GLAUCOMA

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GLAUCOMA
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• Sufficient rise in intraocular pressure to cause
  visual damage

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Classification

• Congenital Glaucoma
• Primary Glaucoma
• 1- Open angle
• 2- closed angle
• Secondary Glaucoma
• Absolute Glaucoma

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Congenital

• Features
• Buphthalmos
• corneal diameter 12 mm lt 1 yr
• Tears of descemets membrane
• Corneal haze
• Increased A/C depth
• Optic disc cupping

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Primary Glaucoma

• Primary open angle glaucoma
• Features
• Virtually symptom less
• frequent change of glasses
• gross field defect (late stages)
• Diagnosis
• Ophthalmic exam
• Field test

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Optic Nerve
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Field Test
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Humphery Field Trace
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Normal Disc
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Cupped Disc
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Primary Glaucoma's

• Angle closure
• Acute
• Very painful
• Reduced vision
• Nausea vomiting
• Can be triggered by dilating drops

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Acute Glaucoma
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Secondary Glaucomas

• Lens
• Intumescence
• Dislocation
• Phacolytic
• Trauma
• Uveitis
• Neovascular

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Absolute Glaucoma

• Blind
• Painful
• Treatment
• Enucleation
• Laser/Cryotherapy
• Absolute alcohol

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Treatment
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Treatment

• Medical
• Beta blockers (Timolol)
• Carbonic anhydraze inhibitors
• Azopt and Trusopt
• Sympathomimetics
• Propine and Apraclonidine
• Parasympathomimetics (pilocarpine)
• Prostaglandin Derivatives (Xalatan)

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Treatment

• Laser
• Trabeculoplasty
• Sclerostomy
• Cycloablation

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Treatment

• Surgical
• Goniotomy
• congenital
• Trabeculotomy
• for congenital glaucoma's
• Trabeculectomy
• for adult glaucoma's
• Implants
• for difficult non responsive