, J. Soelberg (John Soelberg), -1879
Date:
1864
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Licence: Public Domain Mark

Credit: Glaucoma, and its cure by iridectomy : being four lectures delivered at the Middlesex Hospital / by J. Soelberg Wells. Source: Wellcome Collection.

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    nation, we find that there is a progressive excavation of the optic nerve, that the retinal veins are dilated and tortuous, and that there is either a spontaneous or easily producible arterial pulsation. We not unfrequently find, even after the disease has thus insiduously run its course without any inflammatory exacerbation since the first acute attack, that at a later stage these inflammatory attacks, even of a very acute kind, may recur again. When the disease has run its course, and all, even quantitative perception of light is lost, von Graefe calls it glaucoma consummation, absolutum. Sometimes we meet with a sub-acute form of glau- coma, in which all the inflammatory symptoms are much diminished in intensity, the pain is also less, nor is the sight so much impaired as in the acute cases. There is also a haemorrhagic form, which is peculiarly dangerous, as it is far less favourably influenced by iridec- tomy. The glaucomatous inflammation sometimes super- venes upon certain haemorrhagic affections of the retina, particularly those met with in kidney disease. In these there is very considerable congestion and stagnation of the intraocular circulation. Now, although iridectomy may yield some temporary benefit, yet relapses but too frequently recur, and the operation is occasionally followed in this form by great intraocular haemorrhage, which often destroys the eye. The power of absorption is also very much impaired in these cases, for we find that haemorrhage into the anterior chamber for instance, which is frequently produced by a very slight cause, such as a fit of coughing, &c., is very slowly and imperfectly absorbed. Von Graefe* has lately called attention to a class of cases in which the march of acute glaucoma is most rapid, so that the sight, even all quantitative perception of light, of a previously perfectly good eye, may be perfectly lost within a few hours, or even within half an hour, of the outbreak of the disease. He has termed this glaucoma fulminans. # Archiv. vol. viii, 2.
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