GLAUCOMA

Sufficient rise in intraocular

pressure to cause visual damage
 Classification
• Congenital Glaucoma
• Primary Glaucoma
• 1- Open angle
• 2- closed angle
• Secondary Glaucoma
• Absolute Glaucoma
 Congenital
• Features
• Buphthalmos
corneal diameter 12 mm < 1 yr
• Tears of descemet’s membrane
• Corneal haze
• Increased A/C depth
• Optic disc cupping
 Primary Glaucoma
• Primary open angle glaucoma

• Features
Virtually symptom less
frequent change of glasses
gross field defect (late stages)

• Diagnosis
Ophthalmic exam
Field test
Optic Nerve
Field Test
Humphery Field Trace
Normal Disc
Cupped Disc
 Primary Glaucoma's

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

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

• Blind
• Painful
• Treatment
• Enucleation
• Laser/Cryotherapy
• Absolute alcohol
Treatment
 Treatment
• Medical
• Beta blockers (Timolol)
• Carbonic anhydraze inhibitors
Azopt and Trusopt
• Sympathomimetics
Propine and Apraclonidine
• Parasympathomimetics (pilocarpine)
• Prostaglandin Derivatives (Xalatan)
 Treatment
• Laser
• Trabeculoplasty
• Sclerostomy
• Cycloablation
 Treatment
• Surgical
• Goniotomy
congenital
• Trabeculotomy
for congenital glaucoma's
• Trabeculectomy
for adult glaucoma's
• Implants
for difficult non responsive