HORMONAL CONTROL 



561 



Sallmann and Lowenstein, 1955 ; Gloster and Greaves, 1957), an influence which is 

 probably responsible for the cyclic diurnal variations in the normal intra-ocular pres- 

 sure and, in part perhaps, for the exaggeration of those variations that characterize 

 primary glaucoma (see Duke-Elder, 1952-7) ; but whether its action is mediated by 

 nervous or hormonal factors or both is still unknown. Hypei-pituitarism has been 

 most commonly associated with ocular hypotony (Imre, 1921 ; Marx, 1923), while 

 the reputed cyclic variation of the ocular tension with the menstrual cycle or in 

 association with pregnancy, falling in the progestational phase of both and rising in 

 the oestrogenic post -menstrual period or after delivery, is suggestive (Salvati, 1923 ; 

 Marx, 1923 ; Becker and Friedenwald, 1953), as also is the reported reduction of 

 tension in glaucomatous patients by progesterone (Obal, 1950 ; Posthumus, 1952 ; 

 Becker and Friedenwald, 1953 ; and others). The most positive assertion has been 

 made by Schmerl and Steinberg (1948) and Schmerl (1955) who claimed that the 

 spinal fluid of rabbits contained two active principles, presumably secreted by the 

 posterior lobe of the pituitary body into the third ventricle, one, acting on para- 

 sympathetic centres (" hyperpiesine "), raising, the other, acting on sympathetic 

 centres (" miopiesine "), lowering the intra-ocular pressvire. In the rabbit (a nocturnal 

 animal) the intra-ocular pressure is said to increase during light and to fall during 

 darkness because of this mechanism ; in man (a diurnal animal) the reverse occurs. 

 More experimental investigation, however, is requu'ed to substantiate these claims 

 which are still somewhat nebulous and are not yet based on unequivocal evidence. 

 As in other spheres of physiology and pathology, our knowledge of the complex and 

 far-reaching influence of the diencephalic-hypophyseal system upon the vegetative 

 physiology of the eye is still in an elementary stage. 



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