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October 1963


Author Affiliations

200 Beacon St Boston 16, Mass

Arch Ophthalmol. 1963;70(4):589. doi:10.1001/archopht.1963.00960050591036

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To the Editor.  —The paper titled "Effect of Retrobulbar Anesthesia Upon Intraocular Pressure" (Hill, Lopez, and Hill: Arch Ophthal 70:178-180, 1963) reports that injection of fluid into the retrobulbar space often produces a rise in intraocular pressure and that the raised pressure does not always return to normal or subnormal levels after five minutes of digital pressure applied to the orbital contents through the closed lids. The authors' recommendation, based upon this observation, is that "an incision in cataract surgery should never be made... until hypotony has been proven by measurement with the tonometer."To the uninitiated, the syllogism between observation and recommendation may be less than obvious here. However, sophisticated ophthalmologists (such as the readers of the Archives of Ophthalmology)) will supply the missing premise that increased intraocular pressure before cataract incision is often associated with vitreous loss during cataract surgery. Since all agree that loss of formed vitreous

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