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April 1961

Intravenous Hypertonic Urea in the Management of Acute Angle-Closure Glaucoma

Author Affiliations

From the Massachusetts Eye and Ear Infirmary.

Arch Ophthalmol. 1961;65(4):497-503. doi:10.1001/archopht.1961.01840020499006

The clinical use of urea as an ocular hypotensive agent has only recently been reported in the ophthalmic literature although its effect upon the intraocular pressure was demonstrated experimentally over 45 years ago. In 1914, Hertel1 reported that the intraocular pressure of rabbits was lowered by a 20% solution of urea injected intravenously. Subsequently, Fremont-Smith and Forbes2 noted reduction of intracranial and intraocular pressure of cats after the intraperitoneal injection of hypertonic urea solutions, but little or no clinical application of these observations was made until Javid and Settlage3 emphasized the effectiveness of hypertonic urea solutions in lowering cerebrospinal fluid pressure in neurosurgical patients.

Bunge et al.4 studied the effect of urea upon the intraocular pressure of monkeys; Javid5 noted that the intraocular pressure of human subjects could be reduced by urea injected intravenously. However, it remained for Galin, Aizawa, and McLean6,7,8 to demonstrate

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