GLAUCOMAGLAUCOMA

Sufficient rise in intraocular Sufficient rise in intraocular pressure to cause visual damagepressure to cause visual damage

ClassificationClassification

• Congenital Glaucoma

• Primary Glaucoma

• 1- Open angle

• 2- closed angle

• Secondary Glaucoma

• Absolute Glaucoma

CongenitalCongenital

• Features

• Buphthalmos corneal diameter 12 mm < 1 yr

• Tears of descemet’s membrane

• Corneal haze

• Increased A/C depth

• Optic disc cupping

Primary GlaucomaPrimary Glaucoma• Primary open angle glaucoma

• FeaturesVirtually symptom lessfrequent change of glassesgross field defect (late stages)

• DiagnosisOphthalmic examField test

Optic NerveOptic Nerve

Field TestField Test

Humphery Field TraceHumphery Field Trace

Normal DiscNormal Disc

Cupped DiscCupped Disc

Primary Glaucoma'sPrimary Glaucoma's

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

Acute GlaucomaAcute Glaucoma

Secondary GlaucomasSecondary Glaucomas

• Lens

• Intumescence

• Dislocation

• Phacolytic

• Trauma

• Uveitis

• Neovascular

Absolute GlaucomaAbsolute Glaucoma

• Blind

• Painful

• Treatment

• Enucleation

• Laser/Cryotherapy

• Absolute alcohol

TreatmentTreatment

TreatmentTreatment• Medical• Beta blockers (Timolol)• Carbonic anhydraze inhibitors

Azopt and Trusopt• Sympathomimetics

Propine and Apraclonidine• Parasympathomimetics (pilocarpine)• Prostaglandin Derivatives (Xalatan)

TreatmentTreatment

• Laser

• Trabeculoplasty

• Sclerostomy

• Cycloablation

TreatmentTreatment

• Surgical• Goniotomy

congenital• Trabeculotomy

for congenital glaucoma's• Trabeculectomy

for adult glaucoma's• Implants

for difficult non responsive