Year : 1965 | Volume
: 13 | Issue : 4 | Page : 148--150
A clinical study of the effect of oral administration of glycerine on ocular tension
P Siva Reddy, M Satapathy
Institute of Ophthalmology and Sarojini Devi Eye Hospital, Hyderabad, India
P Siva Reddy
Institute of Ophthalmology and Sarojini Devi Eye Hospital, Hyderabad
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Reddy P S, Satapathy M. A clinical study of the effect of oral administration of glycerine on ocular tension.Indian J Ophthalmol 1965;13:148-150
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Reddy P S, Satapathy M. A clinical study of the effect of oral administration of glycerine on ocular tension. Indian J Ophthalmol [serial online] 1965 [cited 2021 Jan 27 ];13:148-150
Available from: https://www.ijo.in/text.asp?1965/13/4/148/39260
A search has been made for a potent osmotic agent during recent years for lowering the intra-ocular tension without any untoward side effects, as the use of intra venous urea is attended with toxic effects like, nausea, vomiting, headache and thrombophletitis. The oral administration of glycerine is very handy due to the easy availability, administration and absence of toxicity as studied by Thomas (196.3).
Glycerine is a trihydric alcohol, a syrupy liquid and a good dehydrating agent. It is used locally in cases of corneal oedema by ophthalmologists. It acts by virtue of its osmotic effects. It is converted into glucose and the resulting hyperglycemia raises osmotic pressure of blood and lowers the intra-ocular pressure, as it passes through the uveal vessels.
Methods and Material
To assess its hypotensive effects, first a control group of ten patients were selected, having normal intraocular tension. These patients were admitted to the hospital for various ocular diseases, a majority of them being optic atrophies of varying etiology.
Twenty cases with raised intraocular tension formed a second group for trial of oral administration of glycerine. All kinds of glaucoma were included in these series, e.g. chronic simple glaucoma, acute glaucoma and secondary glaucoma, narrow-angled and wide-angled.
A brief account of their present and past illnesses was recorded and the family history elicited. An examination of all the systems was performed, particularly of the cardiovascular system in each case and the ocular findings, I.O.P. and gonioscopie classification of the angle were noted.
At this stage the patient was weighed and one ml. of pure glycerine per kilogram of body weight was given orally. To make the liquid more palatable a few drops of the essence of pineapple were added.
Intraocular tension was recorded at ten minute intervals for the first half hour after the administration of glycerin. One reading was taken after the second half hour and thereafter hourly readings were taken upto four hours followed by two-hourly readings upto eight hours. Two further readings were taken, one at the 12th hour and the second after 24 hours.
With the record of intraocular tension, at the above periods, records of pulse and blood pressure were also maintained.
During the course of recording, the patients were allowed to continue their daily routine, e.g. sitting up in bed and walking about, bathing etc. Food was given to them after four hours. But they were not allowed to use any miotics or Diamox during the observation period. Those patients, who were already on routine treatment for glaucoma, were made to discontinue the same, twenty-four hours prior to administration of glycerine. Only those cases of glaucoma were included in this series, who, in spite of their antiglaucoma regime, were having high intraocular tension. The intraocular tension readings were then plotted on a graph.
10 patients with normal tension and 20 cases of raised intraocular tension (7 each of open angle, closed angle and 3 each of secondary and absolute) were selected for oral administration of glycerine.
From the above table it is evident that commencement of fall of tension began within 10 to 30 minutes and maximum response took place within 1 to 2 hours.
The responses were most marked in congestive glaucoma and poor in absolute glaucoma. This may be due to the extremes of the field of action in cilio-capillaries available for osmosis to take place in these two types of glaucoma. [Figure 1].
Out of the thirty cases studied, only one case did not show any response to the oral administration of glycerine. The rest showed a definite fall in intraocular tension.
No toxic or undesirable side effects of the drug were seen during this study except few minor complaints, like mild frontal headache, burning sensation in the throat and vomiting, which did not last for more than half an hour.
Majority of the cases responded to the effect of glycerine within ten to thirty minutes and practically every case responded within one hour.
The maximum effect of glycerine was evident at the end of about two hours in the majority of cases.
With regard to the amount of fall of intraocular tension, the closed angle glaucoma group gave the best response. The range of drop in this group was from twenty-three per cent to eighty per cent, whereas in open angle glaucoma it was from sixteen per cent to sixty-eight per cent. One case of traumatic cataract with secondary glaucoma had the maximum fall of 82 per cent. Then comes the normal ocular tension group. It showed a fall from twenty to fifty per cent only.
The closed angle glaucoma group also had a longer duration of the effect of glycerine than in other groups. It varied from three hours to twenty-three hours. In normal tension group the duration varied from one hour to eleven hours only.
Secondary glaucoma group showed the maximum duration of twenty- three and half hours.
The effect of glycerine on intraocular pressure was assessed in 30 cases and the usefulness of the drug in glaucoma therapy especially as an expedient in acute congestive and secondary glaucomas prior to operation, was confirmed. In view of the low cost, compared to drugs like Diamox, its ready availability and relatively non-toxic nature it is a tension lowering measure of choice.
|1||Thomas, P. R. (196.3) Arch. Ophthal 70, 625.|