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which you remember lies posterior to the periphery of the iris, secretes the nasal spray fluticasone lymph which flows into the posterior chamber in front of the lens, and through the pupil into the anterior chamber, to fluticasone propionate nasal be carried off by Schlemm's canal. As long as this filtration angle is open a proper balance between secretion and ex- cretion is preserved, but if the iris is pushed against the cornea in this angle, it is blocked oft', filtration is interfered with, afid an increase in tension of the eye- ball results. (See Figs. 6 and 7.) If this condition persists, adhesions form between the iris and flovent mg the periphery of the cornea, and it is almost, or quite, impossible to tear the iris order flovent away, so that an iridectomy, to be of use, must be done before this stage. A dilated pupil acts mechanically in produc- ing glaucoma by crowding into the angle and block- ing it up. If the secretion continues while filtration is stopped, the increased fluid must go somewhere, and the direction of the least resistance is the optic disk. Here the tough sclera is represented by a few scattered fibres, mostly of elastic tissue, and the soft nerve tissue readily yields, causing excavation, a process which means fluticasone salmeterol death to the retina, either rapid or gradual. The pressure is felt first by the tempor- al side of the optic nerve, hence flovent price the nasal side of the field is the first to go, then follows the temporal, while central vision may remain fair for a long time in the chronic cheap flovent cases. (Sec Figs. 3 and 4.) JEtioloi^y. — The direct cause is interference with filtration. The contributing causes are many — a small eyeball, a small cornea, refractive errors, espe- cially hypcrmetropia, middle age or past it (Priestly Smith found the percentage increased with each decade over twenty), in the female sex, although the ratio is about six women to five men, constipation. sedentary occupation, loss of sleep, and grief. generic flovent Priestly Smith found that while the fluticasone spray eyeball does not grow appreciably larger after the fifth year, the kns flovent cost does, probably because, bemg epiblastic in struc- ture, the cells continue to proliferate within a closed sac without being thrown off. This disturbs the re- lations of the surrounding structures, and the iris is pushed forward peripherally, damming up the fil- tration angle. Refractive errors excite by producing a constant congestion of the ciliary body, constipa- tion and fluticasone nasal sedentary purchase flovent online occupation by the sluggish circu- lation, loss of sleep partly by the dilated pupils, for when we lie awake in the dark the pupils are dilated and the filtration angle partially shut off, and order flovent online also by the hyperasmia purchase flovent of the cerebral vessels. Grief probably acts also by congestion of the bloodvessels of the head and eyes. Sytiiptoiiis. — These differ widely in the acute and chronic varieties. The acute attack is often ushered in with such violent constitutional disturbance that the fact that the inflamed eye flovent online is the exciting cause is overlooked, and the patient is treated for a bilious attack, neuralgia, erysipelas, toothache, ptomaine poisoning, etc. The diagnostic points are: i. The rapid failure of sight in that eye ; 2, increase in ten- sion (test by trying your eye. then patient's) ; 3. the dull cornea, it looks steamy, like glass that has been breathed upon ; 4, anaesthesia of the cornea, when a wisp of cotton touches it the lids do not wink: (5) the semidilated and nonresponsive pupil ; (6) shal- low anterior chamber, the iris seems to be pushed against the cornea; (7) the lids are somewhat swol- len and discolored, fluticasone nose spray conjunctiva injected and swollen, and there is dull, red, ciliary injection; (8) pain in the eyeball, reflected over the brow and temple, and around buy cheap flovent the lower margin of the orbit. The eye is suddenly attacked with pain, which increases in severity. It is frequently accompanied hv vomiting, and the patient is prostrated. Often •Chiiinic glaucoma. Fields, right eye, male, aged ntry-two years. Vision 0/6. Blacltened area shows part lost from normal field: a. talien Ma,v 31, 1902: h, ' -" — """ two years later. — Ifrom Dr. Thorington's clinic. Fig. ,. _. fltty-two years from same eye these attacks come on during the night, or in the early morning hours, the patient being awakened by the buy flovent sharp pain in the eye. It is the family doc- tor who is sent for, not the specialist, and buy flovent online it lies with him to make the correct diagnosis, and having made

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