Glaucoma in PPt.Eye-Education

1. GLAUCOMA
Glaucoma is a progressive optic neuropathy (a
disease of the optic nerve) characterized by a optic
nerve-head atrophy with cupping & arcuate nerve-
fibre bundle visual field defects.There is death of
the retinal ganglion cells, the axons of which
comprise the optic nerve and carry the visual
impulses from the eye to the brain. Glaucoma
represents a final common pathway resulting from
a number of different conditions that can affect the
eye, many of which are associated with elevated
IOP. It is important to realize that elevated IOP is
not synonymous with glaucoma, but rather is the
most important risk factor we know of for the
development and/or progression of glaucomatous
damage.

2. OTHER PRESSURE-INDEPENDENT:
“PERFUSION-PRESSURE”=BALANCE B/W
IOP VS BP 0F THE RBV OF THE OPTIC
NERVE HEAD*
MAJOR RISK FACTORS+ PRESSURE-
DEPENDENT=HiGH IOP=I/O PRESSURE
NR=14—20 mmHg. 21=Border-Line.
22mmHg & above=liable to cause
Ischaemic compression of optic nerve
head & arcuate nerve-fiber bundles.

3. TYPiCAL GLAUCOMA & VARiANTS
AT 2 ENDS = OCULAR
HYPERTENSIVES=^IOP but Normal
VFs & NORMAL TENSION
GLAUCOMA=Normal ‘IOP’ but
abnormal VFs!

4. TYPES 0F GLAUCOMA:
*CONGENiTAL= BUPHTHALMOS
**ACQUiRED= OPEN-ANGLE=
Classical POAG & Sec.Open-
Angle.
ANGLE-CL0SURE= PACG &
Sec.Angle-Closure.

5. CLINICAL PARAMETERS=
1*VISUAL FIELDS; 2*FUNDOSCOPY;
3*IOP; 4*GONIOSCOPY;
5*RETINAL NERVE-FIBRES
PH0T0GRAPHY; 6*OCT= OPTiCAL
C0HERENCE T0M0GRAPHY.

6. TREATMENTS:
*BUPHTHALMOS= GONIOTOMY;
TRABECULOTOMY.
**POAG=Anti-Glaucoma Drugs; ALT;
TRABECULECTOMY.
***PACG= IV MANNIT0L & TRABE.
****SEC.TYPES=N0RMALiZE IOP &
TREAT The PRiMARY CAUSE eg.
PHAC0M0RPHiC GLAUC0MA!

7. GLAUCOMATOUS ViSUAL-FiELD
DEFECT$:
1.Baring of the Blind-Spot.
2.Para-Central Scotoma.
3.Seidel’s Scotoma.
4.Arcuate Scotoma.
5.Double-Arcuate Scotoma.
6.Roenne’s Nasal-Step
7.Temporal Wedge.
8.Generalized Contraction of Overall Visual-Field