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Updated: May 11, 2025
In the eye there is probably a normal equilibrium between blood pressure, tissue activity, and intra-ocular tension. This may be destroyed either by increasing the intra-ocular tension, or lowering the tissue activity, or the blood pressure. Lowered blood pressure has been suggested by Paton as an explanation of symptoms usually ascribed to vascular obstruction.
Another matter: I am satisfied that the delayed filling of the wound by connective tissue is desirable in most cases of chronic glaucoma. A complete drainage of the intra-ocular fluids that results from long delayed union of the wound edges, allows the interior of the eye to regain, as far as possible, the status quo ante.
Jackson virtually puts aside the volumetric theory with his statement, that "the balance of intra-ocular pressure is not maintained by the slight distensibility of the sclero-corneal coat." Further discussion on the inadequacy of the volumetric theory need not detain us. It is well to recall a few anatomical features because of their bearing on the theories herein considered.
Many authors, for example, Darier, Grandclement and others, are strong in their recommendation of adrenalin, particularly if this drug is added to the various myotic mixtures, and yet adrenalin is certainly not without danger in the treatment of glaucoma. McCallan has seen a number of instances of striking increase of intra-ocular tension following this instillation in the conjunctival sac.
The clinical fact remains that either by mechanical means, as it were, in the liberation of a plugged filtering angle, or by the increasing of iris-surface filtration, the myotics markedly reduce the abnormal intra-ocular pressure. Methods of Administration and Indications.
These observations were made while he was experimenting on irritation of the sympathetic as a method of producing increased intra-ocular tension. This is not in accord with Axenfeld's recent observations.
In a few instances endeavor has been made to reduce the intra-ocular tension, or at least to relieve glaucomatous symptoms, by galvanism of the cervical sympathetic, for example, by placing one electrode along the whole length of this nerve in the neck and one on the back of the neck on the opposite side, 15 to 20 ma. of current being used.
It is not germane to the subject to name the various ocular diseases which were treated in this manner, but Clausnizer has made an investigation of the influence of diathermy on intra-ocular tension. In a number of diseases, for example, iridocyclitis, the method produced distinct rise of pressure.
At one time in my career I experimented very extensively with massage, not alone for the purpose of reducing intra-ocular tension, but in various diseases of the lid and cornea, and taught a trained nurse, who herself had a nebulous cornea, to make what I may call a specialty of this particular therapeutic procedure. She became exceedingly skillful and was quite faithful.
This work has been so slightly related to practical ophthalmology, and so contradictory in its results that alterations in the fluids can only be regarded as a possible etiologic factor. Glaucoma secondary to intra-ocular hemorrhage, operations on the lens or its capsule, or severe nutritional disturbance may be capable of such explanation. Different Kinds of Glaucoma
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