The practical details of cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1903
Catalogue details

Licence: In copyright

Credit: The practical details of cataract extraction / by H. Herbert. Source: Wellcome Collection.

    123/142 page 101
    eye as yet uninfluenced by glaucoma, cataract, or cataract extraction, that of the glaucomatous eye is generally dis- tinctly the shallower of the two. In a few cases the difference in depth is inappreciable ;* but it must be borne in mind that the dilated pupil and altered iris of the affected eye prevent very exact comparison between the two eyes. This difference in anterior chambers, though not quite exclusively the property of these cataractous glaucomas, is sufficiently so to remain their chief distinctive feature. During the period of collection of the statistics given below it was found but five times in glaucomatous eyes without cataract, or with only incipient cataract. In ordinary congestiv^e glaucoma the relation is commonly reversed ; the chamber of the affected eye is less shallow than that of the unaffected —but predisposed—eye. (See Czermak, quoted in the Ophthalmic Review, xvi. 199.) It is by no means contended that the cataract formation always takes a very large place in the etiology of these high tensions. For the large majority of such swollen cataracts pass through their whole course without altering the tension of the eye at all. And of the thirty-three of these cataracts associated with recent congestive glaucoma, of which I have notes, five had advanced to the Morgagnian stage, though in four out of these five cases the glaucoma was by no means advanced. In two of them there was still some pupillary reaction obtainable ; in one of these two and in another case the tension gave way completely to eserine before operation ; and in the fourth case the attacks of high tension had been intermittent. Among other factors in etiology may be noted the predis- * I have very rarely seen congestive glaucoma together with Mor- gagnian cataract and an anterior chamber deeper than that of the unaffected eye ; but in only one case was the glaucoma apparently of recent origin. In this case it must be assumed that the cataract played no part in the production of the high tension.
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