Medical epidemics : glaucoma and iridectomy : a review.

  • Wilde, William Robert Willis, 1815-1876.
Date:
1860
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Licence: Public Domain Mark

Credit: Medical epidemics : glaucoma and iridectomy : a review. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    larities of pupil; hence Tyrrell’s definition of “glaucomatous cataract.” The disease in this stage is generally painless. The term “ acute glaucoma” has been applied to a peculiar form of arthritic internal inflammation of the eye, arising suddenly, attended with great pain and total loss of vision, and having its principal seat in the iris, choroid, and retina, without much effusion of lymph; pupil generally dilated, and loss of cho- roidal pigment frequently occurring during the progress of the disease. Like the former, it is nearly always fatal to vision. In the foregoing description we have endeavoured, without too great minutiae, to be as simple, general, and, at the same time, as forcible as possible. Without entering into an arch- eological history of the disease, let us take up the writings of half a dozen good practical men, and see what their ideas have been upon the subject. When ophthalmic surgery made a burst about 130 years ago, glaucoma and cataract were considered synonymous, the seat of the latter not being then well deter- mined. Shortly after Brisseau demonstrated the pathology of cataract, our own countryman, O’Halloran (whose labours we brought under the notice of our readers in vol. vi. of this Journal), wrote one of the best books on the subject of what was known in his day as the “ glaucoma or cataract.” The learned Mackenzie has reproduced in a concentrated form the opinions of most authors, ancient and modern; Dr. Hayes, of Philadelphia, in his edition of “Lawrence’s Treatise on the Diseases of the Eye,” published in 1847, has added some other authorities; while Hirnly brings together all the ideas of the continental writers upon the subject. The true pathology of the disease has not been very well made out. At first it was believed that there was a “ scum” behind the pupil; then that the seat of the disease was in the vitreous humour, which be- came green; then it was supposed deposits took place in the vitreous body. Others, and with reason, attribute the greenish reflexion to the want of pigment in the choroid. Lastly, the ophthalmoscope has been brought into use, and finds a hol- lowed or cupped appearance in the entrance of the optic nerve, a peculiar condition of the retinal vessels within the limit of the papilla, and pulsation in the arterial trunks. Edward Jaeger first pointed out some of these peculiarities; but long before he wrote Mackenzie had noted a change in the retina, and in dissection found no trace of limbus luteus or foramen centrale. The matter stood nearly thus until about four years ago, when Dr. A. von Graefe, of Berlin, published some essays upon the subject in the Archiv filr Ophthalmologie wherein he attributed to intra-ocular pressure the condition of the optic
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