These slides were prepared by me when teaching undergraduates. They are basically for MBBS level.

1. Secondary glaucomaSecondary glaucoma
associated with lens disordersassociated with lens disorders
glaucoma capsulareglaucoma capsulare
 PseudoexfoliationPseudoexfoliation
syndromesyndrome
 Exfoliative materialExfoliative material
 Glaucoma due toGlaucoma due to
deposits of fibrillardeposits of fibrillar
basement membranebasement membrane
material on TBMmaterial on TBM
 Treatment as in POAGTreatment as in POAG

2. Secondary glaucomaSecondary glaucoma
lens disorderslens disorders
phacomorphic glaucomaphacomorphic glaucoma
 Swollen intumescentSwollen intumescent
lens causes pupillarylens causes pupillary
blockblock
 Control of IOP followedControl of IOP followed
by lens extractionby lens extraction

3. Secondary glaucomaSecondary glaucoma
lens disorderslens disorders
phacolytic glaucomaphacolytic glaucoma
 Due to micro leak of lensDue to micro leak of lens
protein in hypermature /protein in hypermature /
mature cataractmature cataract
 Lens particle loadedLens particle loaded
macrophages block themacrophages block the
TBMTBM
 Control of IOP and lensControl of IOP and lens
extractionextraction

4. Secondary glaucomaSecondary glaucoma
lens disorderslens disorders
phaco anaphylacticphaco anaphylactic
 Associated with latentAssociated with latent
period during whichperiod during which
sensitization to lenssensitization to lens
protein occursprotein occurs
 Seen more commonly inSeen more commonly in
young patientsyoung patients
 Control of IOP and uveitisControl of IOP and uveitis

5. Secondary glaucomaSecondary glaucoma
lens disorderslens disorders
ectopia lentisectopia lentis
 Secondary glaucoma dueSecondary glaucoma due
to congenital, traumatic orto congenital, traumatic or
spontaneous lensspontaneous lens
subluxation or dislocation.subluxation or dislocation.
 Mechanism: pupillaryMechanism: pupillary
block, angle closure orblock, angle closure or
phacolyticphacolytic

6. Secondary glaucomaSecondary glaucoma
pigmentary glaucomapigmentary glaucoma
 Young myopic patientsYoung myopic patients
 Secondary open angleSecondary open angle
glaucoma due to pigmentaryglaucoma due to pigmentary
obstruction of TBMobstruction of TBM
 Krukenburg’s spindleKrukenburg’s spindle
 Retroillumination: radial spokeRetroillumination: radial spoke
like defects in the irislike defects in the iris
 Treatment as in POAGTreatment as in POAG

7. Secondary glaucomaSecondary glaucoma
Neovascular glaucomaNeovascular glaucoma
 Rubeosis iridis associated withRubeosis iridis associated with
glaucomaglaucoma
 Seen in conditions:Seen in conditions:
Diabetic retinopathyDiabetic retinopathy
CRVOCRVO
Sickle cell retinopathySickle cell retinopathy
ROPROP
Treatment: Control of IOP,Treatment: Control of IOP,
photocoagulation with Trabphotocoagulation with Trab

8. Secondary glaucomaSecondary glaucoma
neovascularisationneovascularisation

9. Secondary glaucomaSecondary glaucoma
inflammatoryinflammatory

10. Secondary glaucomaSecondary glaucoma
uveitisuveitis
 Due to plasmoid aqueous andDue to plasmoid aqueous and
cells obstructing the anglecells obstructing the angle
 In chronic due to posteriorIn chronic due to posterior
synechia/goniosynechiasynechia/goniosynechia
 TreatmemtTreatmemt
control of IOPcontrol of IOP
control of uveitiscontrol of uveitis

11. Secondary glaucomaSecondary glaucoma
uveitisuveitis

12. Secondary glaucomaSecondary glaucoma
after cataract surgeryafter cataract surgery

13. Secondary glaucomaSecondary glaucoma
corneal ulcercorneal ulcer

14. Secondary glaucomaSecondary glaucoma
cataract surgerycataract surgery
epithelial downgrowthepithelial downgrowth

15. Secondary glaucomaSecondary glaucoma
cataract surgerycataract surgery

16. Secondary glaucomaSecondary glaucoma
cataract surgerycataract surgery
pupillary blockpupillary block

17. Secondary glaucomaSecondary glaucoma
traumatic hyphematraumatic hyphema

18. Secondary glaucomaSecondary glaucoma
traumatic lens dislocationtraumatic lens dislocation

19. Secondary glaucomaSecondary glaucoma
Sturge-Weber syndromeSturge-Weber syndrome

20. Secondary glaucomaSecondary glaucoma
high episcleral venous pressurehigh episcleral venous pressure

21. Secondary glaucomaSecondary glaucoma
hyperthyroidhyperthyroid

22. Secondary glaucomaSecondary glaucoma
high episcleral venous pressurehigh episcleral venous pressure

23. Secondary glaucomaSecondary glaucoma
Steroid inducedSteroid induced
 Secondary open angle glaucomaSecondary open angle glaucoma
 Usually following topical therapy in high responders (marked rise ofUsually following topical therapy in high responders (marked rise of
IOP after about 6 wks of steroid therapy), occasionally occurs afterIOP after about 6 wks of steroid therapy), occasionally occurs after
systemic therapy alsosystemic therapy also
 Deposition of mucopolysaccharides in the TBMDeposition of mucopolysaccharides in the TBM
 Typically resembles POAGTypically resembles POAG
 Judicious use of steroids is advocated to avoid above complicationJudicious use of steroids is advocated to avoid above complication
 Discontinue steroids, IOP will get down in 10days-4 wks periodDiscontinue steroids, IOP will get down in 10days-4 wks period
 Timolol maleate may be used if requiredTimolol maleate may be used if required
 Surgery in intractable casesSurgery in intractable cases

24. Secondary glaucomaSecondary glaucoma
causes of high episcleral venous pressurecauses of high episcleral venous pressure

25. Secondary glaucomaSecondary glaucoma
venous drainagevenous drainage

26. Secondary glaucomaSecondary glaucoma
ICE syndromeICE syndrome

27. Secondary glaucomaSecondary glaucoma
Inflammatory glaucomaInflammatory glaucoma