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Neovascular glaucoma

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  • CHANGE TITLE
  • Sudden blurring of vision of both eyes… the exact date not known. Basta the patient noted that he can still see properly during the barangay elections which was last week of October Worse at nightEye pain OSNo medications were taken No consult was done
  • Symptoms persisted which prompted consult in another institution where he was diagnosed to have mature cataract of both eyeHe was being worked up for hypertension and lab tests were requested but due to financial constraints, he was not able to do them
  • Few days after that consult the patient’s left eye became red and very painful. He can only perceive light. This prompted him to consult our institution for the first time
  • Few days after that consult the patient’s left eye became red and very painful. He can only perceive light. This prompted him to consult our institution for the first time
  • Asthma and/or COPD – limit the use of topical beta blockersSystemic hpn – systemic beta blocers may mask elevated IOPDiabetes – increasingly prevalent and associate with open angle and neovascular glaucomaUrinary stones – limit systemic carbonic anhydrase inhibitors
  • Asthma and/or COPD – limit the use of topical beta blockersSystemic hpn – systemic beta blocers may mask elevated IOPDiabetes – increasingly prevalent and associate with open angle and neovascular glaucomaUrinary stones – limit systemic carbonic anhydrase inhibitors
  • Asthma and/or COPD – limit the use of topical beta blockersSystemic hpn – systemic beta blocers may mask elevated IOPDiabetes – increasingly prevalent and associate with open angle and neovascular glaucomaUrinary stones – limit systemic carbonic anhydrase inhibitors
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  • Full and equal
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  • Aqueous humour is secreted into the posterior chamber by the ciliary body, specifically the non-pigmented epithelium of the ciliary body(pars plicata). It flows through the narrow cleft between the front of the lens and the back of the iris, to escape through the pupil into the anterior chamber, and then to drain out of the eye via the trabecular meshwork. From here, it drains into Schlemm's canal by one of two ways: directly, via aqueous vein to the episcleral vein, or indirectly, via collector channels to the episcleral vein by intrascleral plexus and eventually into the veins of the orbit.[edit]
  • almost always ischemic in nature. Under hypoxic conditions, diffusible angiogenic factors, including vascular endothelial growth factor, have been detected in the human and animal retina and vitreous, promoting new vessel growth. Clinically, the three most common conditions responsible for NVG are diabetic retinopathy, central retinal vein occlusion and carotid artery obstructive disease.Anterior segment neovascularization involving the iris, the angle or both is accompanied by the formation of a fibrovascular membrane that is seen histologically.
  • This membrane initially obstructs the aqueous outflow through the trabecular meshwork and results in open-angle glaucoma, which may be amenable to pharmacological management of the elevated IOP as the disease progresses, the proliferating myofibroblasts of the fibrovascular membrane contract, leading to ectropionuveae, peripheral anterior synechiae and, ultimately, total synechial angle closure. This stage is not reversible by PRP. The resultant secondary glaucoma is often refractory to pharmacological management and requires surgical intervention.
  • three most common conditions responsible for NVG are diabetic retinopathy, central retinal vein occlusion and carotid artery obstructive disease.
  • Intravenous fluorescein angiogram and electroretinography (ERG) to assess retinal ischemiaB-scan ultrasoundOptical coherence tomography2- Images observed per grade of neovascular glaucomaGrade 1: No modificationGrade 2: A slightly hyper-reflective linear iris secondary to neovascularizationGrade 3: A thickened hyper-reflective iridocorneal angle with possible iridocorneal synechiaeGrade 4: Closed iridocorneal angle associated with iris contraction and uveae ectropion
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  • Transcript

    • 1. Ophtha Case Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8
      Ateneo School of Medicine and Public Health
    • 2. Identifying data
      VR, 59 yr old male
      Blurring of vision, OU
      Informant reliability: 80%
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 3. History of Present Illness
      VR, 59 yr male
      Chief complaint: blurring of vision, OU
      1 month PTC
      • Sudden blurring of vision, OU
      • 4. Worse at night
      • 5. With an associated eye pain, OS
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 6. History of Present Illness
      VR, 59 yr male
      Chief complaint: blurring of vision, OU
      1 month PTC
      • Sudden blurring of vision, OU
      • 7. Worse at night
      • 8. With an associated eye pain, OS
      2 weeks PTC
      • Diagnosed to have mature cataract, OU in another institution
      • 9. Financial constraints prevented him to have lab tests done
      • 10. Given anti-hypertensive meds
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 11. History of Present Illness
      VR, 59 yr male
      Chief complaint: blurring of vision, OU
      1 month PTC
      • Sudden blurring of vision, OU
      • 12. Worse at night
      • 13. With an associated eye pain, OS
      2 weeks PTC
      • Diagnosed to have mature cataract, OU in another institution
      • 14. Financial constraints prevented him to have lab tests done
      • 15. Anti-hypertensive drugs given
      1 week PTC
      • Patient’s left eye became red and painful until vision was only light perception
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 16. History of Present Illness
      VR, 59 yr male
      Chief complaint: blurring of vision, OU
      1 month PTC
      • Sudden blurring of vision, OU
      • 17. Worse at night
      • 18. With an associated eye pain, OS
      2 weeks PTC
      • Diagnosed to have mature cataract, OU in another institution
      • 19. Financial constraints prevented him to have lab tests done
      • 20. Anti-hypertensive drugs given
      1 week PTC
      • Patient’s left eye became red and painful until vision was only light perception
      2 days PTC
      • Consult at this institution
      • 21. T/C ARMD, OD and Narrow angle glaucoma, OS
      • 22. Given Acetazolamide250 mg 2 tabs then TID for 3 days
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 23. Review of Systems
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      No history of trauma
      No weight loss
      No cough and cold
      No rashes
      No changes in hair/nails
      No changes in color
      No tinnitus
      No nosebleeds
      No hemoptysis
      No chest pain
      No syncope
      No changes in bowel habits
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 24. Past Medical History
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      No known history of asthma and/or COPD
      No known history of diabetes
      No known history of urinary stones
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 25. Past Medical History
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Medications:
      Losartan and Betahistine
      Acetazolamide 250 mg 2 tab, then 3x/day for 3 days
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 26. Family History
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Paternal history of Pulmonary tuberculosis
      Maternal history of Diabetes mellitus
      Maternal history of Hypertension
      No known family history of the following:
      - cancer
      - stroke
      - asthma
      - allergies
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 27. Personal and Social History
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Inactive carpenter
      43 pack year smoker
      Non-alcohol beverage drinker
      Lives with his wife
      Has four children with families of their own
      Poor health-seeking behavior
      Financial constraints
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 28. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Awake, ambulatory,
      not in cardiorespiratory distress
      BP: 160/80 (hypertensive)
      HR: 75(normal)
      RR: 20 (normal)
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 29. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      HENNT
      No TPC, No CLAD
      Neck veins not dilated
      Intact tympanic membrane
      Midline septum, no discharge
      No neck rigidity
      Dry lips, moist buccal mucosa
      Nonhyperemic pharynx
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 30. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Chest/Lungs
      Symmetrical chest expansion
      Resonant on percussion
      Equal tactile and vocal fremiti
      No retractions
      No rales
      No wheezes
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 31. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Heart
      Adynamicprecordium
      No heaves or thrills
      Apex beat is at 5th ICS MCL
      Normal rate, regular rhythm
      No murmurs
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 32. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Abdomen
      Flat, soft abdomen
      No tenderness
      No organomegaly
      No masses
      Normoactive bowel sounds
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 33. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Extremities
      Full pulses
      No edema, no cyanosis
      Good turgor
      No rashes, no lesions
      Equally distributed hair
      No clubbing
      CRT <2sec
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 34. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Neuro
      Awake, cooperative, coherent
      Motor: 5/5 on all extremities
      Sensory: 100% on all extremities
      Gait: normal, very slow
      GCS 15
      Cranial Nerves: intact
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 35. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Ophthalmologic
      Visual Acuity
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 36. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      Ophthalmologic
      Gross Examination
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 37. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      mid-dilated, poorly reactive, OS
      Ophthalmologic
      Gross Examination
      OS
      OD
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 38. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      mid-dilated, poorly reactive, OS
      Ophthalmologic
      Extra-ocular Movements
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 39. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      mid-dilated, poorly reactive, OS
      Ophthalmologic
      Tonometry
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 40. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      Mid-dilated, poorly reactive, OS
      Increased IOP, OS
      Ophthalmologic
      Fundoscopy
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 41. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      Mid-dilated, poorly reactive, OS
      Increased IOP, OS
      Ophthalmologic
      Neovascularization, OS
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 42. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      Mid-dilated, poorly reactive, OS
      Increased IOP, OS
      Iris neovascularization, OS
      Ophthalmologic
      Optic nerve
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 43. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      Mid-dilated, poorly reactive, OS
      Increased IOP, OS
      Iris neovascularization, OS
      Ophthalmologic
      Peripheral anterior synechiae with trabecular meshwork seen
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 44. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      Mid-dilated, poorly reactive, OS
      Increased IOP, OS
      Iris neovascularization, OS
      Ophthalmologic
      Closed angle
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 45. Physical Examination
      VR, 59 yr male
      CC: blurring of vision, OU
      Eye pain, OS
      Diagnosed with cataract, OU
      T/C ARMD, OD
      T/C Narrow angle glaucoma, OS
      Unknown history of hypertension
      2 months PTC, patient had right sided weakness
      No history of ocular trauma
      Family history of PTB, DM, hypertension
      Hypertensive
      Light perception, OS
      Mid-dilated, poorly reactive, OS
      Increased IOP, OS
      Iris neovascularization, OS
      Ophthalmologic
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 46. Salient Features
      • 59 year old male
      • 47. CC: blurring of vision, OU
      • 48. Eye pain, OS
      • 49. Unknown history of hypertension
      • 50. 2 months PTC, patient had right sided weakness
      • 51. No history of ocular trauma
      • 52. Family history of PTB, DM, hypertension
      • 53. Hypertensive
      • 54. Light perception, OS
      • 55. Mid-dilated, poorly reactive, OS
      • 56. Increased IOP, OS
      • 57. Iris neovascularization, OS
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 58. Salient Features
      Neovascular Glaucoma
      • 59 year old male
      • 59. CC: blurring of vision, OU
      • 60. Eye pain, OS
      • 61. Unknown history of hypertension
      • 62. 2 months PTC, patient had right sided weakness
      • 63. No history of ocular trauma
      • 64. Family history of PTB, DM, hypertension
      • 65. Hypertensive
      • 66. Light perception, OS
      • 67. Mid-dilated, poorly reactive, OS
      • 68. Increased IOP, OS
      • 69. Iris neovascularization, OS
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 70. Differential Diagnosis
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 71. At the OPD
      Brimonidinetartrate
      Possible valve implant, OS
      Anti-VEGF injection, OS
      CP clearance
      Hypertension work-up (IM referral)
      HPN Stage II
      BP Monitoring for two weeks
      Captopril 25 mg ½ tab OD
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 72. Signs and Symptoms
      • classified as a secondary glaucoma
      • 73. historically, it has been referred to as hemorrhagic glaucoma, thrombotic glaucoma, congestive glaucoma, rubeotic glaucoma, and diabetic hemorrhagic glaucoma
      • 74. secondary ocular and systemic diseases that share one common element, retinal ischemia/hypoxia and subsequent release of an angiogenesis factor
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 75. Pathophysiology
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 76. Pathophysiology
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 77. Pathophysiology
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 78. Pathophysiology
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 79. Diagnostics
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 80. Treatment
      Goals of treatment
      • reducing elevated IOP
      • 81. treating the underlying disease that led to the ischemic insult
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 82. Treatment
      • Panretinal photocoagulation
      • 83. Medical treatment
      • 84. Anti-VEGF therapy
      • 85. Surgical intervention
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 86. Treatment
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 87. Treatment
      • Surgical intervention
      • 88. Valve implant
      • 89. Trabeculectomy
      OphthaCase Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8, Ateneo School of Medicine and Public Health
    • 90. Ophtha Case Presentation
      By: Cristal Ann G. Laquindanum
      Year Level 8
      Ateneo School of Medicine and Public Health