Aqueous Veins

Aqueous Veins

544 BOOK REVIEWS explain. Certainly Reiter's disease is a rarity in American urologie clinics, and the per­ centage incidence of this syndrome as a ...

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544

BOOK REVIEWS

explain. Certainly Reiter's disease is a rarity in American urologie clinics, and the per­ centage incidence of this syndrome as a cause of uveitis in this country is insignifi­ cant. Perhaps English and American urolo­ gists have different diagnostic criteria, but against this assumption is the fact that American army physicians found a relatively high incidence of this disease in troops in Korea. Perhaps Dr. Perkins humorous sug­ gestion that the unknown etiologic agent of Reiter's disease is killed off by the central heating prevalent in the United States, is as good as any other explanation! Dr. Perkins is somewhat loathe to draw hard and fast deductions from his figures, many of which are admittedly highly sug­ gestive. Nevertheless, his final conclusion that "It is my belief that except when the uveal inflammation is secondary to other local conditions in the eye, uveitis is the ocular manifestation of a general disease," is one that all American students of uveitis will fully concur in. This monograph, whatever its limitations, is a distinct contribution to the epidemiologic and etiologic study of uveitis. Alan C. Woods.

peutic advance was made with the introduc­ tion of the carbonic anhydrase inhibitors by Becker and a remarkable clinical observation by Ascher revealed a structure that had al­ ways been present and that was shown to be of great importance to the understanding of aqueous turnover in the eye. This structure is the aqueous vein system. Twenty years have passed since Ascher's original paper on the aqueous veins and he has continued to work indefatigably in this field, publishing a great many communica­ tions on the morphology and function of the aqueous veins in the normal eye and in glau­ coma. He has now collated all his observa­ tions and published them in a monograph which incidentally represents his thesis for the American Ophthalmologic Society. This is an expertly done piece of work and cov­ ers every facet of the subject from the his­ tory of the discovery of these veins to their response to various medical and surgical antiglaucoma procedures. The writing is clear and expressive and the illustrations amply support the author's statements. Ascher points out that aqueous veins may also con­ tain whole blood or plasma but he still feels that this is the best name for them.

By Karl W. Ascher, M.D., Springfield, 111., Charles C Thomas, 1961. 269 pages, 53 figures. Price: $12.00. It has been over 130 years since William Mackenzie showed that glaucoma is charac­ terized by an increase in the intraocular pres­ sure. Since then an enormous literature has accumulated on the mechanism of the main­ tenance of the normal ocular tension and its derangement in glaucoma. The 19th century focussed its interest on therapy and this culminated in both a surgical and a medical triumph: Von Graefe's iridectomy and Laqueur's discovery of the efficacy of miotics in reducing the ocular tension in glaucoma. In the 20th century emphasis shifted to investigation of the physiology and pathology of aqueous secretion and flow. The whole subject is on a firmer footing because of Grant's work on tonography. A great thera­

Examination of the aqueous veins has al­ ready contributed to the study of open-angle glaucoma by showing that in this disease there is an obstruction to the outflow of aqueous rather than an increased production of this fluid. In the seemingly totally unre­ lated field of contact lenses, Ascher was able to show an interference with aqueous flow by pressure over the drainage system at the limbus. This is now being related to glau­ coma by McLean and his group with the de­ velopment of a perilimbal suction cup to study aqueous flow. Unquestionably further benefits will be derived from continuing study of the aqueous veins and Dr. Ascher in his concluding chapter indicates some of the avenues of investigation. This monograph should be read by all people in allied fields who have an interest in the disease. David Shoch.

AQUEOUS VEINS.