Lectures on diseases of the eye / by Charles Bell Taylor.

  • Bell Taylor
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on diseases of the eye / by Charles Bell Taylor. Source: Wellcome Collection.

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    flabby, or the patient intractable, it is by no means easy to arrive at a just conclusion, especially when the case is not a very decided one, and the subjective symptoms not very marked. Moreover, in cases of simple glaucoma tension is not increased, or only very slightly increased; but you will say. There is no inflammation in simple glaucoma, no sus- picion of iritis, no fear of adhesions ; then why use atropine at all ? Why, indeed ? Nevertheless, it is frequently used in these cases by practitioners obUvious of the maxim, Priinum -non nocere, simply by way of doing something, or in order to clear up the diagnosis. The patient complains of dimness of vision; to the unpractised eye there is an appearance of opacity; the case is supposed to be one of cataract, and atro- pine is used either to improve sight by dilating the pupil or facilitate ophthalmoscopic examination, often with fatal effect. I remember a case of this kind occurred at this institution when it was first inaugurated. The patient was an aged female suffering from simple glaucoma; atropine was used through some mistake, and the symptoms were so much aggra- vated that she declined all further treatment on the ground that them drops had blinded her. Are there no means of dilating the pupil without incurring these terrible risks ? Have we no mydriatic that is safe ? Are not some safer than others ? These are questions which at present it is very difficult to answer. I am, however, inclined to think that cocaine will be found the safest mydriatic to employ in a doubtful case. Certainly it reduces the tension of the normal eye in a most marked degree—a fact we have frequently demonstrated during the operations for cataract performed under its influence ; whether its effect will be innocuous, beneficial, or otherwise in glaucoma, however, remains to be proved. Any way it will be
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