Abstract Introduction Shortly after the recent introduction of intravenous urea solution into clinical neurosurgery,1 we began using this drug in selected cases of glaucoma which were resistant to conventional medical therapy.2,3 Hertel4 in 1914, and Fremont-Smith and Forbes5 in 1927, noted that hypertonic urea solution produced lowering of intraocular pressure in experimental animals, but they did not use urea for this purpose clinically. In 1957, Bunge, Danforth, and Settlage6 confirmed these results in monkeys and suggested clinical trial of this drug. Studying the effect of intravenous urea on intraocular pressure in patients with normal eyes, we were impressed with the marked reduction of pressure produced. Figure 1 shows the response in a typical normal patient. It soon became apparent that, as one might expect, reduction of elevated intraocular pressure by intravenous urea solution was temporary, unless the cause of the elevated pressure was removed before the References 1. Kindly supplied under the trade name "Urevert" by the Travenol Laboratories, Incorporated, Morton Grove, Ill. 2. Javid, M., and Settlage, P.: Effect of Urea on Cerebrospinal Fluid Pressure in Human Subjects , J.A.M.A. 160:943-949, 1956.Crossref 3. Javid, M.: Urea—New Use of an Old Agent: Reduction of Intracranial and Intraocular Pressure , S. Clin. North America 38:907-928 ( (Aug.) ) 1958. 4. Javid, M.: A Valuable New Method for the Reduction of Intracranial and Intraocular Pressure by the Use of Urea , Tr. Am. Neurol. A. 83: 113-117, 1959. 5. Hertel, E.: Experimentelle Untersuchungen über die Abhängigkeit des Augendrucks von der Blutbeschaffenheit , von Graefes Arch. Ophth. 88: 197-229 ( (June) ) 1914.Crossref 6. Fremont-Smith, F., and Forbes, H. S.: Intraocular and Intracranial Pressure, An Experimental Study , Arch. Neurol. & Psychiat. 18: 550-564 ( (Oct.) ) 1927. 7. Bunge, R. P.; Danforth, R. C., and Settlage, P. H.: Effect of Intravenous Urea on Intraocular Pressure in the Monkey , A.M.A. Arch. Ophth. 57:659-667 ( (May) ) 1957. 8. Galin, M. A.; Aizawa, F., and McLean, J. M.: Urea as an Osmotic Ocular Hypotensive Agent in Glaucoma , A.M.A. Arch. Ophth. 62: 347-352 ( (Sept.) ) 1959. 9. Galin, M. A.; Aizawa, F., and McLean, J. M.: Intravenous Urea in Glaucoma , Am. J. Ophth. 50:379-384 ( (Sept.) ) 1960. 10. Klöti, R.: Harnstoff-Infusion in der Glaucomtherapie , Ophthalmologica 140:135-146 ( (Aug.) ) 1960. 11. Tyner, G. S., and Scheie, H. G.: Mechanism of the Miotic-Resistant Pupil with Increased Intraocular Pressure , A.M.A. Arch. Ophth. 50: 572-579 ( (Nov.) ) 1953. 12. Javid, M., and Anderson, J.: The Effect of Urea on Cerebrospinal Fluid Pressure in Rhesus Monkeys Before and After Bilateral Nephrectomy , J. Lab. & Clin. Med. 53:484-489 ( (March) ) 1959.
Archives of Ophthalmology – American Medical Association
Published: Apr 1, 1961