This document discusses glaucoma, which is characterized by optic nerve damage and elevated intraocular pressure caused by congestion of fluid in the eye. It can cause vision loss or blindness but is usually asymptomatic until late in the disease. Risk factors include age, family history, diabetes, and corticosteroid use. Treatment aims to prevent further optic nerve damage through medication, laser treatment, or surgery. The document also discusses cataracts, which are lens opacities that are the leading cause of blindness. Cataracts develop due to aging, trauma, radiation exposure, or systemic conditions. Early cataracts are treated with glasses but later cataracts require surgical removal and lens replacement.

1. ‫محمد‬ ‫كامل‬ ‫وداد‬ ‫الدكتورة‬ ‫المساعد‬ ‫االستاذ‬

2. Refers to a group of ocular conditions
characterized by optic nerve damage.
A condition of elevated IOP .
The optic nerve damage is related to the IOP
caused by congestion of aqueous humor in the
eye.

3. Is the 2nd leading cause of blindness in adult
in the US.
Is more prevalent in people older than 40 yrs.
of age.
There is no cure for glaucoma, but this
disease can be control.

4. Family history
Thin cornea
Older age
D.M.
Cardiovascular disease
Eye trauma
Prolong use of corticosteroids
Myopia

5. There are 2 theories regarding how increase
IOP damage the optic nerve in glaucoma.
The direct mechanical theory suggested :
High IOP damages the retinal layer as it
passes through the optic nerve head.

6. The indirect ischemic theory suggested that
high IOP compresses the microcirculation in
the optic nerve head, resulting in cell injury
and death.

7. Open angle glaucoma
Angle-closure glaucoma
Congenital glaucoma and
Glaucoma associated with other condition,
such as developmental anomalies or
corticosteroid use .

8. “Silent thief of sight”
Most pts. Are unaware that they have the
disease until they have experienced visual
changes and vision loss.
Blurred vision or “halos” around lights,
difficulty focusing , loss of peripheral vision,
aching or discomfort around the eye and
headache.

9. Ocular and medical history must be detailed to
investigate the history of predisposing
factors.
Tonometery to measure the IOP.
Ophthalmoscope to inspect the optic nerve.
Gonioscopy to examine the filtration angle of
the anterior chamber
Perimetry to assess the visual fields.

10. The aim of all glaucoma treat.
Is prevention of optic nerve damage.
Pharmacological therapy (miotics).
laser trabeculoplasty)
)
Laser procedures
surgery or a combination of these approaches

11. Is a lens opacity or cloudiness.
Cataract affecting 40 yrs old of age.
Cataract is the leading cause of blindness in
the world.

12. Pathophysiology :
Cataract can develop in one or both eyes at any
age.
Three common type of cataract are define by their
location in the lens:
1. Nuclear
2. Cortical
3. Posterior subcapsular

13. Visual impairment depends on their :
Size
Density
Location in the lens
More than one type can be present in the eye.

14. A nuclear cataract :tends to have a substantial
genetic component that causes a central
opacity in the lens. It is associated with
myopia.
A cortical cataract :involves the anterior,
posterior, or equatorial cortex of the lens.
Vision is worse in very bright light.
Posterior subcapsular cataract :occur in front
of the posterior or equatorial cortex of the
lens.

15. Aging
Loss of lens transparency
Decreased oxygen uptake
Decrease in level of vitamin C, protein
Increase in sodium and calcium
Accumulation of a yellow- brown pigment due
to the break-down of lens protein

16. Associated ocular conditions
Retinitis
Myopia
Retinal detachment and surgery
Infection

17. Toxic Factors
Ionizing radiation
Aspirin use
Corticosteroids
Alkaline chemical eye burns, poisoning
Cigarette smoking
Calcium, copper , iron, gold, sliver, and
mercury

18. Nutritional factors:
Reduced level of antioxidants
Poor nutrition
Obesity

19. Physical factors
Dehydration
Blunt trauma
Electrical shock
Perforation of the lens with sharp object or
foreign body,
Ultraviolent radiation in sunlight and x-ray

20. Systemic Diseases and Syndrome
Diabetes
Down Syndrome
Renal disorder
Disorder related to lipid metabolism
Musculoskeletal disorder

21. Painless
Blurred vision
Diplopia
Reduce visual acuity
Astigmatism: refractive error due to an
irregularity in the curvature of the cornea.

22. The Snellen visual acuity test.
Ophthalmoscope
Slit lump examination.

23. Medications, eye drops, eye glasses
treatment cures cataract or prevents age-
related cataract.
In the early stage of cataract development,
glasses, contact lenses, may improve vision.

24. Intracapsular cataract Extraction:
Extracapsular cataract Extraction:
Phacomulisification:
Lens Replacement:

25. Providing preoperative care:
Withhold any anticoagulation(e.g. aspirin,
warfarin) to reduce the risk of hemorrhage.
Dilating drops are administer every 10 minutes
for 4 doses at least one hour before surgery.

26. Providing postoperative care:
The patient receive verbal and written
Instruction about how protect the
eye Administer medication
Recognizes the signs of complications and
obtain emergency care.
Instruct the patient to take a mild analgesia
agent, as needed.
Anti-inflammatory and corticosteroid eye
drops or ointment.

27. Teaching patient self care:
Eye patch for 24 hrs. after surgery.
followed by eye glasses worn during the
day,.
Sunglasses should be worn.
A clean , damp wash cloth may be used to
remove eye discharge.

28. Eye patch remove after the first follow up
appointment .
Vision is stabilized when the eye healed,
usually within 6-12 weeks.