The mechanism of external filtration.

Chemistry of the Lens

The fact that so many operations have been described for the relief of ocular hypertension indicates that none are entirely satisfactory. The procedure we have used for several years is not original, but as it is not widely used we feel that our experience with it is worth recording. After several unsatisfactory experiences with other kinds of filtering operations, some ten years ago one of us adopted iridotasis for certain types of glaucoma. This was satisfactory so far as the relief of hypertension was concerned, but the updrawn pupil caused a rather unsightly eye. For a number of years then we used iridencleisis through the usual keratome incision. Occasionally when the anterior chamber was shallow we scratched the anterior lens capsule with the lance point. While this does not necessarily produce a cataract, it may do so, and it often produces monocular diplopia. This accident happens occasionally in the hands

Iridencleisis in glaucoma

The literature relative to the various operations for iris inclusion is extensive. It is, however, almost wholly concerned with the clinical aspects of this operation on man. The results, as discussed, are compared with other filtering operations. The raison d'etre for its continuation as a logical surgical attack is almost universally based on its apparent clinical results in lowering the glaucomatous tension. Some histologic studies have been made on eyes that have been enucleated after this operation. Naturally, these studies have usually been made on those eyes in which the operation was a failure, though histologic studies have also been made in certain cases in which the operation had continued to be successful over a period of several years. Holth recently presented observations based on a study of three eyes enucleated after death. In these he dealt with the histology of fistulas following anterior sclerotomy. Holth presented, on

Iris inclusion operation in the eye of the rabbit: a histologic study

In 1912, I began to do the trephine operation. Since 1925, I 1 have employed a pocket-flap in all operations for cataract or glaucoma. In many of the latter operations, the iris inclusion method was used with sclerectomy. The appearance of the eye with a bleb of subconjunctival pigmentation due to the included iris is not cosmetically desirable, and there is danger of irritation from the incarcerated iris. A case in which panophthalmitis occurred owing to a late infection and the return of pain and tension in several other eyes following iris inclusion led me to adopt a suggestion by Herbert, 2 namely, an iridodialysis. However, instead, of cutting the sphincter as he suggests and pulling the tongues of the iris into the angles of the wound, I have combined iridodialysis with a Lagrange sclerectomy and a pocket-flap. In 1894, de Wecker 3 suggested sclerotomy with iridodialysis instead of iridectomy.

Pocket-flap sclerecto-iridodialysis in glaucoma

https://bjo.bmj.com/content/bjophthalmol/14/9/433.full.pdf

The future of iris-inclusion in glaucoma.

paralysis of Papilloedema to dioptres is found, due to of intra-cranial tension. The severe cases are more evidently cases of lead encephalopathy. Explanation given of why soluble lead is available, and why and how it is ingested. Lead is found in the urine. No albumin is found in the urine.)

https://bjo.bmj.com/content/bjophthalmol/15/11/633.full.pdf

The micro-organism of indian superficial punctate keratitis.

The Ideal Glaucoma Incision

We see therefore that the buphthalmic eye with the average measurements chosen above would have to be 31 mm. long in order that it might' be emmetropic. It is interesting to note that the normal aibhakic eye, i.e., the aphakic eye with normal corneal curvature, must also be 3.1 mm. long in order that parallel incident rays may be focussed upon the retina. Such an eye, before the lens is removed, would have a myopia of (31-23) X 3 24 D.

https://bjo.bmj.com/content/bjophthalmol/4/5/216.full.pdf

An improved iris prolapse operation for glaucoma

are agreed that for the tried and experienced hand the operation of election is certainly litholapoxy. In cataract extraction we have not yet reached that point, but this is rather because there are many methods of doing cataract which have been attended with equally good results. We believe that there is no one operation which is agreed upon as the best, and the methods of Herbert, Maynard, Pope, Elliot and Henry Smith (to mention only those who have recently written on the subject) are not the same, but we believe all have been followed by equally good results. It is with special pleasure, therefore, that we introduce to our readers the admirable little handbook on the " Practical Details of Cataract Extraction" written by Major H. Herbert, F R.C.S., I.M.S., for several years past head of the large Ophthalmic Hospital at Bombay, whose name is also well known to all who read the special literature of ophthalmology. The little book before us differs from all other books which deal with cataract, in that it is largely made up of practical details which are usually omitted from the chapters dealing with the operation in ordinary ophthalmic text-books. Major Herbert tells us that he has attempted to record what he has learnt from the performance of several thousand cataracts and from his teaching in the lecture theatre and hospital duri 11 othe past seven years. We certainly ay;ree with the author in his modest hope that the accumulation of these facts and experiences will do something to " bridge over the gap between the beginner and the finished operator." We must now briefly give a synopsis of the various chapters in this useful little book. After a preliminary chapter on the stages and varieties of cataracts, and a lucid discussion of the important question as to when progressive cataract is fit for operation or not, in which by-the-bye we see it laid down that it is not justifiable to operate on both eyes at the

The Practical details of cataract extraction

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H. Herbert

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