the treatment of tobacco amblyopia BY
ACETYL-CHOLINE. BY
B. H. House
CRAGG, L.M.S., M.D.,
Surgeon,
Bristol
Eye Hospital.
Since 22nd July,
1936, five patients, all males, from tobacco suffering amblyopia have been treated at the Bristol Eye Hospital by the intramuscular " ejection of pragmoline," acetyl-choline bromide. This drug is available in two doses, dose A being 0'03 grammes, and dose B 0-125 grammes. Each patient first received two injections of dose A ^vith one clear day's interval between, and then a daily injection of dose B until no further treatment ^ras considered necessary, or until improvement ceased. the addition, patients 4 and 5 were given
Physostigmine
sulphate gr. x|o daily by mouth, suggestion that the action of acetyl?holine is enhanced by minute doses of this drug. It is hoped by this method to accelerate the treatment of tobacco amblyopia. The results in these cases are encouraging: treatment y this method gives more rapid improvement in yision, the patient in most cases realizing that over-
following
the
iiidulgence in tobacco has
been the
cause
of his defective
vision.
Case 1.?Age 72. This man complained of failing vision a. Perlocl ?f fiye months. He reported on 9th June, 1936,
atGrwhich time
his vision was R2 6~Uweeks later there was ?
lx
i
a
2
T. -L? "6 (J. no
s^?pped smoking.
On ] ?6
Was Emitted
discharge,
rp 237
on
22nd
two weeks
July,
improvement, although and received ten
injections,
later, his vision was L. TV partly.
R. 18 months later vision showed
no
further
he
change.
238
Treatment
Tobacco Amblyopia
of
This patient reported Case 2.?Age 65. complaining of defective vision. Vision R. He
He has failed to
This
R6
patient
T 10 d T2"'
.
?
July,
injections.
On
since then.
report
Case 3.?Age 66. time his vision was
31st
L.
wg-
admitted and received nine three weeks later, vision was R. f partly. L. f partly.
was
discharge,
on
attended in 1933, at which
T, -L1*
6
.
"3"6
>
T
12
12-
He was advised to stop smoking, but did not do so. On admission on 25th August, 1936, his vision was slightly worse. He was treated for four weeks, receiving seventeen injections. At the time of discharge his vision was R- t?8 ; J t\ (slowly). L. -ft ; J (slowly). in addition to signs of arteriosclerosis, revealed the presence of fine haemorrhages. Two months later his vision was His
fundi,
partly partly ; J x6a slowly. L. patient has resumed smoking.
R. 1% This
; J
slowly.
Case 4.?Age 60. This patient had noticed failing vision for six weeks. On 24th September, 1936, vision was R.
partly
L- t%
J xf
;
?
partly
;
J
He was admitted on 25th September, and discharged on 21st October, and received during that time seventeen injections. On discharge his vision was R. t?h He has not
partly; reported
J
T\.
since
L. f
J T\.
partly; discharge.
Case 5.?Age 62. This patient had noticed failing vision for six weeks. On 28th September, 1936, vision was R6 12 ?
T
.
?
J
10
T, ^
12-
6
.
III
T
8
TS'
He was admitted on 30th September, and discharged on 21st October, having received thirteen injections. His vision on
discharge R. f
was
partly
He reported in vision.
I
am
hospital
a
;
later,
indebted to the for
L. f
J iV
month
permission
to
partly
and there
was
;
J iVthen
no
change
honorary surgeons of the publish these cases.
ACETYL-CHOLINE. BY
B. H. House
CRAGG, L.M.S., M.D.,
Surgeon,
Bristol
Eye Hospital.
Since 22nd July,
1936, five patients, all males, from tobacco suffering amblyopia have been treated at the Bristol Eye Hospital by the intramuscular " ejection of pragmoline," acetyl-choline bromide. This drug is available in two doses, dose A being 0'03 grammes, and dose B 0-125 grammes. Each patient first received two injections of dose A ^vith one clear day's interval between, and then a daily injection of dose B until no further treatment ^ras considered necessary, or until improvement ceased. the addition, patients 4 and 5 were given
Physostigmine
sulphate gr. x|o daily by mouth, suggestion that the action of acetyl?holine is enhanced by minute doses of this drug. It is hoped by this method to accelerate the treatment of tobacco amblyopia. The results in these cases are encouraging: treatment y this method gives more rapid improvement in yision, the patient in most cases realizing that over-
following
the
iiidulgence in tobacco has
been the
cause
of his defective
vision.
Case 1.?Age 72. This man complained of failing vision a. Perlocl ?f fiye months. He reported on 9th June, 1936,
atGrwhich time
his vision was R2 6~Uweeks later there was ?
lx
i
a
2
T. -L? "6 (J. no
s^?pped smoking.
On ] ?6
Was Emitted
discharge,
rp 237
on
22nd
two weeks
July,
improvement, although and received ten
injections,
later, his vision was L. TV partly.
R. 18 months later vision showed
no
further
he
change.
238
Treatment
Tobacco Amblyopia
of
This patient reported Case 2.?Age 65. complaining of defective vision. Vision R. He
He has failed to
This
R6
patient
T 10 d T2"'
.
?
July,
injections.
On
since then.
report
Case 3.?Age 66. time his vision was
31st
L.
wg-
admitted and received nine three weeks later, vision was R. f partly. L. f partly.
was
discharge,
on
attended in 1933, at which
T, -L1*
6
.
"3"6
>
T
12
12-
He was advised to stop smoking, but did not do so. On admission on 25th August, 1936, his vision was slightly worse. He was treated for four weeks, receiving seventeen injections. At the time of discharge his vision was R- t?8 ; J t\ (slowly). L. -ft ; J (slowly). in addition to signs of arteriosclerosis, revealed the presence of fine haemorrhages. Two months later his vision was His
fundi,
partly partly ; J x6a slowly. L. patient has resumed smoking.
R. 1% This
; J
slowly.
Case 4.?Age 60. This patient had noticed failing vision for six weeks. On 24th September, 1936, vision was R.
partly
L- t%
J xf
;
?
partly
;
J
He was admitted on 25th September, and discharged on 21st October, and received during that time seventeen injections. On discharge his vision was R. t?h He has not
partly; reported
J
T\.
since
L. f
J T\.
partly; discharge.
Case 5.?Age 62. This patient had noticed failing vision for six weeks. On 28th September, 1936, vision was R6 12 ?
T
.
?
J
10
T, ^
12-
6
.
III
T
8
TS'
He was admitted on 30th September, and discharged on 21st October, having received thirteen injections. His vision on
discharge R. f
was
partly
He reported in vision.
I
am
hospital
a
;
later,
indebted to the for
L. f
J iV
month
permission
to
partly
and there
was
;
J iVthen
no
change
honorary surgeons of the publish these cases.
