Inflammatory glaucoma by dr. Nermin
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This document discusses inflammatory glaucoma, including its pathogenesis, classifications, diagnostic dilemmas, treatment approaches, and comparisons to other conditions. Specifically, it notes that inflammatory glaucoma is caused by ocular inflammation elevating intraocular pressure over time through multiple mechanisms. It can be open or closed angle and is classified further. Treatment involves controlling both the inflammation and pressure through medications, laser procedures, or surgeries while managing risks of hypotony or increased inflammation. Comparisons are made to conditions like steroid-induced glaucoma and Posner-Schlossman syndrome.
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This document discusses mydriatics and cycloplegics, which are drugs that dilate the pupil (mydriasis) or paralyze accommodation (cycloplegia). It describes how the iris and ciliary muscles are innervated by the third cranial nerve and how pharmacological agents like atropine and phenylephrine work by blocking the responses of the sphincter muscle of the iris and ciliary body muscles to produce mydriasis and cycloplegia. These drugs are used clinically to dilate the pupil for exams or produce cycloplegia for refractive exams.
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Reducing Uveitic Glaucoma: therapeutic judgement is the key
Reducing Uveitic Glaucoma: therapeutic judgement is the key
Similar to Inflammatory glaucoma by dr. Nermin
Post Dengue Choroiditis: Case Report
This case report describes a 32-year old male who presented with sudden loss of vision in both eyes preceded by fever, malaise, and headache. Ophthalmic examination revealed multiple foci of retinochoroiditis and retinal hemorrhages in both eyes. Serologic testing confirmed elevated antibodies for dengue virus. The patient was treated with steroids and his vision improved after 3 months. This report discusses dengue-related ocular complications as under-reported manifestations that can present as inflammatory maculopathy with focal retinochoroiditis and hemorrhages.
Posner Schlossman Syndrome
Posner Schlossman Syndrome (PSS) is characterized by recurrent unilateral attacks of ocular hypertension and mild discomfort. It was first described in 1948 and affects patients aged 20-50, mostly males. During attacks, patients experience increased intraocular pressure, mild anterior chamber inflammation, and normal optic nerves and visual fields between attacks. The pathophysiology may involve vascular endothelial dysfunction, inflammation, or infectious causes like cytomegalovirus. Treatment focuses on controlling pressure and inflammation medically during attacks. Some patients with recurrent or treatment-resistant attacks can develop glaucomatous damage and require surgical intervention.
Posner schlossmann syndrome
Posner-Schlossman syndrome is characterized by recurrent unilateral attacks of ocular hypertension accompanied by mild anterior chamber inflammation. It was first described in 1948 and affects people aged 20-50, with males and females equally impacted. The exact pathogenesis is unknown but may involve trabecular meshwork obstruction by mononuclear cells. Symptoms include blurred vision and eye discomfort. Signs include elevated IOP out of proportion to mild inflammation and open iridocorneal angles. While usually self-limiting, long-term damage from recurrent attacks can occur, so treatment focuses on IOP control and inflammation management medically or surgically if needed.
Uvea sclera 990829
The document discusses anatomy and diseases of the eye. It describes the layers of the eyeball including the uvea and sclera. Various types of uveitis are classified and their symptoms, signs, etiologies, and treatments are explained. Specific uveitic entities like HLA-B27 associated uveitis, sarcoidosis, and toxoplasmosis are also summarized along with their diagnostic approach and management. Uveal tumors and scleral diseases are briefly covered as well.
case report.This is a 60 years old female patient, a known Glaucoma patient:pptx
The document discusses various causes of unilateral acute granulomatous anterior uvitis with high intraocular pressure (IOP). It describes conditions like glaucomatocyclitic crisis, Fuchs heterochromic iridocyclitis, herpes zoster or simplex-associated uveitis, phacolytic and phacoantigenic glaucoma, and ciliary body inflammation and rotation with angle closure glaucoma that can lead to these symptoms. It also discusses evaluating and managing patients with uveitis and elevated pressure, including recognizing underlying syndromes, controlling IOP and inflammation, and addressing specific conditions like Fuchs heterochromic iridocyclitis and herpetic uveitis.
Inflamatory glaucoma
presentation on Inflamatory glaucoma
all you need to know about Inflamatory glaucoma by Judith Wokwen
Uveitis
This document provides information on various types of uveitis (inflammation of the uveal tract of the eye) including:
- Types of uveitis based on location such as iritis, cyclitis, choroiditis, etc.
- Causes of uveitis including infectious, autoimmune, neoplastic, and idiopathic.
- Presentation of uveitis depending on factors such as onset (sudden or insidious), duration (limited or persistent), activity level, and presence of complications.
- Investigations, treatment approaches including medications, injections and surgery, and management considerations for different types of uveitis.
Glaucoma & target iop
Glaucoma is a group of diseases characterized by optic neuropathy and visual field loss caused by elevated intraocular pressure. The document discusses the various types of glaucoma including open-angle glaucoma, angle-closure glaucoma, and childhood glaucoma. It covers topics such as the definition and classification of glaucoma, risk factors, clinical evaluation including measurement of intraocular pressure and examination of the optic nerve and visual fields, and medical and surgical treatment options.
Intermediate Uveitis.pptx
This document discusses intermediate uveitis, including its definition, causes, symptoms, signs, diagnosis, and treatment. Intermediate uveitis involves inflammation in the vitreous, pars plana region, and ora serrata region of the retina. Common causes include multiple sclerosis, Lyme disease, sarcoidosis, and various infections. Symptoms are often floaters and blurred vision. Signs include vitreous cells and snowbank formations in the inferior vitreous. Treatment involves topical or injected steroids, with immunosuppressants used for non-responsive cases.
Vogt koyanagi-harada disease
Vogt-Koyanagi-Harada disease is an autoimmune reaction to melanocytes that causes bilateral uveitis and can involve other organs. It has three phases: a prodromal phase with influenza-like symptoms, an uveitic phase with ocular inflammation and retinal detachment, and a chronic phase with depigmentation and recurrence of inflammation. Diagnosis involves evaluating for ocular inflammation as well as neurological, auditory, and integumentary symptoms. Treatment is with systemic corticosteroids, though recurrence and complications are possible.
Disorders of uveal tract
The uveal tract disorders include uveitis, uveal melanoma, aniridia, and albinism. Uveitis is the inflammation of the uveal tract and is a common cause of blindness. Symptoms include eye redness, blurred vision, eye pain, and photophobia. Uveitis can be classified anatomically by the area of inflammation (anterior, intermediate, posterior, or pan) and clinically or pathologically. Treatment involves medications like corticosteroids and lifestyle changes. Complications can include cataracts, glaucoma, synechiae, and retinal issues if not properly treated and monitored.
結膜炎 JAMA 2013
Ceftriaxone: 1 g IM once
C16,47
Lavage of the infected eye
C16
Treatment to cover chlamydia is indicated
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Dual therapy
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1) Conjunctivitis is inflammation of the conjunctiva that covers the sclera and inside of the eyelids.
2) Causes of conjunctivitis include viral (most common), bacterial, allergic, toxic, autoimmune, and tumoral. The most common viruses are adenoviruses.
3) Treatment depends on the cause but may include antibiotics, antivirals, cold compresses
Glaucoma associated with ocular trauma and intraocular haemorrhage,inflammatory
Glaucoma can develop due to ocular trauma, inflammation, or intraocular hemorrhage. Trauma-induced glaucoma is caused by angle recession, uveal effusion, or proliferative changes in the trabecular meshwork. Intraocular hemorrhage like hyphema can lead to glaucoma if blood cells obstruct the outflow tract. Inflammatory glaucoma occurs when inflammatory cells or debris block the trabecular meshwork, as seen in conditions like sarcoidosis, juvenile rheumatoid arthritis, and ankylosing spondylitis. Management involves medical treatment, laser trabeculoplasty, or filtering surgeries depending on the underlying cause and severity of glau
Neovascular glaucoma
Done by huda alhashimy - ophthalmology resident doctor
source of information - kaniski clinical ophthalmology
INFECTIVE UVEITIS-SEMINAR.pptx
This document discusses various infectious causes of uveitis. It begins by classifying uveitis etiologies as infectious, non-infectious, or masquerade syndromes. Common bacterial causes discussed include tuberculosis, syphilis, leptospirosis, and brucellosis. Viral causes mentioned are cytomegalovirus, herpes simplex, herpes zoster, and others. Fungal causes like candidiasis and aspergillosis as well as parasitic causes such as toxoplasmosis are also reviewed. Diagnosis and treatment approaches for specific infectious etiologies like tuberculosis, syphilis, and brucellosis are provided. The document concludes with sections
Glaucoma
Glaucoma is a group of eye diseases characterized by increased pressure in the eye due to excess fluid. If left untreated, it can cause damage to the optic nerve and result in vision loss and blindness. The two most common types are open-angle glaucoma, which develops slowly over time, and angle-closure glaucoma, which develops acutely and requires urgent treatment to prevent vision loss. Treatment involves medications or surgery to lower eye pressure and prevent further damage to the optic nerve. Nursing care focuses on administering eye drop medications correctly, providing a safe environment, teaching patients self-care techniques, and ensuring follow-up medical care.
Meningitis
This document discusses different types of meningitis, including acute pyogenic meningitis, acute lymphocytic meningitis, and chronic meningitis. Acute pyogenic meningitis is caused by bacteria and results in inflammation of the meninges around the brain. Common causative organisms vary with age. Acute lymphocytic meningitis is usually viral and has milder symptoms that resolve more quickly. Chronic meningitis includes tuberculous and cryptococcal types, which cause long-term granulomatous inflammation that may lead to hydrocephalus. Diagnosis is based on examination of cerebrospinal fluid characteristics.
Episcleritis and scleritis.ppt
you will get information about the layers of sclera and its diseases such as episcleritis and scleritis.
types of scleritis and episcleritis are also eplained in these slides. such as diffuse and nodular types of episclera, necrotizing and non-necrotizing types of anterior scleritis, posterior sleritis.
there etiologies. complications, investigations and treatment are also explained in detail.
Episcleritis and scleritis (ophthalmology)
This document discusses episcleritis and scleritis. It begins with an introduction to the anatomy of the sclera and its blood supply, innervation and functions. It then discusses episcleritis, describing it as a common, self-limiting condition characterized by redness and mild discomfort. Scleritis is defined as inflammation of the sclera proper and can be classified as anterior or posterior. Anterior scleritis is further classified as non-necrotizing or necrotizing. Signs, symptoms, investigations, and treatments are provided for both conditions. Complications are also mentioned. The document concludes by briefly discussing blue sclera caused by thinning of the scleral collagen.
Uveitis
Uveitis is an interesting disease of the with such a varied and diverse pathogenesis, various systemic causes and Dangerous complications in relation to the eye which makes it difficult and challenging to treat in a proper way. I hope this share will help.
Similar to Inflammatory glaucoma by dr. Nermin (20)
case report.This is a 60 years old female patient, a known Glaucoma patient:pptx
case report.This is a 60 years old female patient, a known Glaucoma patient:pptx
Glaucoma associated with ocular trauma and intraocular haemorrhage,inflammatory
Glaucoma associated with ocular trauma and intraocular haemorrhage,inflammatory
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Electrophysiology in retinitis pigmentosa
This document discusses electrophysiology testing in retinitis pigmentosa (RP) using electroretinography (ERG). ERG measures the electrical response of the retina to light stimulation and can help diagnose and monitor RP. Standard ERG evaluates the full retina and involves assessing rod and cone response amplitudes and implicit times. Abnormal findings in RP include reduced amplitudes and delayed implicit times. Multifocal ERG allows evaluation of local retinal areas and can identify affected regions in RP. ERG is useful for diagnosing RP, distinguishing types of RP, screening relatives, and following disease progression over time.
Recent Advances in Treatment of Uveitis
This document discusses the treatment of uveitis using corticosteroids. It begins by describing the history and development of corticosteroid therapy for uveitis. It then discusses the different types and formulations of topical corticosteroids used to treat anterior uveitis, including dosing guidelines. For more severe cases, periocular and intraocular corticosteroid injections are discussed. The document also covers the use of systemic corticosteroids and corticosteroid-sparing immunomodulatory drugs. Throughout, specific drugs are mentioned along with their dosages and administration guidelines for treating uveitis.
Management of early glaucoma: Evidence based medicine
This document summarizes key findings from several clinical trials related to the management of primary open angle glaucoma. It discusses trials comparing medical vs. surgical treatment, different drug therapies, and surgical techniques. Some of the main conclusions are: 1) Early treatment of glaucoma is associated with less progression, but not all untreated patients progress; 2) Targeted IOP reduction can delay progression but rates vary individually; 3) Surgical options generally lower IOP more but with more complications versus medical management. Screening high-risk groups may help detect glaucoma earlier.
field of vision
from grand round of ophthalmic department-Al Zhraa university hospital (Dr. Jihan Abdallah, lect. of ophth.)
Eye lymphatics
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The document summarizes the anatomy of several cranial nerves involved in vision and eye movement. It describes the nuclei, course, and branches of the oculomotor nerve (CN III), trochlear nerve (CN IV), abducent nerve (CN VI), trigeminal nerve (CN V), and facial nerve (CN VII). It notes their roles in motor control of the extraocular muscles and sensory/parasympathetic innervation of the eye and orbit.
Acute Rise in IOP (Dr. Rasha, senior resident of ophthalmology)
There are several potential causes of acute increases in intraocular pressure (IOP), including glaucomatocyclitic crisis (Posner-Schlossman syndrome), inflammatory open-angle glaucoma, retrobulbar hemorrhage or inflammation, traumatic glaucoma, pigmentary glaucoma, neovascular glaucoma, plateau iris syndrome, and malignant glaucoma. IOP increases above 40mmHg can rapidly damage the optic nerve and cause permanent vision loss within hours. Treatment depends on the underlying cause but generally involves topical medications to lower IOP such as beta-blockers, alpha-2 agonists, and carbonic anhydrase inhibitors as well as systemic therapies like oral acetazol
Refractive changes after posterior segment surgeries (Dr. Nesma, TA ophthalam...
Retinal surgery can induce significant refractive errors including spherical changes from alterations in axial length and astigmatic changes from scleral buckling or vitrectomy. Focal alterations in corneal curvature from surgery can limit visual acuity even when other measurements seem normal. Surgical technique influences induced corneal irregularity. While usually transient, refractive errors sometimes require suture lysis or buckle adjustment. Retinal surgery in young patients also impacts ocular development and long-term refraction. Silicone oil use introduces further refractive changes and complicates intraocular lens power calculations.
femtosecond laser in ophthalmology by Dr. Hind Safwat (Al Azhr university)
Here are the key points about FSL in penetrating keratoplasty:
- FSL allows for precise, consistent cuts that minimize damage to surrounding tissue.
- It can create wound configurations that provide more surface area for healing, improve tissue alignment, require less suture tension, and have superior biomechanical strength.
- Advantages include rapid visual recovery, less astigmatism, and benefits specific to the type of cut (lamellar vs penetrating).
- Contraindications include conditions preventing proper docking of the laser such as severe ocular surface irregularities or recent perforations.
Uveitis in children - by dr. Marwa Mostafa (MS)
This document discusses pediatric uveitis, including its causes, presentations, diagnoses, and treatments. Some key points:
- Pediatric uveitis accounts for fewer than 10% of uveitis cases but can be challenging to diagnose as children may not report symptoms.
- It is important to localize the site of inflammation (anterior, intermediate, posterior) to determine likely causes such as juvenile idiopathic arthritis, toxoplasmosis, pars planitis, etc.
- Treatment typically begins with topical corticosteroids and mydriatics. Systemic corticosteroids or immunosuppressants may be used if inflammation is not well controlled. Long term complications can include cataracts, gl
Pco - by dr. Heba mahmoud (M D)
Posterior capsular opacification (PCO) is the most common complication of cataract surgery where an opaque membrane develops over the posterior capsule. The incidence of PCO ranges from 2-97% depending on the type of surgery and time since surgery. Risk factors include younger age, diabetes, uveitis, and surgical technique. PCO occurs via proliferation, migration, and differentiation of residual lens epithelial cells into either Elschnig pearls or fibrotic membranes. Grading of PCO ranges from grade 0 to 4 based on the degree of visual axis obscuration. Prevention strategies focus on surgical techniques like continuous curvilinear capsulorhexis and cortical cleanup as well as intraocular lens factors like sharp
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The pupil is an opening in the iris that controls the amount of light entering the eye. It constricts and dilates under autonomic nervous system influence. The normal pupil diameter ranges from 2.5-4 mm in daylight and 1.3-10 mm in extremes. Unequal pupil sizes is called anisocoria. The pupil constricts in response to light and near vision. Abnormal pupils can be congenital, traumatic, inflammatory, or neurological in origin. Tests like cocaine, hydroxyamphetamine, and pilocarpine help localize lesions causing abnormalities like Horner's syndrome or Adie's tonic pupil.
Posterior segment complications of refractive surgery
This document discusses various posterior segment complications that can occur after refractive eye surgery procedures like LASIK and lens-based refractive surgeries. It describes complications such as retinal detachments, macular hemorrhages, macular holes, choroidal neovascular membranes that have been reported after LASIK. It also discusses complications for lens-based refractive surgeries like perforated globe, suprachoroidal hemorrhage, dropped nucleus, cystoid macular edema, macular phototoxicity, retinal detachment, and endophthalmitis. Risk factors and management strategies for many of these complications are provided. The document concludes with recommendations for refractive surgeons to help prevent or properly manage some of these complications.
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- 2. • Inflammatory glaucoma, also known as uveitic glaucoma, is a condition in which ocular inflammation causes a persistent or recurrent IOP elevation resulting in anatomical and physiological changes
- 3. Diagnostic dilemmas: 1-IOP fluctuation :very sever in inflammatory glaucoma 2-cillary body shut down:occuring in acute exacerbation 3-steriod induced glaucoma 4-deficalty to assess fundus and pirmetry 5-iris vessels confuse with NVG
- 4. • Pathogenesis Intraocular pressure is regulated by a balance between aqueous humor production and its outflow. During episodes of intraocular inflammation, IOP is typically reduced because of aqueous humor hyposecretion from ciliary body inflammation and increased uveoscleral outflow. Over time, multiple mechanisms can increase the resistance to aqueous outflow during episodes of uveitis, thereby leading to elevated IOP.
- 6. 1-open angle: A- acute:either d.t. -trabeculitis -trabecular obestraction
- 8. B-chronic: -d.t. trabecular scarring or sclerosis 2ny to trabeculitis -defecult to diagnose
- 9. 2-closed angle: A- with seclusio pupillae B-with PAS:mainly in granulomatous inflamation
- 12. c/p: 1-open angle : A-aute: -IOP -open angle -sign of uveitis -+/- keratitis
- 13. B-chorinic: -IOP -open angle -no active inflammation -sign of pervious episiod -disc ,field changes
- 14. 2-closed angle: A- with seclusio pupillae: -IOP -seclusio pupillae -iris bombe -shallow AC -appositional angle closure -sign of previous epesiod
- 15. B-with synechial closure: -IOP -shallow AC - angle closure -sign of previous epesiod
- 17. TTT: • Medical: The following drug is CI: 1-miotics 2-PG analogue 3-biremonidine 4-metipranolol
- 18. • So, the 1st line of ttt is B-blocker Then we may use : -CIA (systemic or topical) -Alpha agonist
- 19. • TTT of uvitis : • Steriod • Cycloplegic • Cyclosporin • Cytotoxic drugs
- 20. Laser PI: • Should be large &multiple • Intensive topical steriod
- 21. Surgical ttt: A-pre-op precutions: 1-control uveitis for 3 m 2-topical steriod 3-systemic steriod
- 22. Intra –op precautions: 1-aviod combined cat –trab. Surgery 2- use MMC 3-tight scleral suture to aviod hypotony Post op.: • Steriod tapered ccording to inflammation
- 23. 2-GDD: If trab with MMC failed Has good result valves with Small surface area are preferred 2 step surgery to avoid hypotony
- 24. 3-cyclodestruction : May cause: -increase inf. -sever hypotony
- 25. Posner-Schlossman: • unilateral recurrent episodes of mild cyclitis and heterochromia. • Its pathogenesis still remains unknown, with suggested possible associations including an immunogenetic factor involving HLA-Bw54, viral infections (HSV and CMV)
- 26. Symp.: • Blurring of vision • Haloes • No pain • No redness
- 27. Sign: • The IOP is in the range of 40 – 70 mmHg during an acute attack • Minimal flare • Few cells • Few KPs • No PAS&PS • No shallow AC • Open angle
- 29. D.D: • Prodromal stage of ACG-----other eye shallow AC • Disc form kiratitis------decrease corneal sensation Ttt: • Steriod Aquas subresent
- 30. Fuch's Heterochromic Iridocyclitis • Def.:chronic non-granulomatous ant. Uveitis • age: middle • Sex: F • Unilat.
- 31. Symp: • Decrease VA • Floaters • heterochoromia
- 32. Sign: • White eye • Cornea:KPs • Iris: -atrophy -irir nodule -heterochoromia -no PS • Angle:neovasculrization • Vit.:vitrites • Fundus : • systemic
- 35. Ttt: • Posterior subtenon steriod • vitrectomy
- 36. HSV ant. Uveitis: • Granuloatous ant. Uveitis • IOP • Sectoral iris atrophy • Spontanous hyphema • Corneal sign Ttt: • Steriod • Oral aciclovire
- 38. Juvenile idiopathic arthritis: • Inf.arthritis lasting at least for 6wks befor the age of 16 • Classification: -pauciarticular -polyarticular -systemic onset
- 39. • Ant. • Unilat • Chronic • Non-granulomatous Symp.: • Asymptomatic • VA • Floaters
- 40. Sign: • White eye • Band keratopathy • KPs • Flare &cells • PS • CAT • Glaucoma • Vitritis Ttt: • Screening • Topical steriod
- 41. Thank you