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Title: Studies on the eye
Author: Clark, Charles V.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1990
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The thesis comprises a series of studies on the eye, with particular reference to the pathogenesis of the primary glaucomas, and the complex effects of autonomic nerve function on the eye. The first section is devoted to studies on the primary glaucomas. The integrity of autonomic nerve function is investigated, and a significant prevalence of autonomic dysfunction - both systemic and ocular - is identified in each of the major categories of primary glaucoma. The association between diabetes mellitus and the primary glaucomas is defined by a series of prospective and retrospective studies. Diurnal variation in the dimensions of the anterior chamber is described, with shallowing of the anterior chamber in the evening, which is comparable to the diurnal variation in the onset of closed-angle glaucoma. Finally, factors predisposing to the development of posterior synechiae after glaucoma operations are assessed, and the potential application of mifepristone (RU486) as a peripheral blocker of dexamethasone and progesterone is evaluated. The second section examines the relationship between autonomic nerve function and the eye, in conditions other than glaucoma. The effects of systemic autonomic nerve stimulation on the eye are assessed in a series of studies. In the anterior segment of the eye, the effects of systemic autonomic nerve stimulation on intraocular pressure are described in normal subjects and diabetic patients. In the posterior segment of the eye, the effects of systemic autonomic nerve stimulation on the retinal circulation are evaluated in normal subjects, demonstrating a significant association between systemic autonomic stimulation and retinal vessel calibre. This response is shown to be reproducible, and the association between autonomic nerve stimulation and retinal vessel calibre is supported by the results of further studies on patients with diabetes, diabetic nephropathy, and cervical sympathectomy. Finally, in this section, the efficacy of autonomic nerve function in various conditions is described. A high prevalence of systemic autonomic neuropathy and ocular autonomic neuropathy is identified in patients with proliferative diabetic retinopathy, and ocular autonomic neuropathy in patients with progressive autonomic failure. The third section comprises three miscellaneous papers, describing the association between diminished skin wrinkling and diabetes mellitus, not associated with other recognised complications of diabetes (retinopathy or autonomic neuropathy), the histopathology of extraocular muscle in congenital third nerve palsy, and the histopathology of carcinoid tumour in the lacrimal gland.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Sc.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available