GLAUCOMA

ZALDI
FAKULTAS KEDOKTERAN
UNIVERSITAS ISLAM SUMATERA UTARA
MEDAN
2014
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Global causes of Visual

Impairment, inclusive of
blindness, as percentage

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Global causes of blindness as

percentage of global blindness in 2010

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CATEGORY OF VISUAL ACUITY

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DEFINITION
DEFINITION
Glaucoma is an optic neuropathy
which is characterized by:

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Optic nerve fibers death optic disc

damage,
Progressive visual field defect.
Predisposing factor is Intra ocular
pressure (IOP)
1. High tension glaucoma
2. Normo tension glaucoma
3. LowGLAUCOMA
tension glaucoma
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MORTALITY / MORBIDITY
Glaucoma is the third leading cause
of blindness in the US.
The risk of becoming legally blind in
one eye from open-angle glaucoma is
approximately 20%, with bilateral
blindness occurring in 9%.

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EXAMINATION

FUNDUSCOPY
TONOMETRY
SLITLAMP
GONIOSCOPY
OCT ( OPTICAL
COHERENCE
TOMOGRAPHY )

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TONOMETRY

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GONIOSCOPY

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GOLDMAN PERIMETRY

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GLAUCOMA
A. PRIMARY GLAUCOMA
1. Open-angle glaucoma
a. Primary open-angle glaucoma
b. Normal-tension glaucoma (low-tension glaucoma)
2. Angle-closure glaucoma
a. Acute
b. Subacute
c. Chronic
d. Plateau iris
B. CONGENITAL GLAUCOMA
C. SECONDARY GLAUCOMA
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AQUEOUS HUMOUR OUTFLOW SYSTEM

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ETIOLOGY
Three factors
determine the IOP :
Production humor
aqueous
Resistance to
aqueous outflow
across trabecular
meshwork-canal
schleems system
The level of episcleral
venous pressure

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CLASSIFICATION

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PATOGENESIS

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DIRECT
OPHTHALMOSCOPY
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FUNDUSCOPY
OPTIC NEUROPATHY
SHAPE
DEMARCATION
CUP DISC RATIO
CUPPING /
EXCAVATION
SHIFT /
NASALISATION
ATROPHY
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VISUAL FIELD

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THE NORMAL VISUAL

FIELD

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GLAUCOMA
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Optic Neuropathy

VF loss

RGC death
Mechanical
damage

Neuroprotection
Neutrophin
withdrawal

Stop
axoplasmic
flow

IOP
IOP
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Retina

ISCHEMIA
ONH

Vascular dysregulation

PP

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Sclerotic vascular wall

vasospasm

BP
OBF

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PATOGENESE

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OPTIC NEUROPATHY

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CONGENITAL GLAUCOMA
Primary : autosomal juvenille
Secondary : Trauma, uveitis, neoplasma

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VISUAL FIELD

Normal

Glaucoma

Glaucoma
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Absolute Glaucoma
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RISK FACTORS

Level of elevated IOP

Family history of glaucoma
Race
Age
Myopia
Sex

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THERAPY
DRUGS
Beta adrenegik blockers (timolol,
betaxolol, carteolol, levobunalol,
metipranolol)
Hyperosmotic agent (manitol,
glyserin )
Asetazolamid
Myoticum
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REFERENCES
American Academy of Ophthalmology, Glaucoma,
Section 10, 2011-2012
American Academy of Ophthalmology, External
Disease and Cornea, Section 8, 2011-2012
Khurana AK, Comprehensive Ophthalmology, Fourth
Edition , New Delhi, New Age Internasional (p)
Limited Publisher, 2007.
Vaughan & Asbury's :
General Ophthalmology
17th Edition , Mc Graw- Hills Companies , May 2007

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