Tetralogia (1972)
Download the entire book as a PDF (Finnish, 238 pages)
Summary
This book of 230 pages including 723 case reports from the author's own practice deals with the most crucial role held by hypermetropia in ophthalmology and general diseases as well. Thus the book is composed of a tetralogy: hypermetropia, one or two vertical furrows on the forehead as the consequence of that, migraine and elevated ocular pressure, all of which appear as a sketch on the cover of the book.
A description containing 49 pages of a scrupulous and far-detailed method for testing refraction is presented. The essential principle is a binocular and very much blurred initiation of the visual examination, by which method latent hypermetropia can be detected far more effectively and more completely than by cycloplegia which has often proved rather defective. The superioritY,of the procedure described is made apparent by demonstrating the contingency of erroneaus diagnoses of "myopia", astigmatism, an isometropia, migraine and glaucoma if the method is not mastered. The importance of keeping to spherical lenses of equal effectivity as a guarantee for satisfied patients cannot be overemphasized in this connection. The furthest progressed "myopes" are found in the group that has either learnt to read at a very early age or got their negative lenses young. The chapter on pseudomyopia includes theories of the ethiology, complications and prophylaxis of "school-myopia".
A table of migraine potients has been drawn up on the basis of 174 cases, all of which being either pronounced hypermetropes or pseudomyopes. Two separate tables are made of certain particular cases picked up from among the total migraine material. One presents 25 cases with drastic neurological symptoms even epilepsy and quadrant-anopsia, the other consisting of 14 migraine cases with typical refractional etiology, examined or treated neurologically, but with negative outcome.
The essential role of hypermetropia in all cases of elevated intraocular pressure (excluding secondary glaucomas after inflammation or trauma) is demonstrated by a table of 60 glaucoma cases. Tables showing pseudoexfoliation and cataract findings have been given as these seem to be regularly associated with hypermetropia.
A theory of hypermetropia as an etiological factor in arterial hypertension is suggested on the basis of 84 cases. In addition to marked hypermetropia lack or inadequacy of lenses often to a very high age is characteristic of these cases.
The author suggests the old term "cataracta in oculo glaucomatoso" to be substituted by or used parallelly with the new diagnostic term "hypertensio et cataracta (et/seu Pseudoexfoliatio) in oculo hyperopioso".
The book terminates in dreams of future objectives of research and practical activity; it also presents a collection of quoted aphorisms concerning the unfettering power of errors which leads to fresh prospects, offer new alternatives and stimulates continuous criticism.
