Glaucoma
Glaucoma
Glaucoma
Definition
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DEMOGRAPHIC
•Age
•Gender
•Race
OCULAR
•Intraocular pressure
•Optic nerve head
•Myopia
•Hypermetropia
SYSTEMIC
•Diabetes
•Systemic hypertension
GENETIC
•Family history
OTHER
•Cigarette smoking
•Alcohol intake
•Socioeconomic factors
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Trabecular system Uveoscleral system
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The theory of mechanical
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10-21mmHg (1mmHg=0.133Kpa)
Normal range of the IOP
diurnal variation<8mmHg within 24hr.
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IOP
Anterior chamber
Visusal field
Optic disc
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※Primary glaucoma
-Primary angle closure glaucoma (PACG)
-Primary open angle glaucoma (POAG)
※Secondary glaucoma
※Congenital glaucoma
-Infants
-Juvenile
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• Poor drainage is caused
because the angle between
the iris and the cornea is too
narrow and is physically
blocked by the iris. This
condition leads to a sudden
build up of pressure in the
eye.
• Angle closure glaucoma with
pupillary block leading to
peripheral iris obstruction of
the trabecular meshwork
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• Risk factors
1. Age (>50 year old)
Risk increases with increasing age
2. Race
More common in blacks
3. Gender(Female)
4. Refractive error(Myopes are more predisposed)
5. Family history
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Anatomical predisposed eyes
-Short axial length,small cornea,shallow anterior
chamber,anterior chamber,narrow angle,thicker,anterioly
placed lens.
-Peripheral iris bombe
-Pupillary block
Precipitating factors
◎Dim illumination
◎Emotional stess
◎Drugs(anticholenergics,adrenergics,s
ystemic drugs)
Acute angle closure glaucoma
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Disease Stating
Presymptomatic stage
Absolute stage
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Acute onset sequela:
■Visual acuity get better
■KP
■Iris:atrophy,pigmentation defects and limited sticky
■The pupil can't return to normal
■Cloudy-glaucoma spot on the anterior lens capsule
■Anterior chamber Angle extensive stick
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※intermittent stage :
symptoms to ease and anterior chamber angle open.
※Chronic stage:
anterior chamber angle extensive stick
※Absolute stage:
the continuous high intraocular pressure, poor
eyesight or no light feeling.
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■No symptom at the early age
■IOP elevation,increased IOP fluctuation
■Open anterior chamber angle
■Glaucomatous optic neuropathy
-Optic disc cupping,RNFL defect,hemorrhage
-Glaucomatous visual field loss
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Principle
-Comprehensive medical therapy
lower IOP,constict pupil,prevent peripheral
anterior synechiae,lessen inflammtory reaction.
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Medical therapy
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Surgical management
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■Filtering suergery (surgery to improve the rate of aqueous
outflow)
-Trabeculectomy
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■Cyclodestructive surgery (surgery to reduce the rate
of aqueous production)
-Cyclophotocoagulation
-Cyclocryotherapy
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Traumatic glaucoma
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Cataract expansion glaucoma
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Neovascular glaucoma
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※Infantile glaucoma:
Photophobia, Tears, Corneal increases and cloudy,
anterior chamber deepened.IOP Increased and
physiological concave expand.
※Juvenile glaucoma
※Others
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Reviews
1. Definition?
2. Types of glaucoma?
3. Normal range of IOP?
4. Treatments: medication, surgery.
5. Symptoms and signs of PACG?
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