GLAUCOINLA. (Lat., from Gk. y2.aiixo,aa, opac ity of the crystalline lens, from yitartc6c, glaukos, bluish-green; so called from the appearance of the eye in this disease). An important disease of the eye, characterized by increased intraocular tension. In addition to primary and secondary glaucoma, a congenital glaucoma is described. According to the rapidity of onset and the severi ty of the disease, primary glaucoma is divided into inflammatory or congestive, and non-in flammatory or simple. The inflammatory type may be acute or chronic. The cause of glaucoma is unknown. The disease has been observed chiefly in old persons, particularly in women, and usually involves the eyes successively. Jews seem predisposed to it. Heredity, gouty and rheumatic diatheses, cardiac and arterial disease, and chronic constipation seem to exert an in fluence. Persons with hyperopia (see SIGHT, DEFECTS oF) are often afflicted with glaucoma; those with myopic eyes, very rarely. Various forms of excitement, eye-strain, improper use of atropine, and other causes of venous congestion of the eyes are mentioned as exciting factors. The essential feature of the disease is the in crease of pressure within the eye, the present view being that there is undue retention of fluids within the eye. Acute inflammatory glaucoma may begin with a prodromal stage, in which sight is somewhat obscured by edema of the cornea, with some dilatation of the pupil and increased tension in the eyeball. A number of these attacks, each followed by increased pres byopia, (see SIGHT, DEFECTS OF ) , are succeeded by the stage of active glaucoma. This is marked by sudden failure of vision, with great pain in the eye, and headache. There is marked in
crease of tension, cloudiness and insensibility of the cornea; the pupil is oval, fixedly dilated, and often greenish; the iris is dull and changed in color. The conjunctiva is congested, including the space around the cornea. The interior of the eye is cloudy. Recovery takes place with practically a persistence of all these appearances in a slight degree, and from time to time other attacks occur, the eye being left in worse con dition after each. Finally the stage of absolute glaucoma is reached: blindness, increase of the changes in appearance noted in the early attacks, increased tension, and in some cases pain at intervals. Degeneration of the eyeball may fol low. Cases of unusual severity, resulting in blindness within a few hours, are known as glaucoma fulminans. Chronic inflammatory glau coma differs from the acute only in the mild ness of its initial symptoms and the slowness of its course, the final result being the same. Simple glaucoma is a very slowly progressing type, with no active symptoms of inflammation, simply the increased tension and gradual failure of vision. Secondary glaucoma is an increase of tension, with other symptoms of glaucoma, secondary to other disease of the eye or to injury. Congenital glaucoma usually affects both eyes, leading to blindness. In the treatment of glau coma atrophic must never be employed. Eserine and pilocarpine, locally, may give some relief. Iridectomy, an excision of part of the iris, is the most effectual treatment. Sclerotomy, an inci sion through the sclera or white of the eye, is sometimes employed in its place.