HISTORY OF TREATMENT

Soon after the first recognition of hydrophthalmia we find descriptions of the manner in which the early surgeons endeavoured to diminish the quantity of fluid in the eye. Boerhaave in 1749 advised, in addition to purgatives and mercurial hydragogues, a puncturing of the eye at the side of the lens from time to time until the eye recovered its normal size. Maitre-Jan (1740) proposed an anterior scleral incision in the external angle of the eye.

Pellier de Quengay (1789) wrote that if diuretics and hydrogogues failed one should not hesitate to puncture the eye. Amongst his good results one reads in his book of a certain “Ferrien of Cette, who after several punctures of the anterior chamber, the use of diuretics, and fondants and ophthalmic opiates, cured a buphthalmia so marked that the cornea was opaque and the globe of the eye so large that the lids could not cover it”.

Though Gleize (1786) preferred local medication, finding operation difficult and insufficient, he reported the facts that Guerin and Woolhouse advised scleral puncture and that Mr Toubervil, an English oculist, also performed this operation and considered it capable of lessening the size of the eye and preventing cataract.

A thesis by Grellois (1836) summarised the treatment in use at the time. He reviews the advantage of anti-herpetic, anti-syphilitic and anti-scrophulous methods, recommending blisters to the forehead “setons a la nuge”, compresses of lead acetate, and the application to the globe of hot sachets of dry aromatic plants. He recalled the fact that the surgeons who compressed the globe were using a procedure already employed by Rhazes.

In Annales d'oculistiques, March 1841, we read: “M. O'Beirne, the clever Irish surgeon, who has published a work on the treatment of hydrophthalmia, thinks that in the majority of cases this disease may be cured without operation. According to him, the trouble is usually connected with a rheumatic diathesis, and may fortunately be dissipated with the aid of calomel, repeated until there is salivation. He reports a serious case which he cured in this way, and refers to several others. Here is a new clinical history which supports this assertion.”