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Case study- Glaucoma

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Case Study of the Biochemistry of Glaucoma

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Case study- Glaucoma

  1. 1. Katherine Brastad CASE STUDY: GLAUCOMA
  2. 2. - Katie, a 38 year old female, presented in private practice for an examination. Her main presenting symptom was having difficulty with reading fine print and general blurriness in sight. - Previous ocular history: She had been prescribed spectacles in her early twenties for reading. Distance vision is quite clear and she is currently using hobby glasses to read more comfortably. - Personal Medical History: No reported medical conditions, with no prescribed medication being taken. - Family Medical and Ocular History: No reported history of glaucoma, cataracts, unusual eye conditions, blindness, heart or blood pressure problems, or diabetes. CLINICAL HISTORY
  3. 3. WHAT TESTS WOULD YOU RUN TO CONFIRM A DIAGNOSIS?
  4. 4. Measure the pressure in your eye (tonometry) - Tonometer- measures eye pressure. - Normal eye pressure generally ranges between 10 and 21 mmHg - Glaucoma can have damage to their optic nerve lower than 21 mmHg. Inspect your optic nerve (ophthalmoscopy) - Inspects your optic nerve for signs of damage using an ophthalmoscope Test your side, or peripheral, vision (visual field test) - The visual field test will check for blank spots in your vision Measure the thickness of your cornea — the clear window at the front of the eye (pachymetry) - A very thin cornea may increase your risk of glaucoma. TESTING
  5. 5. WHAT WOULD YOUR INITIAL DIAGNOSIS BE?
  6. 6. Glaucoma is the result of damage to the optic nerve. As this nerve gradually deteriorates, blind spots develop in your visual field. For reasons that doctors don't fully understand, this nerve damage is usually related to increased pressure in the eye. Elevated eye pressure is due to a buildup of a fluid (aqueous humor) that flows throughout your eye. This fluid normally drains into the front of the eye (anterior chamber) through tissue (trabecular meshwork) at the angle where the iris and cornea meet. When fluid is overproduced or the drainage system doesn't work properly, the fluid can't flow out at its normal rate and pressure builds up. Glaucoma is one of the leading causes of blindness in the United States. It can occur at any age but is more common in older adults and tends to run in families. In some people, scientists have identified genes related to high eye pressure and optic nerve damage. GLAUCOMA
  7. 7. NORMAL VS GLAUCOMIC EYE
  8. 8. Taken from a PubMed journal, it has been found that several observations noted by early investigators supported the supposition that in most cases, congenital glaucoma is determined by genetic factors. The genetic heterogeneity of PCG was confirmed by genetic linkage studies conducted in the 1990s when the authors determined that CYP1B1 is the congenital glaucoma gene at the GLC3A locus. The coding sequence of CYP1B1 has been subjected to extensive screening in familial and sporadic cases of glaucoma from numerous countries and from a large number of ethnic groups. These studies have provided evidence for extensive allelic heterogeneity at the GLC3A locus. This article also discusses the molecular evidence for reduced penetrance in congenital glaucoma and the phenotypic heterogeneity of CYP1B1 mutations, mouse models of CYP1B1, and the biochemistry of CYP1B1. GENETICS AND BIOCHEMISTRY
  9. 9. Medications: - Glaucoma medication: Lowers eye pressure. - Beta blocker: Slows heart rate and decreases blood pressure. When taken in eye-drop form, it reduces eye pressure. Surgery: - Laser surgery: Surgery using an intensely hot and focused beam of light to remove tissue and control bleeding. Medical procedure: - Trabeculoplasty: Using a laser to improve fluid drainage in the eye and reduce eye pressure. TREATMENTS
  10. 10. https://www.google.com/search?q=glaucoma&rlz=1C1CHWA_enUS564US5 64&espv=2&biw=1366&bih=638&source=lnms&tbm=isch&sa=X&ved=0ah UKEwif3t3S6YHRAhVKNiYKHT-cA5QQ_AUIBigB&dpr=1#imgrc=Ca- 1emSEHeDEsM%3A https://www.ncbi.nlm.nih.gov/pubmed/14740995 http://www.webmd.com/eye-health/glaucoma-eyes CITATIONS

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