If other conditions than increased tension can produce a typical (ampulliform) glaucomatous excavation of the disc, why may not the cavernous atrophy and cup in glaucoma be due in part at least to similar processes, possibly in the nature of a toxic oedema of the nerve, either in association with tension or independent of it, as contended for by Schnabel?
Concerning Non-Surgical Measures for the Reduction of Increased Intra-ocular Tension
BY
George Edmund de Schweinitz, M.D.,
Philadelphia.
Only a few years ago the literature of glaucoma was big with discussions of the comparative value of the surgical and non-surgical treatment of glaucoma, and especially of the chronic types of this disease. Now, thanks to the achievements of Lagrange, Fergus, Herbert and Elliot, the value of a filtering cicatrix, although known for a long time, has attained increased importance, due to the improvement and elaboration of operative technic, and the medical journals of the day are weighted with opinions and experiences from all over the world as to these surgical measures. But true as this is, we are not yet in a position to discard non-surgical procedures (1) because operation is not always possible, (2) because operation is not always permitted, and (3) because in certain circumstances operation is not advisable. Hence a glance at the non-surgical methods of reducing increased intra-ocular tension is not out of place, and for convenience they may be catalogued as follows:
1. Myosis produced by means of solutions of various drugs, a myosis followed by reduction of intra-ocular tension.
2. Reduction of tension by means of various mechanical measures, notably massage, vibration massage and suction massage, and by means of electricity and diathermy.
3. Indirect reduction of intra-ocular tension, accomplished by lowering general vascular pressure.