=Symptoms.=—Tension comes gradually; no inflammatory signs; pupil
somewhat dilated and sluggish, the cornea may look slightly smoky.
With the ophthalmoscope a cupped disc may be noted. There is gradual
diminution of sight, which begins by contraction of the field.
There are many theories advanced as to the cause of intra-ocular
tension in glaucoma. (Fuchs, Weeks, De Schweinitz).
=Treatment.=—Eserine is used instead of atropine. The object is to
contract the pupil and draw it away from the side wall of the eye
ball so the sinus (Schlemm’s canal) and the pectinate ligament (the
filtering angle) may become free. The good effect of this is more
marked in inflammatory glaucoma. In simple primary glaucoma miotics do
little good.
Reports from osteopathic treatment of this condition have been
favorable in a number of cases. Careful manipulation of the structures
of the orbit with the finger or with Dr. Ruddy’s third finger eye
instrument is good in restoring better circulation of the lymph and
blood. Special attention to the venous drainage should be given. Treat
the points of the fifth nerve, the nasopharynx and cervical region,
spring the jaw. Treat second dorsal.
Have the patient avoid strong emotions or excitement. Keep the bowels
free and use only a very bland diet.
Iridectomy is considered the best operation in glaucoma.
In the treatment of secondary glaucoma the other diseases or
complications must be considered in conjunction with the foregoing
treatment.