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Special Article |

Insight Into Glaucoma Treatment in the Early 1900s:  Harvey Cushing's 1905 Operation FREE

Katherine Latimer, BS; Courtney Pendleton, BS; Alejandro Martinez, BS; Prem S. Subramanian, MD, PhD; Alfredo Quiñones-Hinojosa, MD
[+] Author Affiliations

Author Affiliations: Department of Neurosurgery and Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland (Mss Latimer and Pendleton and Drs Subramanian and Quiñones-Hinojosa); and Tecnologico de Monterrey School of Medicine, Monterrey, Nuevo Leon, Mexico (Mr Martinez).


Arch Ophthalmol. 2012;130(4):510-513. doi:10.1001/archophthalmol.2011.1184.
Text Size: A A A
Published online

Rapid advances in understanding glaucoma occurred following the invention of the ophthalmoscope in the mid-19th century. To our knowledge, attempts by neurosurgeon Harvey Cushing, MD, to cure the condition during his years at Johns Hopkins Hospital have never been previously reported. The Johns Hopkins Hospital surgical records from 1896 through 1912 were reviewed. A case in which Cushing attempted a surgical cure for a patient diagnosed as having glaucoma was selected for review. In 1905, Cushing performed extirpation of the superior cervical ganglion of a patient believed to have chronic glaucoma experiencing an acute episode who had previously underwent bilateral iridectomies. The patient reported stabilization of vision and decreased pain after the procedure. Respected neurosurgeon Cushing undertook surgical treatment of glaucoma at the turn of the 20th century. His approach provides insight into contemporary glaucoma therapies and pathophysiology.

Figures in this Article

A newly discovered surgical case file from 1905 reveals that Harvey Cushing, MD, the man widely regarded as the father of modern neurosurgery, attempted a surgical cure of glaucoma during his time at Johns Hopkins Hospital. He received encouragement in undertaking his chosen operation from an ophthalmology colleague. At that time, Cushing was still in the early years of his surgical career. His contributions to the medical field would ultimately include the use of a cuff for blood pressure monitoring during surgery, the invention of hemostatic techniques including silver clips and electrocautery, and the definition of the constellation of symptoms now known as Cushing disease and Cushing syndrome.1

The history of glaucoma is rich and celebrated;2 descriptions of the condition can be found dating back to the writings of Hippocrates.35 In fact, the term glaucoma came from the early Greek glaukos, meaning shining or gleaming, and it evolved to describe a sea-green color in affected eyes.57 Thorough histories such as that written by Gordon have given credit to many individuals who contributed to the understanding of glaucoma over centuries; these individuals include Bourdelot, the blind physician of King Louis XIV whose donated eyes postmortem led to the conclusion that glaucoma was not due to abnormalities of the lens, and von Graefe, the proponent of iridectomy in the 1850s.4,8,9

Despite these vivid clinical descriptions, the pathophysiology of glaucoma remained elusive during much of ophthalmological history7; the condition was nearly indistinguishable from cataract and inflammatory conditions of the eye prior to the 17th century.5,6 The invention of the ophthalmoscope and improvements in measuring intraocular pressure (IOP) in the mid 19th century provided tools for better understanding of the disease's key features distinct from other ophthalmologic conditions.7,8 Dramatic advances were made—in the mid 1800s, Donders discovered that high IOP caused blindness.10,11 Von Graefe and Jaeger asserted that the cupping they viewed in the eyes of patients through the ophthalmoscope was due to swelling of the optic disc.12,13 This phenomenon and the symptoms of glaucoma were suspected to be due to elevated aqueous pressure.1214 Although their hypothesis was slow to take hold, by the end of the century, it became an established theory, albeit with competition and some skeptics.15 The work of Leber revealed the ciliary body as a source of aqueous humor secretion,16,17 and scientific articles published in 1905 demonstrated an understanding of fluid dynamics within the eye.18

Along with enhanced pathophysiologic understanding, pharmacological and surgical treatment strategies for glaucoma rapidly began to evolve. In 1876, Laqueur introduced the anticholinergic agent physostigmine as a medical treatment of glaucoma.14,16,19 Contemporaneously, von Graefe experimented with the ordeal bean, a natural physostigmine source,20 and Weber introduced pilocarpine.14,16,21 During the 1800s and into the 20th century, induced pupillary miosis was presumed to be the mechanism of relief provided by the drugs. The effects on the anterior chamber depth, morphology of the angle, and prevention of pupillary block would not be discovered and synthesized into theory until after 1906 and into the mid-1900s.14 The emphasis on pupil diameter in the late 1800s was enforced by observations that mydriatics such as atropine could cause acute glaucoma.22,23

Several individuals pioneered surgical advances: Desmares and subsequently Mackenzie proposed corneal puncture as early as 1848,14,24 von Graefe introduced the iridectomy in 1856,9,25 and de Vincentiis developed a form of goniotomy in 189226 although this technique would not gain popularity until 1936.14 The anterior and posterior sclerotomy were also introduced.27 Surgical procedures targeting the sympathetic nervous system emerged in the late 1800s as part of an ongoing trend into sympathetic surgery.28

Cushing's glaucoma file provides insight into the ophthalmologic understanding during that era and serves as a reminder of a lesser-known therapeutic intervention for glaucoma targeting the sympathetic nervous system, which experienced brief popularity in the early 1900s.

Following institutional review board approval and through the courtesy of the Alan Mason Chesney Archives, the Johns Hopkins Hospital surgical records from 1896 to 1912 were reviewed. A case in which Cushing attempted a surgical cure for a patient who was diagnosed as having glaucoma was selected for further review.

On August 28, 1905, a 56-year-old driver from West Virginia with loss of vision was admitted to Johns Hopkins Hospital under Cushing's care. The patient's history was remarkable for bilateral eye pain that had begun “years ago” and was accompanied by changes in vision. He sought treatment from a doctor who gave him a substance called caistres, the composition of which was unclear, that ultimately failed to relieve his symptoms. After an unknown period, the patient presented to another physician with an episode of “acute glaucoma” and bilateral iridectomies were performed. This provided great relief for about 3 years and allowed the patient to have “good vision for distances.” However, 3 weeks prior to presenting at Johns Hopkins Hospital, the patient began to experience intermittent pain and impairment of vision in his right eye, the extent of which was not documented. His physical examination was unremarkable. A note from the eye clinic reads:

Dear Doctor [Cushing],

He has, as you are aware, a chronic glaucoma, with an acute inflammatory attack. The tension is only slightly + now, but likely increases at night. He has two huge iridectomies already so I do not see why this operation you’ve suggested should not be tried.

James J. Mills

While observed in hospital, it was noted on September 9 that the patient was in a great deal of pain “in and about right eye ball” requiring large doses of “morphia” to enable the man to sleep. Cushing noted in the patient's medical record that he had “chronic glaucoma with an acute exacerbation of right eye.” A corneal ulcer of his right eye also was noted. On September 13, Cushing performed an extirpation of the right superior cervical ganglion in an attempt to treat this condition. His operative note recorded:

According to Jenosko's [sic] rule, an incision was made through the sterno cleido mastoid muscle in line with the fibres and nearer the posterior anterior border. Largely by blunt dissection the incision was then carried down to the space back of the large vessels and vagus nerve. The sympathetic was readily disclosed and the superior ganglion freed as high up as the base of the skull. With a small pair of curved scissors the nerve was then cut away apparently above the uppermost cells of the ganglion. The wound was closed without drainage (Figure).

Place holder to copy figure label and caption
Graphic Jump Location

Figure. The first few lines of Harvey Cushing's original 1905 operative note from microfilm in the Johns Hopkins Hospital Surgical Archives.

Following the operation, the patient reported relief of pain for 1 week; however, his pain returned prior to being discharged from the hospital. While one note recorded that the patient had no change in sight, another note reported that the patient described things being “brighter than before.” Ultimately, he was discharged on October 2 after 36 days in the hospital. The reported discharge condition was “unimproved,” a selection made from among the choices of “improved” or “dead.” A follow-up letter from the patient dated February 1906 noted improvement in pain and some stabilization of vision:

I dont suffer vary much more with the pain was in my right eye.

I can see varry well and also in the evening I can tell white from black. I think the meadson is doing me some good and I think that I will conteanue taken it my eyes gets milking sometimes and I cant see as good then as other times. The reason I rote you and asked you about the meadson I thought you wanted me to stop taken it but I will contear taken it for I think it is doing me good. I so thankful that I can see a little I wood of rote suner but the Dr tote to always rite the first of the month and that is the reason I didon rite the reason I asked about the meadson I thought you was going to give me sone other cind.

I will close hoping an early reply

Yours recp,

[patient signature]

Cushing's extirpation of the superior cervical ganglion highlights the focus on the sympathetic nervous system as an area of interest and debate in glaucoma treatment in the early 1900s.

Manipulation of the sympathetic nervous system to treat a multitude of conditions was an area of burgeoning interest at the turn of the 20th century. Although the anatomy of the sympathetic nervous system had been fairly well defined nearly a century prior, cervical sympathectomy was first introduced by Alexander in 1889.29,30 Initially proposed as a treatment for epilepsy, Jennesco of Bucharest and Jaboulay had expanded indications for the procedure to include exophthalmic goiter by 1896.28,30 Relevant to the field of ophthalmology, Jennesco and Abadie performed the procedure in the late 1890s to treat glaucoma, and Ball, another ophthalmologist performing the procedure, extended its application to optic nerve atrophy around the turn of the century.27,30,31

Jennesco's 1896 series became a particularly well-known reference for sympathetic work.32 He reported the results of 61 operations in which he removed the superior cervical ganglion. For 7 patients in his series who were diagnosed as having glaucoma, Jennesco noted that ocular tension was permanently reduced and that the pupil had become markedly and permanently contracted.33 Following Jennesco's publication, several other case series emerged in which extirpation of the cervical ganglion was performed with variable results; iridectomy and sclerotomy were still considered by many as “the most reliable operations” for glaucoma. In the Section of Ophthalmology of the British Medical Journal in 1900, Cross remarked that extirpation was most applicable in “quiet, chronic” cases of glaucoma, where the results of iridectomy were doubtful.33 He skeptically followed that “even though the patient willingly submits to such a heroic measure . . . the surgeon could not undertake it without great anxiety as to the wide ultimate effect on the control of the sympathetic nerve that might be likely to result.”33

Cushing was particularly interested in trigeminal neuralgia early in his career; thus, he arguably first became aware of sympathetic surgery when cervical sympathectomy was proposed as a treatment for trigeminal neuralgia by Pappaldo in 1902. In addition to learning that the operation had been applied to glaucoma, Cushing would have been aware of pharmacological glaucoma therapies such as pilocarpine, which produced miosis and were believed to work through this effect.14,16,22,23 Anatomically, pupil diameter was associated with the cervical sympathetic chain. As surgeon Macewen stated in 1887: “When the cervical sympathetic . . . is divided or paralyzed, the pupil contracts.”34 Presumably, Cushing felt that removing the superior cervical ganglion would cause constriction of the pupil and offer more permanent relief than contemporary pharmaceutical therapy. Perhaps aiming for a permanent effect, he removed the ganglion in its entirety rather than perform a simple transection, a practice he also used in treating trigeminal neuralgia.35

The procedure provides insight into understanding glaucoma and options for refractory cases during this time. Cushing chose to operate on an individual who had undergone 2 iridectomies without lasting improvement. Iridectomies had skeptics since they were not uniformly effective, although iridectomies did prevent blindness in some individuals and the mechanism of action (ie, prevention of pupillary block) was not understood.36

The case is also noteworthy because it documents Cushing's process for using a relatively new treatment strategy for a disorder with which he had relatively little prior experience. Cushing did not perform the treatment without first consulting Mills, an instructor of ophthalmology at Johns Hopkins who clearly expressed approval. Cushing also attempted to maintain follow-up by instructing the patient to write about his progress. Presumably, the fact that the patient did not report significant improvement at discharge (although he did report improvement in pain and stabilization of vision in subsequent correspondence) led to reluctance on the part of Cushing to publish his results and continue extirpation for patients with glaucoma. As the patient likely had chronic glaucomatous damage and resultant optic atrophy, the results may be less indicative of the efficacy of the operation than the fact that the patient's condition was irreversible. Nevertheless, we are limited by our inability to know what the patient's true diagnosis would be by present-day standards. The actual findings from his ophthalmologic exam were not recorded. However, an ophthalmoscope was presumably used because this tool had been developed nearly 50 years prior and had reached general acceptance by that time.37 Furthermore, fundoscopic examination findings were recorded in the Johns Hopkins surgical records for many of Cushing's other patients. According to Mills' note, IOP was also measured; however, the method used and thereby its accuracy are uncertain. Digital measurements of IOP using the index finger against a closed eye were the oldest, simplest, least expensive, and least accurate method in use at the time.14,16,38 In 1862, von Graefe had developed a transpal pebral tonometer.38 In the 1880s, following the emergence of local anesthetic in the form of cocaine, applanation tonometers were developed by von Graefe's student Maklakoff and Fick.38,39 The Schiotz tonometer, which would become widely used in the field, was invented in 1905.14,16,38,39 Nevertheless, the crucial fact remains that the extirpation of the superior cervical ganglion was performed on a patient understood to have glaucoma.

Although Cushing did not repeat the operative technique during his time at Johns Hopkins, following this case, the surgical trend in targeting the sympathetic nervous system would continue. Interestingly, additional indications for the procedure that emerged in the early 1900s including the angina pectoris and vasospastic disorders continue to exist as limited applications. Additionally, in the 1920s, the therapy was applied to hyperhidrosis and blushing, 2 areas that still benefit from the procedure, albeit through less-invasive approaches.28 However, interest in sympathetic surgery for its original targets of epilepsy, goiter, and glaucoma waned. In the case of glaucoma, this was owing to the emergence of further treatments and enhanced understanding.40 Around 1914, Smith remarked, “The operative treatment of glaucoma has undergone more improvement during the last five years than during the previous fifty.”40 In 1916, Curran from Kansas University made the observation that pillars of iris rested heavily on the lens of patients with acute glaucoma, essentially defining an anatomical basis for hindered fluid drainage and resultant pressure increase in this population.37 By 1924, Mitchell commented that despite a burst of interest into the sympathetic nervous system as a point of attack for glaucoma, “The operation does not seem to have remained popular.”41 Now, Cushing's operative note provides an historical reminder of the early understanding and lesser-known advances made in the quest to treat this blinding group of diseases.

Correspondence: Alfredo Quiñones-Hinojosa, MD, Department of Neurosurgery and Oncology, Johns Hopkins School of Medicine, Brain Tumor Stem Cell Laboratory, Cancer Research Building II, 1550 Orleans St, Room 253, Baltimore, MD 21231 (aquinon2@jhmi.edu).

Submitted for Publication: January 10, 2011; final revision received July 24, 2011; accepted August 16, 2011.

Financial Disclosure: None reported.

Funding/Support: Ms Latimer's work is supported by the Bean Student Research Award from the American Osler Society, Ms Pendleton's work is supported by a Howard Hughes Medical Institute–Ivy Research Training Grant, and Dr Quiñones-Hinojosa's work is funded by the KO8 NIH grant NS055851 from the National Institutes of Health and grant 905675 from the Howard Hughes Medical Institute.

Laws ER Jr. Neurosurgery's man of the century: Harvey Cushing: the man and his legacy.  Neurosurgery. 1999;45(5):977-982
PubMed   |  Link to Article
Grzybowski A. History of ophthalmology: a distinguished or extinguished field of scholarly activity?  Acta Ophthalmol Scand. 2007;85(6):691-692
PubMed   |  Link to Article
Sorsby A. Acute glaucoma: an historical note.  Br J Ophthalmol. 1932;16(9):555-559
PubMed   |  Link to Article
Lascaratos J, Marketos S. A historical outline of Greek ophthalmology from the Hellenistic period up to the establishment of the first universities.  Doc Ophthalmol. 1988;68(1-2):157-169
PubMed
Tsatsos M, Broadway D. Controversies in the history of glaucoma: is it all a load of old Greek?  Br J Ophthalmol. 2007;91(11):1561-1562
PubMed   |  Link to Article
Frezzotti R. The glaucoma mystery from ancient times to the 21st century: the glaucoma mystery: ancient concepts.  Acta Ophthalmol Scand Suppl. 2000;(232):14-18
PubMed
Mark HH. Buphthalmos: early glaucoma history.  Acta Ophthalmol (Copenh). 2010;(6):591-594Link to Article
Gordon B. The problem of glaucoma.  Arch Ophthalmol. 1932;19(4):515-547
Link to Article
von Graefe A. Ueber die Coremorphosis als Mittel gegen chronische Iritis und Iridochorioiditis [in German].  Arch Ophthalmol. 1856;2(2):202-257
Link to Article
Donders F. On the Anomalies of Accommodation and Refraction of the Eye. London, England: The New Syndenham Society; 1864
Grewe R. The history of glaucoma.  Klin Monbl Augenheilkd. 1986;188(2):167-169
PubMed   |  Link to Article
Jaeger E. Ueber Staar und Staaroperationen [in German]. Wien: Verlag von L.W. Seidel; 1854
von Graefe A. Vorlaufige Notize uber das Wesen des Glaucoms [in German].  Arch Ophthalmol. 1854;1(1):371-382
Nathan J. Hippocrates to Duke-Elder: an overview of the history of glaucoma.  Clin Exp Optom. 2000;83(3):116-118
PubMed   |  Link to Article
Connor L. Remarks on the causes of glaucoma.  JAMA. 1896;27(20):1037
Link to Article
Barnshaw HD. Great names in the early history of glaucoma.  Int Ophthalmol Clin. 1979;19(1):3-7
PubMed   |  Link to Article
Leber T, Pilzecker A. Neue Untersuchungen uber den Flussigkeitswechsel des Auges [in German].  Arch Ophthalmol. 1906;1(1):1-127
Roberts WH. Pathology of glaucoma.  Cal State J Med. 1905;3(2):41-42
PubMed
Laqueur L. Ueber eine neue therapeutische Verwendung des Physostigmin [in German].  Centralblatt fur die Medicinischen Wissenschaften. 1876;14(24):421-422
von Graefe A. Ueber Calabar-Bohne [in German].  Arch Ophthalmol. 1863;9(3):87-128
Link to Article
Weber A. Die Ursache des Glaucoms [in German].  Arch Ophthalmol. 1877;23(1):1-91
Link to Article
Streatfeild J. Mydriatics and glaucoma.  BMJ. 1882;2(1126):193
Link to Article
Lachkar Y, Bouassida W. Drug-induced acute angle closure glaucoma.  Curr Opin Ophthalmol. 2007;18(2):129-133
PubMed   |  Link to Article
Mackenzie W. Practical Treatise on the Diseases of the Eye. Philadelphia, PA: Blanchard & Lea; 1855
von Graefe A. Iridectomy in glaucoma (translated by F.H. Adler).  Arch Ophthalmol. 1929;1(1):71-86
Link to Article
de Vincentiis C. Incisione dell'angolo irideo nel glaucoma [in Italian].  Ann di Ottal. 1893;22:540-542
Ball J. Society Proceedings St. Louis Medical Society: On Excision of the Right Superior Cervical Ganglion of the Sympathetic for Glaucoma, With Report of a Case. Vol 40. St Louis, MO: Commercial Printing Co; 1899
Hashmonai M, Kopelman D. History of sympathetic surgery.  Clin Auton Res. 2003;13:(suppl 1)  I6-I9
PubMed
Alexander W. The Treatment of Epilepsy. Edinburgh, Scotland: YJ Pentland; 1889
Singh B, Ramsaroop L. Upper limb sympathectomy: a historical reappraisal of the surgical anatomy.  Clin Anat. 2007;20(8):863-867
PubMed   |  Link to Article
Ball J. On removal of the cervical sympathetic in glaucoma and optic nerve atrophy.  JAMA. 1900;34(22):1384-1389
Link to Article
Foster M. Excision of the superior cervical ganglion in inflammatory glaucoma.  Ann Ophthalmol. 1905;14:638-644
Cross F, Hern J, Doss H,  et al.  A discussion on the treatment of chronic glaucoma.  BMJ. 1900;2(2075):1019-1023
Macewen W. The pupil in its semeiological aspects.  Am J Med Sci. 1887;187:123-145
Link to Article
Kellogg R, Pendleton C, Quiñones-Hinojosa A, Cohen-Gadol AA. Surgical treatment of trigeminal neuralgia: a history of early strides toward curing a “cancerous acrimony.”  Neurosurgery. 2010;67(5):1419-1425, discussion 1425
PubMed   |  Link to Article
Richey SO. Management of glaucoma.  Trans Am Ophthalmol Soc. 1896;7:723-730
PubMed
Lowe RF. Curran, Barkan, and Chandler: a history of pupillary obstruction and narrow angle glaucoma.  J Glaucoma. 1995;4(6):419-426
PubMed   |  Link to Article
Kniestedt C, Punjabi O, Lin S, Stamper RL. Tonometry through the ages.  Surv Ophthalmol. 2008;53(6):568-591
PubMed   |  Link to Article
Stuckey GC. Application of physical principles in the development of tonometry.  Clin Experiment Ophthalmol. 2004;32(6):633-636
PubMed   |  Link to Article
Bell PG. Notes on glaucoma.  Can Med Assoc J. 1915;5(1):39-45
PubMed
Mitchell J. Peri-arterial sympathectomy.  South Med J. 1924;17(8):609-613
Link to Article

Figures

Place holder to copy figure label and caption
Graphic Jump Location

Figure. The first few lines of Harvey Cushing's original 1905 operative note from microfilm in the Johns Hopkins Hospital Surgical Archives.

Tables

References

Laws ER Jr. Neurosurgery's man of the century: Harvey Cushing: the man and his legacy.  Neurosurgery. 1999;45(5):977-982
PubMed   |  Link to Article
Grzybowski A. History of ophthalmology: a distinguished or extinguished field of scholarly activity?  Acta Ophthalmol Scand. 2007;85(6):691-692
PubMed   |  Link to Article
Sorsby A. Acute glaucoma: an historical note.  Br J Ophthalmol. 1932;16(9):555-559
PubMed   |  Link to Article
Lascaratos J, Marketos S. A historical outline of Greek ophthalmology from the Hellenistic period up to the establishment of the first universities.  Doc Ophthalmol. 1988;68(1-2):157-169
PubMed
Tsatsos M, Broadway D. Controversies in the history of glaucoma: is it all a load of old Greek?  Br J Ophthalmol. 2007;91(11):1561-1562
PubMed   |  Link to Article
Frezzotti R. The glaucoma mystery from ancient times to the 21st century: the glaucoma mystery: ancient concepts.  Acta Ophthalmol Scand Suppl. 2000;(232):14-18
PubMed
Mark HH. Buphthalmos: early glaucoma history.  Acta Ophthalmol (Copenh). 2010;(6):591-594Link to Article
Gordon B. The problem of glaucoma.  Arch Ophthalmol. 1932;19(4):515-547
Link to Article
von Graefe A. Ueber die Coremorphosis als Mittel gegen chronische Iritis und Iridochorioiditis [in German].  Arch Ophthalmol. 1856;2(2):202-257
Link to Article
Donders F. On the Anomalies of Accommodation and Refraction of the Eye. London, England: The New Syndenham Society; 1864
Grewe R. The history of glaucoma.  Klin Monbl Augenheilkd. 1986;188(2):167-169
PubMed   |  Link to Article
Jaeger E. Ueber Staar und Staaroperationen [in German]. Wien: Verlag von L.W. Seidel; 1854
von Graefe A. Vorlaufige Notize uber das Wesen des Glaucoms [in German].  Arch Ophthalmol. 1854;1(1):371-382
Nathan J. Hippocrates to Duke-Elder: an overview of the history of glaucoma.  Clin Exp Optom. 2000;83(3):116-118
PubMed   |  Link to Article
Connor L. Remarks on the causes of glaucoma.  JAMA. 1896;27(20):1037
Link to Article
Barnshaw HD. Great names in the early history of glaucoma.  Int Ophthalmol Clin. 1979;19(1):3-7
PubMed   |  Link to Article
Leber T, Pilzecker A. Neue Untersuchungen uber den Flussigkeitswechsel des Auges [in German].  Arch Ophthalmol. 1906;1(1):1-127
Roberts WH. Pathology of glaucoma.  Cal State J Med. 1905;3(2):41-42
PubMed
Laqueur L. Ueber eine neue therapeutische Verwendung des Physostigmin [in German].  Centralblatt fur die Medicinischen Wissenschaften. 1876;14(24):421-422
von Graefe A. Ueber Calabar-Bohne [in German].  Arch Ophthalmol. 1863;9(3):87-128
Link to Article
Weber A. Die Ursache des Glaucoms [in German].  Arch Ophthalmol. 1877;23(1):1-91
Link to Article
Streatfeild J. Mydriatics and glaucoma.  BMJ. 1882;2(1126):193
Link to Article
Lachkar Y, Bouassida W. Drug-induced acute angle closure glaucoma.  Curr Opin Ophthalmol. 2007;18(2):129-133
PubMed   |  Link to Article
Mackenzie W. Practical Treatise on the Diseases of the Eye. Philadelphia, PA: Blanchard & Lea; 1855
von Graefe A. Iridectomy in glaucoma (translated by F.H. Adler).  Arch Ophthalmol. 1929;1(1):71-86
Link to Article
de Vincentiis C. Incisione dell'angolo irideo nel glaucoma [in Italian].  Ann di Ottal. 1893;22:540-542
Ball J. Society Proceedings St. Louis Medical Society: On Excision of the Right Superior Cervical Ganglion of the Sympathetic for Glaucoma, With Report of a Case. Vol 40. St Louis, MO: Commercial Printing Co; 1899
Hashmonai M, Kopelman D. History of sympathetic surgery.  Clin Auton Res. 2003;13:(suppl 1)  I6-I9
PubMed
Alexander W. The Treatment of Epilepsy. Edinburgh, Scotland: YJ Pentland; 1889
Singh B, Ramsaroop L. Upper limb sympathectomy: a historical reappraisal of the surgical anatomy.  Clin Anat. 2007;20(8):863-867
PubMed   |  Link to Article
Ball J. On removal of the cervical sympathetic in glaucoma and optic nerve atrophy.  JAMA. 1900;34(22):1384-1389
Link to Article
Foster M. Excision of the superior cervical ganglion in inflammatory glaucoma.  Ann Ophthalmol. 1905;14:638-644
Cross F, Hern J, Doss H,  et al.  A discussion on the treatment of chronic glaucoma.  BMJ. 1900;2(2075):1019-1023
Macewen W. The pupil in its semeiological aspects.  Am J Med Sci. 1887;187:123-145
Link to Article
Kellogg R, Pendleton C, Quiñones-Hinojosa A, Cohen-Gadol AA. Surgical treatment of trigeminal neuralgia: a history of early strides toward curing a “cancerous acrimony.”  Neurosurgery. 2010;67(5):1419-1425, discussion 1425
PubMed   |  Link to Article
Richey SO. Management of glaucoma.  Trans Am Ophthalmol Soc. 1896;7:723-730
PubMed
Lowe RF. Curran, Barkan, and Chandler: a history of pupillary obstruction and narrow angle glaucoma.  J Glaucoma. 1995;4(6):419-426
PubMed   |  Link to Article
Kniestedt C, Punjabi O, Lin S, Stamper RL. Tonometry through the ages.  Surv Ophthalmol. 2008;53(6):568-591
PubMed   |  Link to Article
Stuckey GC. Application of physical principles in the development of tonometry.  Clin Experiment Ophthalmol. 2004;32(6):633-636
PubMed   |  Link to Article
Bell PG. Notes on glaucoma.  Can Med Assoc J. 1915;5(1):39-45
PubMed
Mitchell J. Peri-arterial sympathectomy.  South Med J. 1924;17(8):609-613
Link to Article

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For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
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