2. Relevant anatomy and
physiology
The canal permits fluid to drain out of the eye into
the systemic circulation so a constant intraocular
pressure is maintained.
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6. CLASSIFICATION
(By the anatomic size of the anterior chamber angle)
Open – Angle Glaucoma ( wide)
Angle – Closure Glaucoma
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10. Due to etiological factors
Increased IOP
Compress and damage optic nerve
It fails to carry visual information to the
brain
Results in loss of vision
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11. SIGNS & SYMPTOMS
Eye Pain
Gradual loss of peripheral vision followed by
loss of vision in the end stage
Blurred vision
Rainbow halos around light
Nausea vomiting sometimes, accompanied
by abdominal pain
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12. Redness of the sclera & conjunctiva
Increased IOP
Tunnel Vision
Difficulty to focusing on near or distant
objects
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13. Squinting Or Blinking
Red – Rimmed , Encrusted Or Swollen Lids
Double Vision
Excess Tearing Or Watery Eyes
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15. Gonioscopy: is using a
goniolens together with a
slit lamp or operating
microscope to view the
iridocorneal angle, or the
anatomical angle formed
between the eye's cornea
and iris
Opthalmoscopy:Visualiza
tion of the retina
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16. Perimetry Test: A
visual field test is an eye
examination that can
detect dysfunction in
central and peripheral
vision
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17. Dilated Eye Exam:
examine the health of the
optic nerve and retina.
Slit-lamp examination:
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18. MEDICAL MANAGEMENT
Antiglaucoma medications
Cholinergies: Decrease formation & increase outflow of
aqeous humor. Widens trabecular meshworks. E.g.
pilocarpine, carbachol.
Anticholinergies: Contracts ciliary muscles, which
facilitatets outflow of aqueous humor. E.g. Ecothiophate
iodide, physostigmine.
Adrenergic agonist: Inhibits aqueos production &
facilitates outflow. E.g. Epinephrine, Divirfrin.
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19. Beta-Adrenergic Antagonists (Sympathometics):
Reduces aquueous humor formation & may increase
outflow.E.g. Tilmolo, Betaxolol.
Carbonic anhydrase inhibitors: Decreases aqueous
production by inhibiting carbonic anhydrase in the ciliary
body. E.g. Acetazolamide, Methozolamide.
Hypersomatic agents: Movement of water from
introcular structures to circulation via plasma osmolarity.
E.g. Glycerine, Mannitol
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21. Laser procedure
Laser Trabeculoplasty: It is done on an argon laser
equipped slit lamp, using a Goldmann gonioscope lens
mirror. Specifically, argon laser is used to improve
drainage through the eye's trabecular meshwork, from
which the aqueous humour drains.
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22. Argon & krypton
peripheral iridoplasty is a useful procedure to
eliminate appositional angle closure. The laser is
applied at the iris periphery. Heat from laser
creates iris stromal shrinkage and mechanically
pulls away iris tissue from trabecular meshwork.
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23. Laser iridotomy
laser iridotomy is to allow an equalization of pressure
between the anterior (front) and posterior (back) chambers
of the eye by making a hole in the superior peripheral iris.
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24. Viscocanalostomy
• Viscocanalostomy is a non-penetrating procedure
aimed at increasing the outflow facility by creating
significant morphologic changes at the trabecular
meshwork level. It is an effective procedure in
lowering intraocular pressure (IOP) in open-angle
glaucomatous eyes.
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25. Filtering procedures
Trephine: Step by step operative procedure to
correct strabismus (resection of the right internal
rectus muscle) and resection and advancement of
right external rectus muscle.
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26. SCLERECTOMY
• This surgery works by building up new
outflow pathways for the drainage of the
aqueous humor while maintaining the
integrity of the anterior chamber
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28. TRABECULECTOMY
• Trabeculectomy: This is achieved by making
a small hole in the eye wall (sclera), covered
by a thin trap-door in the sclera.
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29. FILTERING TUBES AND
IMPLANTS
Aqueous shunts or glaucoma drainage devices
(GDD) are artificial filtering devices which
lower the intraocular pressure (IOP) by
draining aqueous humor to the external
subconjunctival space.
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30. CYCLOCRYOTHERAPY
It is a procedure that employs temperatures as low as
-112°F (-80°C) to destroy the ciliary body. Ablation, or
destruction, of part of the ciliary body lowers the IOP
by decreasing the fluid or aqueous humor within the
eye and thus helping to control glaucoma.
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31. CYCLODIALYSIS
• Cyclodialysis is the result of the separation of
the longitudinal ciliary muscle fibers from the
scleral spur, which creates an abnormal
pathway for aqueous humor drainage that may
lead to ocular hypotony. (Spatula)
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