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Updated: May 11, 2025


The enlargement of the anterior perforating veins is an old symptom of chronic glaucoma. Obstruction to outflow of blood through the vorticose veins, by the increased intra-ocular pressure, has long been a recognized explanation of the malignant tendency of glaucoma a part of the vicious circle established in this disease.

Complete interruption of the nutritional stream would be speedy death; partial interruption may be held responsible for most of the visual impairment and pain of glaucoma. The balance of intra-ocular pressure is not maintained by the slight distensibility of the sclero-corneal coat.

Now, it goes without saying, if these data are correct, or even only partly correct, that part of the treatment of the increased intra-ocular pressure state must be constitutional in that the vascular pressures should be lowered in order that the beneficial effect of their relationship to the intra-ocular pressure shall be established.

It is convenient to start with the conception that glaucoma is increased tension of the eyeball, plus the causes and effects of such increase; although a broad survey of the facts may reveal a clinical entity to be called glaucoma, without increased tension constantly or necessarily present, and cases of increased intra-ocular tension not to be classed as glaucoma.

There seems little doubt that Truc and Imbert's observations that high frequency currents can temporarily reduce intra-ocular tension is correct, that they are able to relieve the pain of primary and of secondary glaucoma would seem to be proved by many observations, some of which I have myself made, and other very accurate and excellent ones have been made by Risley in Philadelphia.

It affords a possible mechanism through which may be produced the recognized glaucomatous effects of certain nerve disturbances. But such attacks are not commonly associated with noticeable flushing of the head and face generally; and paralysis of the cervical sympathetic is known to lower the intra-ocular tension.

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