glaucoma · mening the passage for aqueous humor outflow is too narrow that push lens against iris...
TRANSCRIPT
Glaucoma
Tasneem Al-Abbadi
Definition
Pathophysiology
Classification and symptom
Diagnosis
treatment
It is a group of eye diseases in which damage to the optic nerve (optic neuropathy) is usually “ not always” caused by raised ocular pressure (normal IOP is 15.5 mmHg) acting
on the nerve head
Its optic neuropathy and visual field defect
with or without increase intraocular pressure
Definition
Definition
Pathophysiology
Classification and symptom
Diagnosis
Treatment
Anatomy physiology pathology
Pathophysiology
Pathway of aqueous humor flow:
Anatomy physiology pathology
Conventional pathway
Uveo-scleal Pathway
Anatomy physiology pathology
Mechanical damage To optic nerve axons by the raised IOP Ischemia of nerve fibers caused by impaired perfusion pressure (reducing blood flow at optic nerve head)
-Family history of glaucoma
-Age 60 and older.
-Eye injury , certain eye surgeries or chronic eye inflammation.
-Diabetes, high blood pressure, heart disease or hypothyroidism .
-steroids for long periods of time
Risk factors of glaucoma:
Definition
Pathophysiology
Classification and symptom
Diagnosis
treatment
Classification
Primary glaucoma Congenital glaucoma Secondary glaucoma
Chronic open angle glaucoma Acute and chronic closed angle glaucoma
Primary Rubella Secondary to other inherited ocular disorders (e.g. aniridia; absence of iris)
**Corneal diameter will be increased. **white eye NOT red
Trauma Ocular surgery Associated with other ocular diseases (uveitis) by { hypopyon , posterior synechea , steriod tt } Raised episcleral venous pressure Steroid induced
Open angle glaucoma
The angle between cornea and iris
The drainge system slowly gets clogged over time ,so gradual increase in pressure in optic nerve
This increase result in atrophy of outer rim of nerve that result in decrease peripheral vision
Over time loss in central vision
Mening the passage for aqueous humor outflow is too narrow that push lens against iris
Rapid incrase in pressure
Severe eye pain redness blurred vision headache nausea visual haloes
Closed angle glaucoma narrow
Open angle glaucoma~most
common
Because the vision loss is gradual, usu. Bilateral and asymmetrical the patient usually present when severe damage has occurred & Its painless .
Most patients are detected by optometrist routine examination. Other sign is disck cupping .
Visual field defect : Gradual loss of peripheral vision, usually in both eyes, Tunnel vision in the advanced stages
Symptoms
Definition
Pathophysiology
Classification and symptom
Diagnosis
treatment
IOP
Viual field
Look for optic nerve :direct observation
imaging{cupping}
Diagnosis
Thining the outer rim of
nerve
POAG criteria: (you need 2 out
of 3)
POAG criteria: (you need 2 out of 3) 1. IOP 2. Visual field changes 3. Optic nerve damage (cupping) Cupping takes place first then the visual field changes.
Visual field changes: 1) nasal step 2) arcuate scotoma 3) tunnel vision 4) blurring in central vision
POAG: Primary open angle glaucoma
The optic disc marks the exit point of the retinal nerve fibers from the eye. With a sustained rise in IOP the nerve fibers atrophy, leaving the characteristic sign of chronic
glaucoma—the cupped, pale optic disc.
Optic disc cupping
Definition
Pathophysiology
Classification and symptom
Diagnosis
Treatment
Aim of treatment is to decrease the IOP Amount of decrease depends on the level at which no more damage to the optic nerve happens .
This level differs from patient to other
Modalities :
1- Medical Treatment
2- Laser Treatment
3- Surgical Treatment
Management:
Decrease production of aqueous humor
Increase outflow of aqueous humor
Increase outflow and Decrase production
Medical Treatment
Beta adrenergic receptor antagonist
Prostaglandin analogis
Alpha adrenergic
agonist
Trabeculoplasty Open trabecular meshwork for open angle glaucoma
Iridotomy Use laser to puch a tiny hole in iris to treat close angle glaucoma
Surgical Treatment
Definition
Pathophysiology
Classification and symptom
Diagnosis
treatment
