OPHTHALMIC DISORDERS. — The phy sostigmine salts are used extensively in ophthalmic practice on account of their myotic power and their power to relieve high intra-ocular tension. It is not well borne in acute inflammation, or if much ciliary congestion is present (M. L. Fos ter). It is positively contra-indicated in the acute stage of iritis, but is used by some oculists to break up iritic adhesions after the subsidence of the acute symp toms. According to some observers, it has a tendency to increase opacities of the crystalline lens; this should be borne in mind in connection with cases of incipient cataract. In corneal ulcera tions it is often preferable to atropine, and its use may prevent prolapse of the iris after wound or ulceration of the cornea.
In the treatment of glaucoma this drug is generally satisfactory. A solu tion of physostigmine salicylate to 1 grain to 1 ounce of recently-boiled water) instilled into the eye two to five times daily will reduce the tension and pain very decidedly. In some cases pro
longed treatment results in permanent cure without iridectomy; in others the tension returns in a few hours after its discontinuance. In phlyctenular kera titis it is useful in diminishing photo phobia. Cameron has used this drug successfully in paralytic mydriasis fol lowing diphtheria. Instillations of phy sostigma solution may be used to rapidly overcome atropine mydriasis when de sired; as the action of atropine is the more persistent, it may return as the effects of the physostigmine wear off, and necessitate a repeated use of the latter. The solutions used in ophthalmological work generally vary in strength from to 2 grains of the physostigmine salt to the ounce of recently-boiled water.