By Hugh Davison (Auth.)
For 40 years Hugh Davson's body structure of the attention has been considered as the top textbook in ophthalmology. This greatly revised and up-to-date 5th version continues this acceptance and offers the author's lifelong services to the scholar. The constitution and content material were revised to maintain abreast of present educating and learn pursuits, whereas conserving the fashion and readability of earlier variants
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Experimental Studies Fig. 28 illustrates the penetration of some substances into the anterior chamber of the rabbit. In general, the substances fall into three categories. First there are the very large molecules like the plasma proteins, dextrans and inulin which penetrate so slowly as to give the impression of an absolute barrier, although 34 AQUEOUS HUMOUR studies with isotopically labelled proteins leave us in no doubt that there is some, but very slow, penetration. Because the aqueous humour is constantly being drained away the concentration of these large molecules in the aqueous humour never rises very high and we may speak of a steady-state in which the ratio of concentrations is exceedingly low.
Attempts to locate a centre controlling the intraocular pressure have been made by v. Sallmann & Loewenstein and Gloster & Greaves, by inserting stereotactically controlled stimulating electrodes into different parts 46 AQUEOUS HUMOUR of the brain. T h e parts of the brain from which effects on intraocular pressure could be obtained were in the hypothalamus, but since this region contains many centres controlling the autonomic system generally, it is important to distinguish primary effects on the intraocular pressure from the secondary consequences of stimulating these autonomic centres.
LARGE MOLECULES On the basis of this scheme, we may interpret the blood-aqueous barrier phenomena qualitatively. Thus large lipid-insoluble molecules such as the plasma proteins will probably be held back partially by the capillaries in the ciliary processes, so that only small amounts will be available to the epithelial cells; penetration into these cells, moreover, will be greatly restricted so that the primary secretion may contain only minimal amounts. During the fluid's sojourn in the posterior and anterior chambers some may diffuse from the iris, but these amounts will be small because of the obstructions that the large molecules will meet in the form of the epithelial covering of the posterior surface of the iris.