Primary congenital glaucoma is caused by abnormalities in the trabecular meshwork that result in elevated intraocular pressure. It presents in infants younger than 4 years old with symptoms of epiphora, photophobia, and blepharospasm due to corneal edema. On examination, signs include elevated IOP, corneal enlargement with Haab striae, and progressive optic nerve cupping. The main treatment is surgical, with goniotomy or trabeculotomy as first line options, and trabeculectomy or glaucoma drainage devices for refractory cases. Prognosis depends on degree of corneal scarring, anisometropia, amblyopia, and optic nerve
Glaucoma is a group of eye disorders characterized by optic nerve damage and vision loss caused by increased pressure in the eye. The document discusses the definition, epidemiology, causes, clinical features, diagnosis, and management of primary open angle glaucoma and primary angle-closure glaucoma. Key points include that glaucoma has various clinical manifestations, causes include blockage of aqueous outflow, signs involve optic nerve changes and visual field loss, and treatment aims to lower intraocular pressure through medication, laser treatment, or surgery.
This document provides an overview of glaucoma, including:
1. Definitions of glaucoma, classifications, examination methods, primary open angle glaucoma, primary angle closure glaucoma, and glaucoma surgeries.
2. Details on the anatomy of the eye related to aqueous humor production and drainage, as well as the causes and mechanisms of increased intraocular pressure in glaucoma.
3. Risk factors, clinical features, and management approaches for primary open angle glaucoma and primary angle closure glaucoma. Surgical management via trabeculectomy and laser trabeculoplasty is also discussed.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Congenital-glaucoma presention thired year .pptxsadiq90000000
This document provides an introduction to glaucoma and congenital glaucoma. It defines glaucoma as a group of disorders characterized by progressive optic neuropathy and visual field defects, often with elevated intraocular pressure. Congenital glaucoma is defined as developmental abnormalities of the anterior chamber angle leading to elevated pressure. The document classifies glaucoma, discusses the pathogenesis, clinical presentation, examination, and management of congenital glaucoma, including surgical options like goniotomy and trabeculotomy.
This document provides an overview of glaucoma, including congenital glaucoma. It begins by defining the angle of the anterior chamber and classifying glaucoma. Primary glaucoma includes open angle, angle closure, and childhood glaucomas. Congenital glaucoma is usually caused by developmental abnormalities of the anterior chamber angle. Clinical presentation includes eye rubbing, tearing, enlarged eyes and corneal signs. Diagnosis involves examination under anesthesia and imaging the anterior chamber angle. Treatment priorities are glaucoma surgery to improve aqueous outflow, such as goniotomy or trabeculotomy. Refractory cases may require drainage devices or cyclodestructive procedures to lower pressure. The goal of management is preserving vision through
This document discusses primary open-angle glaucoma (POAG), including its definition, risk factors, prevalence, characteristics, symptoms, signs, progression, evaluations methods, and treatment options. POAG is the most common type of glaucoma, has no known cause but may be genetic or due to poor circulation. Treatments include pharmaceutical options like beta-blockers, prostaglandins, and surgery. The goal of treatment is to lower intraocular pressure to prevent further optic nerve damage and vision loss.
Glaucoma is a group of eye disorders characterized by optic nerve damage and vision loss caused by increased pressure in the eye. The document discusses the definition, epidemiology, causes, clinical features, diagnosis, and management of primary open angle glaucoma and primary angle-closure glaucoma. Key points include that glaucoma has various clinical manifestations, causes include blockage of aqueous outflow, signs involve optic nerve changes and visual field loss, and treatment aims to lower intraocular pressure through medication, laser treatment, or surgery.
This document provides an overview of glaucoma, including:
1. Definitions of glaucoma, classifications, examination methods, primary open angle glaucoma, primary angle closure glaucoma, and glaucoma surgeries.
2. Details on the anatomy of the eye related to aqueous humor production and drainage, as well as the causes and mechanisms of increased intraocular pressure in glaucoma.
3. Risk factors, clinical features, and management approaches for primary open angle glaucoma and primary angle closure glaucoma. Surgical management via trabeculectomy and laser trabeculoplasty is also discussed.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Congenital-glaucoma presention thired year .pptxsadiq90000000
This document provides an introduction to glaucoma and congenital glaucoma. It defines glaucoma as a group of disorders characterized by progressive optic neuropathy and visual field defects, often with elevated intraocular pressure. Congenital glaucoma is defined as developmental abnormalities of the anterior chamber angle leading to elevated pressure. The document classifies glaucoma, discusses the pathogenesis, clinical presentation, examination, and management of congenital glaucoma, including surgical options like goniotomy and trabeculotomy.
This document provides an overview of glaucoma, including congenital glaucoma. It begins by defining the angle of the anterior chamber and classifying glaucoma. Primary glaucoma includes open angle, angle closure, and childhood glaucomas. Congenital glaucoma is usually caused by developmental abnormalities of the anterior chamber angle. Clinical presentation includes eye rubbing, tearing, enlarged eyes and corneal signs. Diagnosis involves examination under anesthesia and imaging the anterior chamber angle. Treatment priorities are glaucoma surgery to improve aqueous outflow, such as goniotomy or trabeculotomy. Refractory cases may require drainage devices or cyclodestructive procedures to lower pressure. The goal of management is preserving vision through
This document discusses primary open-angle glaucoma (POAG), including its definition, risk factors, prevalence, characteristics, symptoms, signs, progression, evaluations methods, and treatment options. POAG is the most common type of glaucoma, has no known cause but may be genetic or due to poor circulation. Treatments include pharmaceutical options like beta-blockers, prostaglandins, and surgery. The goal of treatment is to lower intraocular pressure to prevent further optic nerve damage and vision loss.
POAG and PACG are two major types of glaucoma. POAG is caused by increased intraocular pressure due to improper drainage of fluid from the eye. It progresses slowly and causes damage to the optic nerve and visual field loss over time. PACG occurs when the iris blocks the drainage angle, often in hyperopic eyes, and can progress more rapidly. Treatment options include medications, laser therapy, and surgery to lower pressure and prevent further vision loss. Regular eye exams are important for early detection and management of glaucoma.
This document provides an overview of the approach to glaucoma, including its classification, clinical evaluation, investigations, and principles of management. It begins by defining glaucoma and describing its causes. Clinical evaluation involves taking a thorough medical history and performing examinations of the eye, including visual acuity, visual fields, gonioscopy, and evaluation of the optic nerve head. Glaucoma is classified based on age of onset, etiology, and iridocorneal angle assessment. Proper clinical evaluation and classification are important for developing an appropriate management plan for glaucoma.
Glaucoma presentation for ophthalmology course, presented as a student seminar. Class location: ophthalmology unit, An-Najah National University Hospital.
This document provides information about primary open-angle glaucoma (POAG):
- It defines POAG as a chronic, progressive optic neuropathy characterized by an open anterior chamber angle and elevated intraocular pressure.
- Risk factors, clinical presentation, diagnosis, differential diagnosis, evaluation, and treatment options are discussed. Treatment may involve medications, laser trabeculoplasty, or glaucoma surgery with the goal of reducing intraocular pressure to halt optic nerve damage.
- Two case studies are presented to exemplify the evaluation and treatment of patients with POAG.
This document provides an overview of glaucoma, including its definition, causes, risk factors, symptoms, diagnostic tests, treatment options, and post-operative complications. Glaucoma is an eye disease where damage to the optic nerve leads to vision loss. It is often caused by abnormally high pressure within the eye. Diagnostic tests include visual field testing, tonometry, ophthalmoscopy and gonioscopy. Treatment may involve eye drops, oral medication, laser procedures or surgery to improve fluid drainage from the eye. Surgical options include trabeculectomy, laser treatments, and the use of aqueous shunt devices. Post-operative risks include infection, shallow anterior chamber and over or under filtration of fluid from the eye
Acute Congestive Glaucoma / Optic Neuritis / Painful Loss Of Vision by Dr. Mu...Zeeshan Hameed
About Author:
Dr. Muhammad Zeeshan Hameed MBBS,FCPS(Resident Eye Surgeon)
GMC/DHQ Teachng Hosptal, Gujranwala Pakistan.
About Presentation:
This presentation covers the complete topic of acute congestive glaucoma, optic neuritis and ddx of sudden painful loss of vision
Glaucoma is an optic neuropathy characterized by cupping of the optic disc and loss of visual field. It is usually associated with increased intraocular pressure (IOP). If left untreated, glaucoma can lead to irreversible blindness. There are several types of glaucoma including open-angle glaucoma, angle-closure glaucoma, congenital glaucoma, and secondary glaucoma caused by injuries, infections, tumors or inflammation. Treatment options include medications, laser treatment, or surgery to lower IOP and prevent further vision loss. The goal is early detection and treatment to preserve sight.
A 24-year-old male presented with blunt trauma to the right eye after being punched 1 week prior without eye protection. On examination, he had a hyphema, traumatic cataract, corneal edema, and uveitis in the right eye. He was managed conservatively with medications, close monitoring, and later referred to a vitreoretinal surgeon. Over subsequent follow ups his condition improved, though he was still advised to limit activity and continue regular monitoring. Blunt ocular trauma can cause various injuries like hyphema, cataract, uveitis, retinal tears or detachment depending on the force and location of impact. Evaluation involves examination to identify injuries and rule out perforating injuries, with
Primary angle closure glaucoma is caused by blockage of the aqueous humor outflow due to closure or narrowing of the anterior chamber angle. It progresses through stages from primary angle closure suspect to acute angle closure to angle closure glaucoma, where glaucomatous optic nerve damage and visual field defects are present. Risk factors include hyperopia, smaller anterior chamber angle, older age, and Asian ethnicity. Treatment begins with intravenous mannitol or glycerol to lower pressure urgently, followed by topical eye drop medications like beta-blockers or pilocarpine. The definitive treatment is laser iridotomy or trabeculectomy surgery to permanently open the drainage angle.
Primary angle closure glaucoma is caused by obstruction of aqueous outflow due to closure of the anterior chamber angle. It is the leading cause of glaucoma blindness worldwide, particularly affecting Asian populations. The angle becomes occluded due to pupillary block or anatomical factors. Acute episodes involve severe eye pain and vision loss from high intraocular pressure. Chronic cases develop optic nerve damage and visual field loss over time if not treated with laser iridotomy or medication to lower pressure and open the angle. Late stage "absolute glaucoma" results in a blind, painful eye requiring aggressive interventions like cycloablation.
This document discusses congenital glaucoma, including its definition, pathogenesis, clinical presentation, diagnosis, differential diagnosis, and treatment. Some key points:
- Congenital glaucoma is caused by abnormal development of the anterior chamber angle resulting in impaired aqueous outflow and raised intraocular pressure in early childhood.
- Clinical signs include enlarged globe, corneal edema, tearing, and high intraocular pressure. Diagnosis involves measuring IOP and examining the anterior chamber angle via gonioscopy.
- The primary treatment is surgical to improve aqueous outflow, such as goniotomy or trabeculotomy. Medical treatment and additional surgeries may also be used to manage the condition.
This document discusses congenital glaucoma, including its definition, pathogenesis, clinical presentation, diagnosis, differential diagnosis, and treatment. Some key points:
- Congenital glaucoma is caused by abnormal development of the anterior chamber angle resulting in impaired aqueous outflow and raised intraocular pressure in early childhood.
- Clinical signs include enlarged globe, corneal edema, tears in Descemet's membrane, and high intraocular pressure.
- Diagnosis involves measuring IOP, corneal diameter, examining the optic disc and performing gonioscopy to evaluate the anterior chamber angle.
- The primary treatment is surgical to relieve pressure, through procedures like goniotomy or trabeculotomy. Medical treatment is temporary.
glaucoma and causes sign symptoms treatmentwajidullah9551
1. Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased intraocular pressure.
2. It can be primary, resulting from increased aqueous humor production or decreased outflow, or secondary, caused by other eye diseases.
3. Treatment involves medications, laser therapy, or surgery to lower pressure and prevent further nerve damage. Proper management can help preserve vision if glaucoma is detected early.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased intraocular pressure. The seminar discussed the definition, types, risk factors, diagnostic measures, management, and nursing care of glaucoma. Primary open-angle glaucoma is the most common type and results from impaired outflow of aqueous humor from the eye. Treatment involves medications, laser surgery, or filtering procedures to lower pressure and prevent further nerve damage. Nursing plays an important role in assessing patients, administering treatments, educating about risk factors and complications like vision loss.
This document discusses several topics related to glaucoma, including:
1. Definitions of ocular hypertension and primary open-angle glaucoma.
2. A study showing that topical medications can reduce the risk of developing glaucoma in patients with ocular hypertension over 5 years compared to observation alone.
3. Potential genetic and medical risk factors for normal tension glaucoma.
4. Treatment options for glaucoma including various topical medications and their mechanisms of action.
This document provides an overview of primary angle-closure glaucoma (PACG). It defines PACG as a type of glaucoma caused by blockage of the aqueous humor outflow due to closure of the anterior chamber angle. The document classifies PACG and discusses its clinical presentations, including latent, subacute, acute, chronic, and absolute forms. Diagnosis involves gonioscopy and provocative tests. Management includes medications, laser iridotomy, and surgery. The goal is to reopen the drainage angle and lower intraocular pressure to prevent vision loss from optic nerve damage.
This slide contains information regarding corneal ulcer and glaucoma. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
This document provides an overview of glaucoma, including:
1. It defines and classifies glaucoma as primary, secondary, or congenital. Primary glaucoma is further divided into open angle and angle closure glaucoma.
2. Examination methods for glaucoma are discussed like tonometry, gonioscopy, optic nerve examination, and visual field testing.
3. Primary open angle glaucoma and primary angle closure glaucoma are defined in more detail, including risk factors, clinical features, and management approaches.
4. Glaucoma surgeries like trabeculectomy and other filtration procedures are briefly discussed.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
POAG and PACG are two major types of glaucoma. POAG is caused by increased intraocular pressure due to improper drainage of fluid from the eye. It progresses slowly and causes damage to the optic nerve and visual field loss over time. PACG occurs when the iris blocks the drainage angle, often in hyperopic eyes, and can progress more rapidly. Treatment options include medications, laser therapy, and surgery to lower pressure and prevent further vision loss. Regular eye exams are important for early detection and management of glaucoma.
This document provides an overview of the approach to glaucoma, including its classification, clinical evaluation, investigations, and principles of management. It begins by defining glaucoma and describing its causes. Clinical evaluation involves taking a thorough medical history and performing examinations of the eye, including visual acuity, visual fields, gonioscopy, and evaluation of the optic nerve head. Glaucoma is classified based on age of onset, etiology, and iridocorneal angle assessment. Proper clinical evaluation and classification are important for developing an appropriate management plan for glaucoma.
Glaucoma presentation for ophthalmology course, presented as a student seminar. Class location: ophthalmology unit, An-Najah National University Hospital.
This document provides information about primary open-angle glaucoma (POAG):
- It defines POAG as a chronic, progressive optic neuropathy characterized by an open anterior chamber angle and elevated intraocular pressure.
- Risk factors, clinical presentation, diagnosis, differential diagnosis, evaluation, and treatment options are discussed. Treatment may involve medications, laser trabeculoplasty, or glaucoma surgery with the goal of reducing intraocular pressure to halt optic nerve damage.
- Two case studies are presented to exemplify the evaluation and treatment of patients with POAG.
This document provides an overview of glaucoma, including its definition, causes, risk factors, symptoms, diagnostic tests, treatment options, and post-operative complications. Glaucoma is an eye disease where damage to the optic nerve leads to vision loss. It is often caused by abnormally high pressure within the eye. Diagnostic tests include visual field testing, tonometry, ophthalmoscopy and gonioscopy. Treatment may involve eye drops, oral medication, laser procedures or surgery to improve fluid drainage from the eye. Surgical options include trabeculectomy, laser treatments, and the use of aqueous shunt devices. Post-operative risks include infection, shallow anterior chamber and over or under filtration of fluid from the eye
Acute Congestive Glaucoma / Optic Neuritis / Painful Loss Of Vision by Dr. Mu...Zeeshan Hameed
About Author:
Dr. Muhammad Zeeshan Hameed MBBS,FCPS(Resident Eye Surgeon)
GMC/DHQ Teachng Hosptal, Gujranwala Pakistan.
About Presentation:
This presentation covers the complete topic of acute congestive glaucoma, optic neuritis and ddx of sudden painful loss of vision
Glaucoma is an optic neuropathy characterized by cupping of the optic disc and loss of visual field. It is usually associated with increased intraocular pressure (IOP). If left untreated, glaucoma can lead to irreversible blindness. There are several types of glaucoma including open-angle glaucoma, angle-closure glaucoma, congenital glaucoma, and secondary glaucoma caused by injuries, infections, tumors or inflammation. Treatment options include medications, laser treatment, or surgery to lower IOP and prevent further vision loss. The goal is early detection and treatment to preserve sight.
A 24-year-old male presented with blunt trauma to the right eye after being punched 1 week prior without eye protection. On examination, he had a hyphema, traumatic cataract, corneal edema, and uveitis in the right eye. He was managed conservatively with medications, close monitoring, and later referred to a vitreoretinal surgeon. Over subsequent follow ups his condition improved, though he was still advised to limit activity and continue regular monitoring. Blunt ocular trauma can cause various injuries like hyphema, cataract, uveitis, retinal tears or detachment depending on the force and location of impact. Evaluation involves examination to identify injuries and rule out perforating injuries, with
Primary angle closure glaucoma is caused by blockage of the aqueous humor outflow due to closure or narrowing of the anterior chamber angle. It progresses through stages from primary angle closure suspect to acute angle closure to angle closure glaucoma, where glaucomatous optic nerve damage and visual field defects are present. Risk factors include hyperopia, smaller anterior chamber angle, older age, and Asian ethnicity. Treatment begins with intravenous mannitol or glycerol to lower pressure urgently, followed by topical eye drop medications like beta-blockers or pilocarpine. The definitive treatment is laser iridotomy or trabeculectomy surgery to permanently open the drainage angle.
Primary angle closure glaucoma is caused by obstruction of aqueous outflow due to closure of the anterior chamber angle. It is the leading cause of glaucoma blindness worldwide, particularly affecting Asian populations. The angle becomes occluded due to pupillary block or anatomical factors. Acute episodes involve severe eye pain and vision loss from high intraocular pressure. Chronic cases develop optic nerve damage and visual field loss over time if not treated with laser iridotomy or medication to lower pressure and open the angle. Late stage "absolute glaucoma" results in a blind, painful eye requiring aggressive interventions like cycloablation.
This document discusses congenital glaucoma, including its definition, pathogenesis, clinical presentation, diagnosis, differential diagnosis, and treatment. Some key points:
- Congenital glaucoma is caused by abnormal development of the anterior chamber angle resulting in impaired aqueous outflow and raised intraocular pressure in early childhood.
- Clinical signs include enlarged globe, corneal edema, tearing, and high intraocular pressure. Diagnosis involves measuring IOP and examining the anterior chamber angle via gonioscopy.
- The primary treatment is surgical to improve aqueous outflow, such as goniotomy or trabeculotomy. Medical treatment and additional surgeries may also be used to manage the condition.
This document discusses congenital glaucoma, including its definition, pathogenesis, clinical presentation, diagnosis, differential diagnosis, and treatment. Some key points:
- Congenital glaucoma is caused by abnormal development of the anterior chamber angle resulting in impaired aqueous outflow and raised intraocular pressure in early childhood.
- Clinical signs include enlarged globe, corneal edema, tears in Descemet's membrane, and high intraocular pressure.
- Diagnosis involves measuring IOP, corneal diameter, examining the optic disc and performing gonioscopy to evaluate the anterior chamber angle.
- The primary treatment is surgical to relieve pressure, through procedures like goniotomy or trabeculotomy. Medical treatment is temporary.
glaucoma and causes sign symptoms treatmentwajidullah9551
1. Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased intraocular pressure.
2. It can be primary, resulting from increased aqueous humor production or decreased outflow, or secondary, caused by other eye diseases.
3. Treatment involves medications, laser therapy, or surgery to lower pressure and prevent further nerve damage. Proper management can help preserve vision if glaucoma is detected early.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased intraocular pressure. The seminar discussed the definition, types, risk factors, diagnostic measures, management, and nursing care of glaucoma. Primary open-angle glaucoma is the most common type and results from impaired outflow of aqueous humor from the eye. Treatment involves medications, laser surgery, or filtering procedures to lower pressure and prevent further nerve damage. Nursing plays an important role in assessing patients, administering treatments, educating about risk factors and complications like vision loss.
This document discusses several topics related to glaucoma, including:
1. Definitions of ocular hypertension and primary open-angle glaucoma.
2. A study showing that topical medications can reduce the risk of developing glaucoma in patients with ocular hypertension over 5 years compared to observation alone.
3. Potential genetic and medical risk factors for normal tension glaucoma.
4. Treatment options for glaucoma including various topical medications and their mechanisms of action.
This document provides an overview of primary angle-closure glaucoma (PACG). It defines PACG as a type of glaucoma caused by blockage of the aqueous humor outflow due to closure of the anterior chamber angle. The document classifies PACG and discusses its clinical presentations, including latent, subacute, acute, chronic, and absolute forms. Diagnosis involves gonioscopy and provocative tests. Management includes medications, laser iridotomy, and surgery. The goal is to reopen the drainage angle and lower intraocular pressure to prevent vision loss from optic nerve damage.
This slide contains information regarding corneal ulcer and glaucoma. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
This document provides an overview of glaucoma, including:
1. It defines and classifies glaucoma as primary, secondary, or congenital. Primary glaucoma is further divided into open angle and angle closure glaucoma.
2. Examination methods for glaucoma are discussed like tonometry, gonioscopy, optic nerve examination, and visual field testing.
3. Primary open angle glaucoma and primary angle closure glaucoma are defined in more detail, including risk factors, clinical features, and management approaches.
4. Glaucoma surgeries like trabeculectomy and other filtration procedures are briefly discussed.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
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Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
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7. Primary congenital glaucoma (PCG) is a disease due to
• Genetically-determined abnormalities in the Trabecular Meshwork and
Anterior Chamber angle .
•Resulting in elevated intraocular pressure (IOP)
•Without other ocular or systemic developmental anomalies.
7
INTRODUCTION
8. •Primary Congenital Glaucoma - most common form of primary
childhood glaucoma.
•It is one of two primary childhood glaucomas that presents in children
younger than 4 years of age
•The other primary childhood glaucoma being - Juvenile Open Angle
Glaucoma.
8
INTRODUCTION
10. •International Classification of Childhood Glaucoma- 2013
There are three variants based on the age of presentation as follows:
•1) Newborn onset (0-1 month)
•2) Infantile onset (>1-24 months)
•3) Late onset or late-recognized (>24 months)
•4) Spontaneously arrested cases (very rare, classic findings of eye
stretching including Haab striae with normal IOP; must follow as
glaucoma suspects nonetheless)
10
INTRODUCTION
14. •Most PCG cases are sporadic (with no family history)
• About 10-40% are familial, with an autosomal recessive inheritance
pattern and penetrance varying from 40-100%. Autosomal dominant
inheritance has also been reported.
•Five loci have been identified by linkage analyses: GLC3A (located on
choromosome 2p22-p21), GLC3B (1p36.2-p36.1), GLC3C (14q24.3),
GLC3D (14q24.2-q24.3, not overlapping with GLC3C), and GLC3E
(9p21).
14
ETIOLOGY
15. 15
PATHOGENESIS
Inc accumulation of collagenous
beams in trabecular spaces
Prevent posterior sliding of ciliary body
&peripheral Iris(normally occurs in 3rd trimester
of intrauterine life)
Anterior insertion of Iris Root and Ciliary
Body
Obstructs TM or Narrows or Competely
obstruct Schlem canal
ANDERSON’S HYPOTHESIS
17. SYMPTOMS:
“Clinical Triad" of symptoms including :
• Epiphora
• Photophobia
•Blepharospasm
•.
17
CLINICAL FEATURES
18. • This triad of symptoms is classically associated with PCG due to the
corneal edema that results from the elevated IOP, and causes
irritation.
• Reduced vision can also occur from corneal edema/opacification or
progressive myopia and/or astigmatism. Amblyopia can further worsen
vision. 18
CLINICAL FEATURES
19. SIGNS :
The main clinical signs of PCG include :
•Elevated IOP >21 mmHg
• Corneal edema and/or
• Enlargement of the eye with buphthalmos
•Haab striae
19
CLINICAL FEATURES
21. Other signs related to the eye distension include:
• Abnormally deep anterior chamber
• Myopia (mainly due to elongation and enlargement of the eye)
• Astigmatism (from Haab striae and corneal stretching)
• Anisometropia (almost always present in unilateral PCG)
•Optic Nerve Cupping 21
CLINICAL FEATURES
22. •Optic Nerve Cupping :
• Optic canal stretching and posterior bowing of the lamina cribrosa
without a decrease in the neuroretinal rim.
• When the IOP is normalized, there can be notable reversal of cupping.
•While cupping may resolve, retinal nerve fiber layer damage, if present,
is permanent.
22
CLINICAL FEATURES
25. The diagnosis is CLINICAL even without an accurate measurement
of IOP.
The hallmark of the disease, however, is an elevated IOP and ocular
stretching in the absence of other ocular and systemic conditions
that can cause glaucoma.
26
DIAGNOSIS
26. HISTORY
•Abnormal appearance of the eyes such as a cloudiness or a blue
tint to the eyes.
• Patient behavior such as eye rubbing or shying away from light.
• While there may be tearing, there is no ocular discharge and
usually no eye redness.
27
DIAGNOSIS
29. HISTORY
•The patients are otherwise healthy.
• A positive family history is helpful but often is not present since
most cases are sporadic.
30
DIAGNOSIS
30. PHYSICAL EXAMINATION:
1- Vision Assessment
• Asymmetry in unilateral cases
• Presence of nystagmus and/or reduced fixation response in
bilateral cases.
31
DIAGNOSIS
31. PHYSICAL EXAMINATION:
2-Anterior segment exam
• Corneal diameter
• Presence of one or multiple Haab striae.
• Diffuse corneal edema and/or focal corneal edema or
opacification may obscure Haab striae.
32
DIAGNOSIS
32. •AC depth (deep in PCG)
•Structural abnormalities of the cornea, iris, and lens (no frank
abnormalities are seen in PCG, with the exception of mild iris
changes in newborn-onset PCG)
•IOP measurement
33
DIAGNOSIS
34. •IOP MEASUREMENT :
• Perkins applanation tonometer
• Tono-pen (a portable Mackay-Marg-type tonometer)
• Icare rebound tonometer.
•In older patients, standard Goldmann applanation tonometry can
be performed.
•A pneumotonometer may be useful to confirm IOP during
examination under anesthesia .
35
DIAGNOSIS
35. CORNEAL DIAMETER:
• Millimeter ruler
• Close-up digital photograph with the ruler in place .
• Under anesthesia, calipers with the tips placed at the limbus 180
degrees apart are used across the widest diameter.
36
DIAGNOSIS
36. GONIOSCOPY :
• More commonly, for initial diagnosis of PCG, gonioscopy is
performed under under anesthesia with a Koeppe or similar direct
gonioscopy lens and portable slit lamp. There are different sized
Koeppe lenses to fit different corneal diameters.
37
DIAGNOSIS
37. •AXIAL LENGTH:
• A-scan ultrasonography
Ideally using the immersion and not contact method, either in
clinic or under anesthesia.
38
DIAGNOSIS
38. OPTIC NERVE HEAD EVALUATION :
• Indirect or direct ophthalmoloscopy
• Fundus photography
• B-scan ultrasonography is recommended if the cornea does not
allow fundus examination to rule out posterior disease. Severe
optic nerve cupping may sometimes be noted on the posterior B-
scan. 39
DIAGNOSIS
39. PACHYMETERY:
• Central corneal thickness
The central cornea may be thicker due to corneal edema, and
may be thinner in PCG patients without corneal edema, likely due
to stretching of the tissues.
40
DIAGNOSIS
40. Optical Coherence Tomography
• To evaluate the retinal nerve fiber layer and ganglion cell layer.
• It may be helpful especially if the child cannot perform perimetry.
•Anterior segment OCT can be performed to look for anterior
chamber angle structres
41
DIAGNOSIS
42. For CORNEAL CLOUDING /OPACIFICATION:
• Birth trauma - Descemet tears that are vertical or oblique (unlike
Haab striae which are usually more horizontal or curvilinear)
• Corneal dystrophies - congenital hereditary endothelial dystrophy
or posterior polymorphous dystrophy
43
DIFFERENTIAL DIAGNOSIS
43. • Congenital or developmental abnormalities : sclerocornea, Peters
anomaly
• Keratitis : intrauterine infection or inflammation such as herpetic
infection, congenital syphilis, and maternal rubella, and Riley-Day
syndrome
• Storage diseases : Inborn errors of metabolism (such as
mucopolysaccharidoses, mucolipidoses.
44
DIFFERENTIAL DIAGNOSIS
44. FOR CORNEAL ENLARGEMENT
• High axial myopia
• Megalocornea is an inherited disorder in which infants have clear
corneas with diameters > 14 mm, deep anterior chambers, and
iridodonesis. There have been reports within one family of
megalocornea coexistent with congenital glaucoma.
45
DIFFERENTIAL DIAGNOSIS
46. Treatment Goal :
• Lowering and controlling the IOP
• Treating the secondary complications : Refractive change and
Amblyopia that develop during the course of the disease.
47
TREATMENT
47. •The mainstay of treatment is SURGERY :
•Angle surgery, either GONIOTOMY or TRABECULOTOMY to lower
IOP by improving aqueous outflow.
•If Angle surgery is not successful TRABECULECTOMY
enhanced with mitomycin
OR
• Glaucoma Implant Surgery with a Molteno, Baerveldt, or Ahmed
implant can be performed.
48
TREATMENT
48. • Refractory cases: Cycloablation
(can be performed using an Nd:YAG laser, diode laser, or cryotherapy, with diode laser being
the most widely used device.)
•Temporizing measure Medical therapy
( prior to surgery and to help decrease corneal clouding to facilitate goniotomy, and to
supplement IOP control after surgery.)
49
TREATMENT
49. GONIOTOMY :
• Angle surgery is the first procedure of choice to incise/open the
trabecular meshwork with the hope of allowing aqueous flow
from the anterior chamber directly into Schlemm canal.
•It is most successful in infantile-onset PCG, and less so in newborn
or late-recognized PCG.
50
SURGICAL OPTIONS
50. GONIOTOMY
Goniotomy is preferred when the cornea is clear enough to permit
visualization of anterior segment structures.
51
SURGICAL OPTIONS
52. TRABECULOTOMY :
When the cornea is not clear enough to permit visualization of
the angle, trabeculotomy ab externo (“trabeculotomy”) is the
procedure of choice.
Access to Schlemm canal is obtained externally via a partial scleral
flap to allow cannulation of Schlemm canal.
53
SURGICAL OPTIONS
55. SUCCESS RATE :
• Goniotomy - 30-65%
•Trabeculotomy - 40-80%
with success reported as low as 10% to as high as 94%.
58
SURGICAL OPTIONS
56. TRABECULECTOMY :
Filtering surgery is considered when one or more angle surgeries
have failed.
•Trabeculectomy with or without MMC
•Glaucoma drainage device implantation
59
SURGICAL OPTIONS
57. TRABECULECTOMY :
Trabeculectomy may be best done using fornix-based conjunctival
flaps, small radial cuts, MMC under the sclera flap and
subconjunctival tissue with wider spread to enhance posterior
aqueous flow and reduce bleb-related complications.
60
SURGICAL OPTIONS
58. TRABECULECTOMY :
Use of an anterior chamber maintainer in all cases and releasable
sutures are also recommended.
61
SURGICAL OPTIONS
60. SUCCESS RATE :
• 50-85%
with faliure rate 5.6 times higher in age less than 1 yr due to
complications including buphthalmos , lack of scleral rigidity highly
active healing and scarring.
63
SURGICAL OPTIONS
62. GLAUCOMA DRAINAGE DEVICES :
• All models of GDDs (Molteno, Baerveldt, and Ahmed valve) can
be used in PCG patients, and GDDs can be implanted safely in
neonates with attention to eye and implant parameters.
65
SURGICAL OPTIONS
64. COMPLICATIONS:
Those of trabeculectomy plus
• Cornea-tube touch
• Tube erosion through the conjunctiva or cornea
•Implant migration
•Cataract.
•Fibrovascular ingrowth into the valve chamber – Ahmed Valve
68
SURGICAL OPTIONS
65. CYCLODESTRUCTIVE PROCEDURES :
Refractory PCG - to reduce aqueous production .
• Laser cyclophotocoagulation (CPC) has largely replaced
cyclocryotherapy.
• Diode laser is preferred to Nd:YAG laser - decreased adverse
events such as sympathetic ophthalmia.
•Transscleral and endoscopic applications .
69
TREATMENT
66. CYCLODESTRUCTIVE PROCEDURES :
•Transscleral Micropulse-CPC may have less severe complications
than traditional transscleral CPC.
•The limbal anatomy may be distorted and blind application of
transscleral CPC may be better guided with ultrasound
biomicroscopy.
70
TREATMENT
68. Medical therapy for PCG is typically used as an adjunct to
surgery.
• Timolol - First choice in pediatric glaucoma.
• In cases with insufficient reduction of the intraocular pressure
(IOP), the combination of timolol once a day and dorzolamide
twice a day brings about a good control of the IOP. Both
medications are effective and well tolerated.
73
MEDICAL TREATMENT
69. •The alpha2-agonists have more and potentially serious adverse
effects in children and are contraindicated for children younger
than 2 years of age.
• Latanoprost tends to be less effective in lowering IOP in children
than in adults.
74
MEDICAL TREATMENT
70. Recommended to look for post op :
•Hypotony
•Inflammation
•Infection
under 2 yrs age – 3 monthly
Over 2 yrs age – 6 monthly
75
FOLLOW UP
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
Primary congenital glaucoma (PCG) is a rare disease due to genetically-determined abnormalities in the trabecular meshwork and anterior chamber angle resulting in elevated intraocular pressure (IOP), without other ocular or systemic developmental anomalies. Other terms have been used previously to describe this entity, including trabeculodysgenesis, goniodysgenesis and primary infantile glaucoma, however the term
Primary congenital glaucoma (PCG) is a rare disease due to genetically-determined abnormalities in the trabecular meshwork and anterior chamber angle resulting in elevated intraocular pressure (IOP), without other ocular or systemic developmental anomalies. Other terms have been used previously to describe this entity, including trabeculodysgenesis, goniodysgenesis and primary infantile glaucoma, however the term
Primary congenital glaucoma (PCG) is a rare disease due to genetically-determined abnormalities in the trabecular meshwork and anterior chamber angle resulting in elevated intraocular pressure (IOP), without other ocular or systemic developmental anomalies. Other terms have been used previously to describe this entity, including trabeculodysgenesis, goniodysgenesis and primary infantile glaucoma, however the term
Primary congenital glaucoma (PCG) is a rare disease due to genetically-determined abnormalities in the trabecular meshwork and anterior chamber angle resulting in elevated intraocular pressure (IOP), without other ocular or systemic developmental anomalies. Other terms have been used previously to describe this entity, including trabeculodysgenesis, goniodysgenesis and primary infantile glaucoma, however the term
Coming over to the epidemiology and risk factors of the disease
CSCR is common in the age group of 30 to 50 years with a greater incidence in male population , male to female ratio being 6 to 1. it is common in Asians and Europeans but rare in individuals of African origin. Various risk factors which increase the chances of developing cscr include psychological stress, type A personality
There are two theories to explain the pathogenesis of this disease
Physical strains, smoking and alcohol consumption, myopia and visually demanding work,,, all of these risk factor are common in armed forces personnel presenting to military hospitals…. Apart from this other risk factors include pregnancy , h pylori infection,
Retinal pigment epithelium dysfunction theory states that various infections , immunologic, circulatory and neuronal mechanisms cause damage to RPE, the damaged RPE secretes ions in the direction of retina. Due to secretion of ions, the choroidal fluid gets attracted into this area. This strong flow disrupts the diffusion barrier in this area.
Now coming to the clinical features
Patient presents with unilateral blurred vision with a relative scotoma in central visual field, other features include metmorphosia and / or micropsia along with acquired hyperopia. VA generally ranges from 6/9 to 6/12 though in some cases VA as good as 6/5 to as low as 6/60 have been described. Patients with extrafoveal involvement are generally asymptomatic
Patient presents with unilateral blurred vision with a relative scotoma in central visual field, other features include metmorphosia and / or micropsia along with acquired hyperopia. VA generally ranges from 6/9 to 6/12 though in some cases VA as good as 6/5 to as low as 6/60 have been described. Patients with extrafoveal involvement are generally asymptomatic
This fundus photograph shows neurosensory retinal detachment at posterior pole ,, in second phot you can appreciate yellow dots at the posterior surface
THE OPTIC NERVE cupping in children may be solely due to optic cnala streteching and post bowing of lamina cribrosa without decreease in neuroretinal rim
THE OPTIC NERVE cupping in children may be solely due to optic cnala streteching and post bowing of lamina cribrosa without decreease in neuroretinal rim
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
Other features include impaired dark adaptation , color desaturation, in chronic form retinal pigment epitheliopathy progresses alongwith persistent subretinal fluid, retinal detachment tends to be more diffuse and visual prognosis is guarded,,, chronic cases lead to CNV formation , subretinal lipid deposits and chorio capillary atrophy
Diagnosis of CSCR is mainly based on clinical findings and fundoscopy although certain modalities can aid in diagnosis like FFA, oct , indocyanine green angiography, multifocal erg and microperimetry.
Diagnosis of CSCR is mainly based on clinical findings and fundoscopy although certain modalities can aid in diagnosis like FFA, oct , indocyanine green angiography, multifocal erg and microperimetry.
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
Diagnosis of CSCR is mainly based on clinical findings and fundoscopy although certain modalities can aid in diagnosis like FFA, oct , indocyanine green angiography, multifocal erg and microperimetry.
Physical examination
The physical exam follows the standard ophthalmology exam for infants and young children, with special note of signs related to ocular expansion due to the distensibility of the infant eye. The vision assessment should specifically look for asymmetry in unilateral cases and the presence of nystagmus and/or reduced fixation response in bilateral cases.
The anterior segment exam should specifically look at the corneal diameter. Measurement can be done in clinic by holding a ruler in front of the patient’s eyes, however it may be much more accurate under anesthesia if the patient is not cooperative in clinic. (Details in “diagnostic testing.”)
The cornea should also be examined for clarity and the presence of one or multiple Haab striae (horizontal or oblique breaks in Descemet membrane, described above). These may be obvious or subtle, and sometimes can best be seen after dilation using retroillumination. Diffuse corneal edema and/or focal corneal edema or opacification may obscure Haab striae. The anterior segment exam should also look for anterior chamber depth (deep in PCG), and structural abnormalities of the cornea, iris, and lens (no frank abnormalities are seen in PCG, with the exception of mild iris changes in newborn-onset PCG).
Physical examination
The physical exam follows the standard ophthalmology exam for infants and young children, with special note of signs related to ocular expansion due to the distensibility of the infant eye. The vision assessment should specifically look for asymmetry in unilateral cases and the presence of nystagmus and/or reduced fixation response in bilateral cases.
The anterior segment exam should specifically look at the corneal diameter. Measurement can be done in clinic by holding a ruler in front of the patient’s eyes, however it may be much more accurate under anesthesia if the patient is not cooperative in clinic. (Details in “diagnostic testing.”)
The cornea should also be examined for clarity and the presence of one or multiple Haab striae (horizontal or oblique breaks in Descemet membrane, described above). These may be obvious or subtle, and sometimes can best be seen after dilation using retroillumination. Diffuse corneal edema and/or focal corneal edema or opacification may obscure Haab striae. The anterior segment exam should also look for anterior chamber depth (deep in PCG), and structural abnormalities of the cornea, iris, and lens (no frank abnormalities are seen in PCG, with the exception of mild iris changes in newborn-onset PCG).
The anterior segment exam should also look for anterior chamber depth (deep in PCG), and structural abnormalities of the cornea, iris, and lens (no frank abnormalities are seen in PCG, with the exception of mild iris changes in newborn-onset PCG).
IOP can be reliably measured in clinic with various devices (described below) if the child is calm, sleeping or feeding. Distraction with toys or movies may help during measurement. If the child is crying and uncooperative, then the IOP measurement will likely be artificially elevated and exam under anesthesia may be required.
Gonioscopy can be performed in the clinic on older children, and must be done under anesthesia for younger patients. Further description is in “diagnostic testing.”
After dilation, cycloplegic retinoscopy should be performed to look for myopia, astigmatism, and any corneal irregularity. The fundus exam should include a careful exam of the optic nerve to look for asymmetric or large cupping and for any structural abnormalities. There may be reversal of cupping after reduction in IOP in infants with glaucoma. [44]
Axial length measurement (described in "diagnostic testing") is also a key part of the physical exam in PCG.
The sequence and method the exam is done in clinic may be modified to optimize obtaining IOP measurements when the child is calm. For example, initial anterior segment exam may be done with a penlight or direct ophthalmoscope instead of a portable slit lamp. IOP could be the first part of the exam if the child is sleeping.
The anterior segment exam should also look for anterior chamber depth (deep in PCG), and structural abnormalities of the cornea, iris, and lens (no frank abnormalities are seen in PCG, with the exception of mild iris changes in newborn-onset PCG).
IOP can be reliably measured in clinic with various devices (described below) if the child is calm, sleeping or feeding. Distraction with toys or movies may help during measurement. If the child is crying and uncooperative, then the IOP measurement will likely be artificially elevated and exam under anesthesia may be required.
Gonioscopy can be performed in the clinic on older children, and must be done under anesthesia for younger patients. Further description is in “diagnostic testing.”
After dilation, cycloplegic retinoscopy should be performed to look for myopia, astigmatism, and any corneal irregularity. The fundus exam should include a careful exam of the optic nerve to look for asymmetric or large cupping and for any structural abnormalities. There may be reversal of cupping after reduction in IOP in infants with glaucoma. [44]
Axial length measurement (described in "diagnostic testing") is also a key part of the physical exam in PCG.
The sequence and method the exam is done in clinic may be modified to optimize obtaining IOP measurements when the child is calm. For example, initial anterior segment exam may be done with a penlight or direct ophthalmoscope instead of a portable slit lamp. IOP could be the first part of the exam if the child is sleeping.
.
.
Corneal diameter measurement is another key diagnostic procedure for PCG. Some providers check horizontal diameters only, while some check horizontal and vertical diameters. If there is pannus or scarring obscuring the limbus, the measurement may not be accurate.
Sussman (or similar) indirect gonioscopy lens as it fits easily between a young child’s small palpebral fissure.
The Koeppe lens is best handled with a glove to avoid fingerprint smudges. The Koeppe lens cup is filled with balanced salt solution and placed quickly on the eye or placed on the eye and tilted with one edge abutting the sclera while filling the space between the lens and eye with solution. Then a binocular microscope such as the portable slit lamp is angled towards the angle of interest and the lens can be shifted slightly toward the angle to optimize the view.
It is best done under anesthesia, during baseline examination to determine if the axial length is greater than normal for the patient’s age, and repeated approximately every 3-4 months to assess if the growth rate is greater than average. Of note, measuring axial length itself is not an indication for examination under anesthesia if a patient is otherwise doing well, and can be performed at intervals when examination under anesthesia is needed for clinical management. Sampaolesi and Kiskis provided linear regressions from data of normal children. Sampaolesi used immersion A-scans and found the normal axial length for a one-month-old lies between 17.25 mm (5th percentile) and 20.25 mm (95th percentile). Sampaolesi also recommended that axial length be measured after dilation with cycloplegic drop
Oct aid in diagnosis of CSCR by revealing many aspects of pathophysiology of CSCR like subretinal fluid, pigmentary epithelial detachment and retinal atrophy. It identifies subtle neurosensory and macular detachments. And helpful in identifying complications like CNV. INCREASED choroidal thickening is hallmark of CSCR
Photophobia and blepharospasm are unlikely with nasolacrimal duct obstruction and conjunctivitis, however, may be seen with corneal abrasion/injury, keratitis, or uveitis.
Photophobia and blepharospasm are unlikely with nasolacrimal duct obstruction and conjunctivitis, however, may be seen with corneal abrasion/injury, keratitis, or uveitis.
Photophobia and blepharospasm are unlikely with nasolacrimal duct obstruction and conjunctivitis, however, may be seen with corneal abrasion/injury, keratitis, or uveitis.
Photophobia and blepharospasm are unlikely with nasolacrimal duct obstruction and conjunctivitis, however, may be seen with corneal abrasion/injury, keratitis, or uveitis.
Photophobia and blepharospasm are unlikely with nasolacrimal duct obstruction and conjunctivitis, however, may be seen with corneal abrasion/injury, keratitis, or uveitis.
Treatment involves observation as most cases resolve in 3 months,,, control of steroid levels ,, lifestyle modifications and psychosocial therapies often relieve cscr.. If symptoms persist beyond 3 months then further treatment measures are taken
Treatment involves observation as most cases resolve in 3 months,,, control of steroid levels ,, lifestyle modifications and psychosocial therapies often relieve cscr.. If symptoms persist beyond 3 months then further treatment measures are taken
Treatment involves observation as most cases resolve in 3 months,,, control of steroid levels ,, lifestyle modifications and psychosocial therapies often relieve cscr.. If symptoms persist beyond 3 months then further treatment measures are taken
Laser photocoagulation accelerates resolution of detachment and lowers recurrence rate,,, laser beam destroys diseased pigment epithelial cells thus stopping the secretion of fluid beneath neurosensory retina… resulting scar transports fluid back to chorio capillaries
Laser photocoagulation accelerates resolution of detachment and lowers recurrence rate,,, laser beam destroys diseased pigment epithelial cells thus stopping the secretion of fluid beneath neurosensory retina… resulting scar transports fluid back to chorio capillaries
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
Photodynamic therapy is applied in juxtafoveal and subfoveal lesion and when there is a lack of clearly defined hotspot of leakge … it is also used when there is risk of developing CNV…. It causes chorio capillary narrowing thus reducing choroidal exudation and causes choroidal vascular remodelling
Photodynamic therapy is applied in juxtafoveal and subfoveal lesion and when there is a lack of clearly defined hotspot of leakge … it is also used when there is risk of developing CNV…. It causes chorio capillary narrowing thus reducing choroidal exudation and causes choroidal vascular remodelling
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
Photodynamic therapy is applied in juxtafoveal and subfoveal lesion and when there is a lack of clearly defined hotspot of leakge … it is also used when there is risk of developing CNV…. It causes chorio capillary narrowing thus reducing choroidal exudation and causes choroidal vascular remodelling
Photodynamic therapy is applied in juxtafoveal and subfoveal lesion and when there is a lack of clearly defined hotspot of leakge … it is also used when there is risk of developing CNV…. It causes chorio capillary narrowing thus reducing choroidal exudation and causes choroidal vascular remodelling
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
…. 2-3 moderate intensity burns are applied to leakage site to produce mild graying of rpe… you can appreciatw pre and post treatment retina
Photodynamic therapy is applied in juxtafoveal and subfoveal lesion and when there is a lack of clearly defined hotspot of leakge … it is also used when there is risk of developing CNV…. It causes chorio capillary narrowing thus reducing choroidal exudation and causes choroidal vascular remodelling
Treatment involves observation as most cases resolve in 3 months,,, control of steroid levels ,, lifestyle modifications and psychosocial therapies often relieve cscr.. If symptoms persist beyond 3 months then further treatment measures are taken
Treatment involves observation as most cases resolve in 3 months,,, control of steroid levels ,, lifestyle modifications and psychosocial therapies often relieve cscr.. If symptoms persist beyond 3 months then further treatment measures are taken
In this diagram you can appreciate the serous retinal detachment due to hyper permeability of choroidal capillaries
Treatment involves observation as most cases resolve in 3 months,,, control of steroid levels ,, lifestyle modifications and psychosocial therapies often relieve cscr.. If symptoms persist beyond 3 months then further treatment measures are taken
Laser photocoagulation accelerates resolution of detachment and lowers recurrence rate,,, laser beam destroys diseased pigment epithelial cells thus stopping the secretion of fluid beneath neurosensory retina… resulting scar transports fluid back to chorio capillaries
Laser photocoagulation accelerates resolution of detachment and lowers recurrence rate,,, laser beam destroys diseased pigment epithelial cells thus stopping the secretion of fluid beneath neurosensory retina… resulting scar transports fluid back to chorio capillaries
Combined anti vegf and photodynamic therapy has a greater beneficial role… certain medications are also useful in minor cases like eplerenone and spironolactone ( aldosterone antagonist diuretic) , finesteridide ( 5 alpha reductase blocker), mifepristone ( glucocorticoid antagonist) and ketoconazole ( inhibition of adrenal 11 beta hydroxloase )
Self limiting in 90 percent cases in few months… recurrence in 50 percent cases especially psychiatric patients… few develop complications like cnv,, rpe atrophy and pcv etc… patients whose visual acuity has recovered still have residual metamorphopsia ,scotoma and contrast sensitity…
Self limiting in 90 percent cases in few months… recurrence in 50 percent cases especially psychiatric patients… few develop complications like cnv,, rpe atrophy and pcv etc… patients whose visual acuity has recovered still have residual metamorphopsia ,scotoma and contrast sensitity…