This document discusses different types of glaucoma including open angle glaucoma and closed angle glaucoma. It outlines the diagnostic criteria and tests used to diagnose glaucoma, including tonometry, ophthalmoscopy, and perimetry. Key signs and symptoms of open angle glaucoma include slowly progressive vision loss, cupping of the optic disc, and visual field defects. Closed angle glaucoma presents more acutely with eye pain, redness, nausea and elevated eye pressure. Gonioscopy is used to examine the anterior chamber angle.

1. SUE TING, LIM

2. Raised IOP
 Glaucomatous Optic Nerve Head changes
 Visual Field Defects
 OPEN angle of anterior chamber


3. Raised IOP
 Glaucomatous Optic Nerve Head changes
 Visual Field Defects
 CLOSED angle of anterior chamber


4. a.
b.
c.
Cupping of disc
Visual Field defects
Normal or Low IOP

5. 

Constantly raised IOP
WITHOUT associated glaucomatous damage

6. Rise of IOP
 Associated with primary ocular or systemic
disease
 Types:
1. Secondary Open Angle Glaucoma
2. Secondary Angle Closure Glaucoma


7. OPEN ANGLE GLAUCOMA
ANGLE CLOSURE GLAUCOMA
Insidious and asymptomatic
Severe pain(Vth nerve)
Headache and Eyeache
Nausea, Vomiting asso. With pain
Scotoma
Redness
Frequent changes in presbyopic lens
Lacrimation
Delayed Dark Adaptation
Photophobia
Loss of vision and blindness
H/o intermittent attacks of subacute ACG

8. OPEN ANGLE GLAUCOMA:






Sluggish pupillary reflex
Diurnal variation of IOP (>8mmHg)
Provocative Tests
Persistently raised IOP
Optic disc changes
Visual field defects

9. ANGLE CLOSURE GLAUCOMA:







Eclipse Sign
Provocative tests(PACG suspect)
Closed angle on Gonioscopy
Acute RED eye
Semidilated, vertically oval and fixed pupil
Raised IOP
Optic disc hyperaemic and oedematous

11. DIAGNOSTIC CRITERIA
1. INTRAOCULAR TENSION
2. OPTIC NERVE HEAD CHANGES
DIAGNOSTIC TESTS
TONOMETRY
OPHTHALMOSCOPY
3. VISUAL FIELD DEFECTS
4. ANGLE OF ANT. CHAMBER
PERIMETRY
GONIOSCOPY

12. 


DIGITAL TONOMETRY
INDENTATION TONOMETRY
- Shiotz Tonometer
APPLANATION TONOMETRY
- Goldmann Tonometer
- Perkin’s Tonometer
- Pneumatic Tonometer
- Pulse Air Tonometer
- Tono-Pen

13. 


OCULAR NORMOTENSION: 10-21 mmHg
OCULAR HYPERTENSION
OCULAR HYPOTENSION

14. Early Changes
 Vertically oval cup
 Asymmetry of C:D ratio between two eyes(>0.2)
 Enlarged C:D Ratio (>0.5)
 Pallor Areas

15. Advanced Changes:
 Notch/Thinning of neuroretinal rim
 Pallor of neuroretinal rim
 Superficial disc haemorrhages
 Cupping of disc
 Bayonetting Sign
 Lamellar Dot Sign

16. Glaucomatous optic atrophy:


Neural disc is destroyed
Optic nerve head appears white and deeply
excavated

21. Kinetic Perimetry
a. Confrontation method
b. Lister’s perimetry
 Static Perimetry
a. Automated perimetry
-Humphrey field analyser
-Octopus


22. 







Isopter Contraction
Relative paracentral scotomas
Seidel Scotoma
Arcuate Scotoma/ Bjerrum’s Scotoma
Double arcuate/Ring scotoma
Roenne’s Nasal Step
Temporal Island and Tubular vision
Total lost of vision

26. 

Open Angle
Closed Angle

28. 

Measure the thickness
Corneal thickness has the potential to
influence eye pressure readings

29. 


Optical Coherence Tomography
Scanning Laser Polarimetry
Confocal Scanning laser topography (CSLT)