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. 2020 Mar:211:4-14.
doi: 10.1016/j.ajo.2019.11.011. Epub 2019 Nov 15.

The Use of Electrotherapeutics in Ophthalmology

Kieu-Yen Luu  1 , Min Zhao  2 , Mark J Mannis  3
Affiliations

The Use of Electrotherapeutics in Ophthalmology

Kieu-Yen Luu et al. Am J Ophthalmol. 2020 Mar.

Abstract

Purpose: To present a perspective on the use of electrotherapeutics in the history of ophthalmology along with the development of novel contemporary ophthalmic instrumentation.

Design: Perspective study.

Methods: We reviewed historical journals, articles, and books discussing the use of electricity and electrotherapeutics in ophthalmology.

Results: Electrotherapeutic applications have been researched and used to treat ocular diseases as far back as the 18th century. By the 20th century, research in electrotherapeutics in ophthalmology had caught the eye of Edward Jackson, the first president of the American Academy of Ophthalmology and Otolaryngology and first editor of the present (third) series American Journal of Ophthalmology. Edward Jackson published an extensive review on this topic and reported a variety of modalities used to treat ocular diseases.

Conclusions: While many early therapeutic uses of electricity did not produce effective and replicable results, studies on electrical stimulation of the eye provided the foundation for the development of clinically significant vision enhancing and restoring instrumentation.

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Figures

Figure 1.
Figure 1.
A sketch displaying the use of galvanism to induce muscle contractions.
Figure 2.
Figure 2.
A drawing of Emil Du-Bois Reymond using a galvanometer to measure skin currents and potentials from a wound. The galvanometer used to detect the signal rests on a separate table by his right arm, the one he appears to be tensing. (Courtesy of Dr. Gabriel Finkelstein, University of Colorado, Denver)
Figure 3.
Figure 3.
Edward Jackson (A) and his article on “Electricity in the Diseases of the Eye” (B)
Figure 4.
Figure 4.
Cataphoresis instruments developed by Robert Wirtz for treating corneal diseases using iontophoresis.
Figure 5.
Figure 5.
The thermophore produced by W.E. Shahan of St. Louis in 1916 used to treat patients with pneumococcal ulcers and tumors of the cornea. (Photo courtesy of the Museum of the American Academy of Ophthalmology)
Figure 6.
Figure 6.
The ASR subretinal microchip developed by Optobionics Inc. (Courtesy of and with permission for publication by Alan Chow MD Optobionics Inc.)
Figure 7.
Figure 7.
The healing of a corneal wound by an induced electrical current. Electrical fields can both open (left) and close (right) a wound. An electric field of physiological strength is applied with the polarity pointing away from the wound center at 0 minutes and at 96 minutes, the cells move away from the wound, thus opening the wound. The field polarity is then reversed at 99 minutes and the cells now migrate into the wound resulting in wound closure at 204 minutes.
Figure 8.
Figure 8.
The use of pharmaceutical manipulation and the effects on corneal wound healing. (A) pharmacological manipulation of corneal epithelial transportation of Na+ and Cl− significantly enhances (aminophylline) or decreases (furosemide) endogenous wound electric currents. (B) The healing of circular lesions in the cornea is shown over time. Circular keratectomy was performed on corneas at 0 h. Lesions were labeled yellow with fluorescein and are shown here outlined with dots. Aminophylline was used to increase the wound current which subsequently showed significantly increased wound healing; whereas furosemide that was used to decrease the wound current significantly decreased wound healing. Modified from FASEB J. 2005 Mar;19(3):379–86. Wound healing in rat cornea: the role of electric currents. Reid B1, Song B, McCaig CD, Zhao M. https://www.fasebj.org/doi/10.1096/fj.04-2325com
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