Better Eyesight, December 1920
A MONTHLY MAGAZINE DEVOTED TO THE PREVENTION AND CURE OF IMPERFECT SIGHT WITHOUT GLASSES
VOLUNTARY PRODUCTION OF EYE TENSION A SAFEGUARD AGAINST GLAUCOMA
It is a good thing to know how to increase the tension of the eyeball voluntarily, as this enables one to avoid not only the strain that produces glaucoma, but other kinds of strain also. To do this proceed as follows:
Put the fingers on the upper part of the eyeball while looking downward, and note its softness. Then do any one of the following things:
Try to see a letter, or other object, imperfectly, or (with the eyes either closed or open) to imagine it imperfectly.
Try to see a letter, or a number of letters, all alike at one time, or to imagine them in this way.
Try to imagine that a letter, or mental picture of a letter, is stationary.
Try to see a letter, or other object, double, or to imagine it double.
When successful the eyeball will become harder in proportion to the degree of the strain; but, as it is very difficult to see, imagine, or remember, things imperfectly, all may not be able at first to demonstrate the facts.
GLAUCOMA: ITS CAUSE AND CURE
By W. H. Bates, M. D.
GLAUCOMA is a condition in which the eyeball becomes abnormally hard, and theories as to its cause are endless. The hardness is supposed to be due to a rise in intraocular pressure, and the other symptoms, chief among which is an excavation of the optic nerve, forming in advanced cases a deep cup with overhanging edges, are supposed to be the results of this pressure. Yet all the symptoms commonly associated with increased tension have been found in eyes in which the tension was normal.
The increased tension is supposed to be due to an excess of fluid in the eyeball, and this is commonly attributed to an impeded outflow. The aqueous humor, which is secreted very rapidly, is supposed to escape at the angle formed by the junction of the iris with the cornea, and in glaucoma it is believed that the iris adheres to the cornea so that the angle is obstructed. Yet it is a well-known fact that in many cases no such obstruction can be found.
For more than fifty years iridectomy held the field as the only treatment which gave any hope of relief in glaucoma. The operation, which means the removal of a piece of the iris, was introduced by von Graefe, and often gives relief for a longer or shorter time. If the patient lives long enough, however, the condition always returns. I have seen this happen after the tension had been normal for fifteen years. It is a fact mentioned by all the text-books, moreover, that it often fails to give even temporary relief, and sometimes the condition is made worse than it was before.
The beneficial results of the operation, when it does succeed, have never been satisfactorily explained, but the accepted opinion at the present time is that they are due to the formation of a scar which is more pervious to the fluids of the eye than the normal tissue, and the object of modern operations is to obtain such a scar. For this reason sclerotomy, usually performed by the method of Elliott has gained great vogue. A piece of the entire thickness of the sclera is removed, and thus a permanent fistula covered only by the conjunctiva is formed. Through this the fluids of the interior escape. Like iridectomy this operation sometimes succeeds temporarily, but, according to Elliott himself, it may fail to check the optic atrophy and decline of vision even when the relief of tension is complete.
Although it is the concensus of medical opinion that a glaucomatous eye must eventually be operated upon, and that the sooner this is done the better, some men have attempted to hold the process at bay by the use of myotics. These drugs, by contracting the pupil and thus stretching the iris, are believed to draw the latter away from the "filtration angle" and allow the excess of fluid to escape. They are commonly employed for the purpose of giving temporary relief, but some specialists advise their continuous use. Posey claims that such treatment gives a larger proportion of successes than iridectomy.
Until a few years ago I always treated glaucoma by the old methods, not knowing anything better to do; but I never used the Elliot operation, having early learned that it is very dangerous to allow the fluids of the eyeball to escape, and having seen glaucoma produced by fistula of the cornea. I would not have ventured to predict that the condition could be relieved by relaxation, and only learned by accident that it was amenable to such treatment.