Malignant glaucoma
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Malignant glaucoma is a rare kind of glaucoma presumably due to a misdirection of aqueous humour within the eye....
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Malignant glaucoma
Glaucoma is a condition of the eye when the optic nerve of the eye becomes weak, usually because of a rise in pressure within the eye (Intraocular pressure). Malignant glaucoma is a rare condition when the pressure goes up because of a misdirection of aqueous humour within the eye.....
Malignant glaucoma
This document discusses malignant glaucoma, beginning with definitions and history. It describes the mechanisms behind malignant glaucoma as abnormal forward shifting of the iris-lens diaphragm. Clinical features include increased eye pressure despite patent iridotomy and shallowing of the anterior chamber. Differential diagnosis and management options are provided, including medical therapy, laser treatment, and surgeries like posterior sclerotomy with air injection. The fellow eye is also at risk and may require prophylactic treatment.
Malignant glaucoma
Classic malignant glaucoma is a rare complication of incisional surgery for angle-closure glaucoma where the anterior chamber shallows due to forward movement of the iris-lens diaphragm despite increased intraocular pressure. It can occur in eyes with or without glaucoma and may be triggered by laser treatment, miotics, or trabeculectomy. Treatment involves reducing pressure and vitreous volume medically or surgically with vitrectomy. Definitive management is phacoemulsification, intraocular lens implantation, and removal of the posterior capsule during vitrectomy.
Malignant glaucoma - Dr Shylesh B Dabke
This document discusses malignant glaucoma, a condition characterized by a shallow anterior chamber and elevated intraocular pressure despite a patent iridectomy. It occurs most commonly after glaucoma surgery. Several theories exist for its pathogenesis, involving aqueous misdirection posteriorly due to cilio-lenticular or cilio-vitreal blocks. Clinical features, diagnosis, differential diagnosis, and management approaches are described, including medical therapy with cycloplegics and hyperosmotics, laser treatments, and surgical interventions like vitrectomy. Preventing recurrence in the fellow eye is also addressed.
Malignant Glaucoma
Malignant glaucoma, also known as aqueous misdirection syndrome, is a secondary glaucoma that occurs when aqueous humor takes an abnormal posterior route behind the lens and vitreous instead of flowing normally through the pupil. It presents with a shallow anterior chamber despite high intraocular pressure. Potential causes include prior eye surgery or laser treatment. Diagnosis involves examining for signs of anterior chamber shallowing and ruling out other conditions. Treatment begins with cycloplegic drugs but may require Nd:YAG laser or vitrectomy if unresponsive. Prognosis depends on severity and underlying anatomy.
Surgery in open angle glaucoma
Surgeries for open angle glaucoma were discussed, including trabeculectomy. Trabeculectomy involves making a conjunctival flap, applying antimetabolites, excising a block of tissue from the eye, and suturing the scleral flap. Potential complications include shallow anterior chamber, low or high eye pressure, infection, and visual loss. Careful postoperative monitoring and treatment are important to manage complications while lowering eye pressure to prevent further glaucoma damage.
Surgery Glaucoma
Surgical management of glaucoma includes various laser surgeries, filtering surgeries like trabeculectomy, and other procedures. Laser surgeries like argon laser trabeculoplasty and selective laser trabeculoplasty use laser energy to increase drainage by altering the trabecular meshwork. Trabeculectomy involves creating a small hole in the eye to allow drainage of fluid into a filtering bleb under the conjunctiva. Other options include non-penetrating surgeries, artificial drainage implants, and cyclo destructive procedures to ablate the ciliary body. The goal of all these surgeries is to lower intraocular pressure and slow glaucoma progression.
High Frequency Deep Sclerotomy (HFDS)
This document provides information on High Frequency Deep Sclerotomy (HFDS) surgery for glaucoma. It describes HFDS as a minimally invasive glaucoma surgery that bypasses the trabecular meshwork by using a high frequency probe to create multiple sclerotomies, allowing aqueous humor to drain directly into Schlemm's canal. The document discusses the surgical procedure for HFDS and presents a case study demonstrating reduced intraocular pressure following the surgery. It also compares HFDS to other glaucoma surgeries such as trabeculectomy and reviews their respective success rates and complication profiles.
Recommended
Malignant glaucoma
Glaucoma is a condition of the eye when the optic nerve of the eye becomes weak, usually because of a rise in pressure within the eye (Intraocular pressure). Malignant glaucoma is a rare condition when the pressure goes up because of a misdirection of aqueous humour within the eye.....
Malignant glaucoma
This document discusses malignant glaucoma, beginning with definitions and history. It describes the mechanisms behind malignant glaucoma as abnormal forward shifting of the iris-lens diaphragm. Clinical features include increased eye pressure despite patent iridotomy and shallowing of the anterior chamber. Differential diagnosis and management options are provided, including medical therapy, laser treatment, and surgeries like posterior sclerotomy with air injection. The fellow eye is also at risk and may require prophylactic treatment.
Malignant glaucoma
Classic malignant glaucoma is a rare complication of incisional surgery for angle-closure glaucoma where the anterior chamber shallows due to forward movement of the iris-lens diaphragm despite increased intraocular pressure. It can occur in eyes with or without glaucoma and may be triggered by laser treatment, miotics, or trabeculectomy. Treatment involves reducing pressure and vitreous volume medically or surgically with vitrectomy. Definitive management is phacoemulsification, intraocular lens implantation, and removal of the posterior capsule during vitrectomy.
Malignant glaucoma - Dr Shylesh B Dabke
This document discusses malignant glaucoma, a condition characterized by a shallow anterior chamber and elevated intraocular pressure despite a patent iridectomy. It occurs most commonly after glaucoma surgery. Several theories exist for its pathogenesis, involving aqueous misdirection posteriorly due to cilio-lenticular or cilio-vitreal blocks. Clinical features, diagnosis, differential diagnosis, and management approaches are described, including medical therapy with cycloplegics and hyperosmotics, laser treatments, and surgical interventions like vitrectomy. Preventing recurrence in the fellow eye is also addressed.
Malignant Glaucoma
Malignant glaucoma, also known as aqueous misdirection syndrome, is a secondary glaucoma that occurs when aqueous humor takes an abnormal posterior route behind the lens and vitreous instead of flowing normally through the pupil. It presents with a shallow anterior chamber despite high intraocular pressure. Potential causes include prior eye surgery or laser treatment. Diagnosis involves examining for signs of anterior chamber shallowing and ruling out other conditions. Treatment begins with cycloplegic drugs but may require Nd:YAG laser or vitrectomy if unresponsive. Prognosis depends on severity and underlying anatomy.
Surgery in open angle glaucoma
Surgeries for open angle glaucoma were discussed, including trabeculectomy. Trabeculectomy involves making a conjunctival flap, applying antimetabolites, excising a block of tissue from the eye, and suturing the scleral flap. Potential complications include shallow anterior chamber, low or high eye pressure, infection, and visual loss. Careful postoperative monitoring and treatment are important to manage complications while lowering eye pressure to prevent further glaucoma damage.
Surgery Glaucoma
Surgical management of glaucoma includes various laser surgeries, filtering surgeries like trabeculectomy, and other procedures. Laser surgeries like argon laser trabeculoplasty and selective laser trabeculoplasty use laser energy to increase drainage by altering the trabecular meshwork. Trabeculectomy involves creating a small hole in the eye to allow drainage of fluid into a filtering bleb under the conjunctiva. Other options include non-penetrating surgeries, artificial drainage implants, and cyclo destructive procedures to ablate the ciliary body. The goal of all these surgeries is to lower intraocular pressure and slow glaucoma progression.
High Frequency Deep Sclerotomy (HFDS)
This document provides information on High Frequency Deep Sclerotomy (HFDS) surgery for glaucoma. It describes HFDS as a minimally invasive glaucoma surgery that bypasses the trabecular meshwork by using a high frequency probe to create multiple sclerotomies, allowing aqueous humor to drain directly into Schlemm's canal. The document discusses the surgical procedure for HFDS and presents a case study demonstrating reduced intraocular pressure following the surgery. It also compares HFDS to other glaucoma surgeries such as trabeculectomy and reviews their respective success rates and complication profiles.
Glaucoma in Aphakia and Pesudophakia
This document discusses glaucoma that can occur after cataract surgery (aphakia and pseudophakia). It defines the terms and outlines the incidence of glaucoma after different types of cataract surgery procedures. Various mechanisms by which cataract surgery can lead to glaucoma are described, including effects of viscoelastic substances, inflammation, pigment dispersion, angle distortion, pupillary block, and steroid use. Precautions during surgery and management approaches for early and late post-operative glaucoma are provided. Trabeculectomy is the preferred surgical treatment if maximum medical therapy fails to control glaucoma in these cases.
Introduction to Glaucoma by Dr. Iddi.pptx
This document provides an outline and overview of a presentation on glaucoma for 4th year medical students. The presentation covers the anatomy of the anterior chamber angle, formation and drainage of aqueous humor, classification of glaucomas including open angle glaucoma and angle closure glaucoma. Medical, laser and surgical treatment options for glaucoma are also discussed. Key points like risk factors, clinical features and investigation methods for primary open angle and primary angle closure glaucoma are explained in detail.
Mechanisms of angle closure glaucoma
1) Angle-closure glaucoma (ACG) occurs when the drainage angle between the iris and cornea is blocked. It is more common in Asian populations and causes more vision loss than open-angle glaucoma.
2) Risk factors for ACG include older age, female sex, Chinese ethnicity, family history, anatomically shallow anterior chambers, and thick lenses. Precipitating factors are low light, certain drugs, and stress.
3) Pupillary block is the main mechanism of ACG, where the iris blocks the trabecular meshwork due to apposition between the iris and lens at the pupil. Plateau iris is a variant where the peripheral iris is anteriorly displaced onto the angle
Acg
Primary angle-closure glaucoma is caused by apposition of the peripheral iris against the trabecular meshwork, obstructing aqueous outflow. It is a major cause of glaucoma blindness worldwide. Predisposing anatomical factors include a shallow anterior chamber and narrow anterior chamber angle. Precipitating factors like dim illumination or mydriatic drugs can cause a pupil block mechanism, obstructing outflow. Acute primary angle closure is a medical emergency treated with medications and laser iridotomy. Chronic primary angle closure glaucoma causes optic nerve damage and visual field loss.
Malignant glaucoma
Malignant glaucoma is a complication that can occur after glaucoma filtration surgery where the anterior chamber becomes shallow despite a patent iridotomy. It is caused by abnormal accumulation of aqueous humor behind the lens and iris, causing the iris-lens diaphragm to move forward. Theories of its cause include posterior diversion of aqueous flow, anterior displacement of the vitreous, or pressure from an expanded choroid pushing the lens forward. Treatment involves cycloplegics to pull the lens back, reducing aqueous production and IOP, and sometimes laser treatment or vitrectomy surgery to disrupt the abnormal fluid buildup.
Angle Closure Glaucoma
This document provides an overview of angle closure glaucoma, including anatomy, pathophysiology, diagnosis, and treatment. It begins with a description of the relevant anatomy - the ciliary body, anterior chamber angle, trabecular meshwork, Schlemm's canal. It then discusses intraocular pressure and aqueous humor dynamics. The pathophysiology section defines primary and secondary angle closure glaucoma. Diagnosis involves evaluating the history, ocular examination including gonioscopy and optic nerve/visual field testing. Treatment goals are to lower IOP, preserve vision and prevent further visual field loss through medical management such as medications or surgical options like trabeculectomy or laser procedures.
Angle closure glaucoma
This document provides information on angle closure glaucoma, including its causes, risk factors, stages, clinical presentation, diagnostic tests, and treatment options. Angle closure glaucoma results from obstruction of the aqueous outflow pathway due to apposition or adhesion of the iris to the trabecular meshwork. It is more common in individuals with anatomically narrow anterior chamber angles and certain ethnic groups. Treatment involves lowering intraocular pressure through medications, laser procedures such as peripheral iridotomy or iridoplasty, or incisional surgeries like goniosynechialysis or trabeculectomy if needed.
Glaucoma
This document provides information about glaucoma including its definition, epidemiology, classification, anatomy of the anterior chamber, physiology of the anterior chamber, measurement of intraocular pressure, optic disc examination, visual field testing, and the diagnosis of glaucoma. Glaucoma is a condition associated with elevated intraocular pressure that can cause damage to the optic nerve and vision loss. It is a leading cause of irreversible blindness worldwide.
Glaucoma post cataract extraction, vitreoretinal surgery, keratoplasty and re...
Glaucoma is a common complication of ocular surgeries such as cataract extraction, keratoplasty, vitreoretinal surgery, and refractive surgery. The mechanisms of glaucoma include retained viscoelastic, inflammation, pupillary block, and changes to the angle structure. Glaucoma can occur early due to these mechanisms or late due to factors like steroid response or inflammation. Careful case selection, prevention of complications, and close monitoring are important to manage glaucoma risk in postoperative patients.
Angle recession glaucoma
Angle recession glaucoma is a type of secondary glaucoma that can develop years after blunt ocular trauma causes tearing of the ciliary body and recession of the iris root. It is often underdiagnosed due to delayed onset and forgotten injury history. Management involves topical glaucoma medications, with filtering surgeries used if medication fails to control pressure. Early diagnosis and aggressive treatment are important to prevent glaucoma-related vision loss from this condition.
Approach to the case of pacg
This document provides an overview of the approach to primary angle closure glaucoma (PACG). It begins with definitions and epidemiology, noting it is more common in older females and Asians. Risk factors include age, race, hypermetropia and family history. Examination findings include elevated intraocular pressure, shallow anterior chamber, iris apposition or synechiae on gonioscopy. Symptoms range from acute pain and vision loss to being asymptomatic. Management involves medical therapy to lower pressure initially, followed by laser peripheral iridotomy or filtration surgery depending on the degree of angle closure. The primary mechanism is believed to be pupillary block causing increased resistance to outflow between the iris and lens.
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
Angle Recession Glaucoma
The document summarizes several studies on angle recession glaucoma following blunt ocular trauma.
The first study found that ultrasound biomicroscopy is useful for detecting angle pathology when the media is hazy. Surgical treatment resulted in more stable and normal intraocular pressure compared to medical treatment alone.
The second study in Bangladesh found that conservative treatment controlled intraocular pressure in most cases, while a small percentage required surgery.
The third study found that trabeculectomy with antimetabolic drugs was most effective for uncontrolled angle recession glaucoma, but carried a higher risk of late bleb infection.
Angle Closure Glaucoma
This document provides information about angle closure glaucoma from Amity Medical School. It defines glaucoma and discusses the anatomy of the anterior chamber and drainage angle. It describes the differences between open-angle glaucoma and angle closure glaucoma, including causes and risk factors. Treatment options are outlined, including medical management with eye drops and surgical options like laser trabeculoplasty and laser iridotomy.
Lasers in glaucoma.pptx
Lasers are commonly used in the treatment of glaucoma. ND:YAG lasers are well suited for procedures like peripheral iridotomy due to their wavelength of 1064nm which is absorbed by pigment in the iris but transmits through aqueous and lens. Laser trabeculoplasty procedures like ALT and more selectively SLT are used to lower intraocular pressure by modifying outflow pathways in the trabecular meshwork. Other laser applications include iridoplasty/gonioplasty to surgically treat angle closure glaucoma and malignant glaucoma, as well as revision of failed glaucoma surgeries through techniques like suturolysis. While highly effective, lasers require precision to avoid
Argon laser
The document discusses the history and techniques of laser trabeculoplasty for treating glaucoma. It was first introduced in 1961 using light energy on the eye's anterior chamber angle. The first successful protocol in 1979 used argon laser and since then different laser types have been developed. Laser trabeculoplasty works by lowering eye pressure through various mechanical and biological mechanisms of the trabecular meshwork. The technique involves using a gonioscopic lens and laser settings are calibrated to the eye to apply spots treating areas of the angle to increase outflow with minimal complications.
Cataract Surgery Complications for General Practitioners
1. The document discusses various preoperative, intraoperative, and postoperative complications that can occur with cataract and refractive surgery.
2. Intraoperative complications include posterior capsule rupture, dropped nucleus into the vitreous, and zonular dehiscence.
3. Postoperative complications within the first month include infection/endophthalmitis, raised intraocular pressure, cystoid macular edema, and hyphema. Later complications include retinal detachment and posterior capsule opacification.
4. The document provides details on managing many of these complications, such as techniques for vitrectomy, anterior chamber intraocular lens insertion, and treatments for endophthalmitis, cystoid macular edema
Acute visual loss
This document discusses various causes of acute visual loss, categorizing them as ocular or non-ocular. In the ocular category, it describes common causes such as media opacities, retinal issues including vascular occlusions, and optic nerve disorders. It provides details on evaluating and treating specific conditions like acute angle closure glaucoma, retinal detachment, macular diseases, and ischemic optic neuropathies. It emphasizes that many ocular causes of acute visual loss require prompt diagnosis and treatment to prevent permanent vision loss. Non-ocular causes discussed include stroke and functional visual loss.
Secondary glaucoma
This document discusses various types of secondary glaucoma caused by underlying ocular diseases and conditions. It describes the mechanisms of increased intraocular pressure, clinical features, and treatment approaches for different forms of secondary glaucoma including lens-induced glaucoma, inflammatory glaucoma, pigmentary glaucoma, neovascular glaucoma, and steroid-induced glaucoma among others. Management involves treating the underlying condition causing secondary glaucoma as well as lowering intraocular pressure through medical, laser, or surgical means.
Glaucoma 2 primary angle closure glaucoma,dr.k.n.jha,02.11.16
Angle-closure glaucoma is caused by apposition of the peripheral iris to the trabecular meshwork, reducing drainage of aqueous humor from the eye. Primary angle-closure glaucoma (PACG) has no underlying cause and is due to anatomic factors. It is a leading cause of glaucoma worldwide. PACG presents with acute symptoms like eye pain and blurred vision due to sudden rise in pressure from pupillary block. Treatment involves lowering pressure with medications or iridectomy to prevent future attacks. Long-term management focuses on screening and treatment to prevent angle closure in the fellow eye.
Canaloplasty Overview 3 Year Clinical Results Burchfield111510
The document provides an overview of canaloplasty, a non-penetrating glaucoma surgery technique. Canaloplasty aims to restore normal aqueous outflow by accessing and dilating Schlemm's canal using a microcatheter. This allows placement of a tensioning suture to maintain canal patency. Clinical studies show canaloplasty reduces intraocular pressure by 35-41% at 3 years with a low complication rate, providing an alternative to traditional glaucoma surgeries.
Angle closure glaucoma
This document provides information on angle-closure glaucoma, including its classification, terminology, risk factors, pathogenesis, and clinical presentation. It discusses the three main mechanisms of angle closure - pupillary block, phacomorphic, and plateau iris. Primary angle closure glaucoma progresses from primary angle closure suspects with a narrow angle, to primary angle closure with elevated pressure or synechiae, and eventually to chronic primary angle closure glaucoma if untreated, resulting in optic nerve damage and visual field loss. The clinical presentations include latent, subacute, acute, and chronic forms depending on symptoms.
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Glaucoma in Aphakia and Pesudophakia
This document discusses glaucoma that can occur after cataract surgery (aphakia and pseudophakia). It defines the terms and outlines the incidence of glaucoma after different types of cataract surgery procedures. Various mechanisms by which cataract surgery can lead to glaucoma are described, including effects of viscoelastic substances, inflammation, pigment dispersion, angle distortion, pupillary block, and steroid use. Precautions during surgery and management approaches for early and late post-operative glaucoma are provided. Trabeculectomy is the preferred surgical treatment if maximum medical therapy fails to control glaucoma in these cases.
Introduction to Glaucoma by Dr. Iddi.pptx
This document provides an outline and overview of a presentation on glaucoma for 4th year medical students. The presentation covers the anatomy of the anterior chamber angle, formation and drainage of aqueous humor, classification of glaucomas including open angle glaucoma and angle closure glaucoma. Medical, laser and surgical treatment options for glaucoma are also discussed. Key points like risk factors, clinical features and investigation methods for primary open angle and primary angle closure glaucoma are explained in detail.
Mechanisms of angle closure glaucoma
1) Angle-closure glaucoma (ACG) occurs when the drainage angle between the iris and cornea is blocked. It is more common in Asian populations and causes more vision loss than open-angle glaucoma.
2) Risk factors for ACG include older age, female sex, Chinese ethnicity, family history, anatomically shallow anterior chambers, and thick lenses. Precipitating factors are low light, certain drugs, and stress.
3) Pupillary block is the main mechanism of ACG, where the iris blocks the trabecular meshwork due to apposition between the iris and lens at the pupil. Plateau iris is a variant where the peripheral iris is anteriorly displaced onto the angle
Acg
Primary angle-closure glaucoma is caused by apposition of the peripheral iris against the trabecular meshwork, obstructing aqueous outflow. It is a major cause of glaucoma blindness worldwide. Predisposing anatomical factors include a shallow anterior chamber and narrow anterior chamber angle. Precipitating factors like dim illumination or mydriatic drugs can cause a pupil block mechanism, obstructing outflow. Acute primary angle closure is a medical emergency treated with medications and laser iridotomy. Chronic primary angle closure glaucoma causes optic nerve damage and visual field loss.
Malignant glaucoma
Malignant glaucoma is a complication that can occur after glaucoma filtration surgery where the anterior chamber becomes shallow despite a patent iridotomy. It is caused by abnormal accumulation of aqueous humor behind the lens and iris, causing the iris-lens diaphragm to move forward. Theories of its cause include posterior diversion of aqueous flow, anterior displacement of the vitreous, or pressure from an expanded choroid pushing the lens forward. Treatment involves cycloplegics to pull the lens back, reducing aqueous production and IOP, and sometimes laser treatment or vitrectomy surgery to disrupt the abnormal fluid buildup.
Angle Closure Glaucoma
This document provides an overview of angle closure glaucoma, including anatomy, pathophysiology, diagnosis, and treatment. It begins with a description of the relevant anatomy - the ciliary body, anterior chamber angle, trabecular meshwork, Schlemm's canal. It then discusses intraocular pressure and aqueous humor dynamics. The pathophysiology section defines primary and secondary angle closure glaucoma. Diagnosis involves evaluating the history, ocular examination including gonioscopy and optic nerve/visual field testing. Treatment goals are to lower IOP, preserve vision and prevent further visual field loss through medical management such as medications or surgical options like trabeculectomy or laser procedures.
Angle closure glaucoma
This document provides information on angle closure glaucoma, including its causes, risk factors, stages, clinical presentation, diagnostic tests, and treatment options. Angle closure glaucoma results from obstruction of the aqueous outflow pathway due to apposition or adhesion of the iris to the trabecular meshwork. It is more common in individuals with anatomically narrow anterior chamber angles and certain ethnic groups. Treatment involves lowering intraocular pressure through medications, laser procedures such as peripheral iridotomy or iridoplasty, or incisional surgeries like goniosynechialysis or trabeculectomy if needed.
Glaucoma
This document provides information about glaucoma including its definition, epidemiology, classification, anatomy of the anterior chamber, physiology of the anterior chamber, measurement of intraocular pressure, optic disc examination, visual field testing, and the diagnosis of glaucoma. Glaucoma is a condition associated with elevated intraocular pressure that can cause damage to the optic nerve and vision loss. It is a leading cause of irreversible blindness worldwide.
Glaucoma post cataract extraction, vitreoretinal surgery, keratoplasty and re...
Glaucoma is a common complication of ocular surgeries such as cataract extraction, keratoplasty, vitreoretinal surgery, and refractive surgery. The mechanisms of glaucoma include retained viscoelastic, inflammation, pupillary block, and changes to the angle structure. Glaucoma can occur early due to these mechanisms or late due to factors like steroid response or inflammation. Careful case selection, prevention of complications, and close monitoring are important to manage glaucoma risk in postoperative patients.
Angle recession glaucoma
Angle recession glaucoma is a type of secondary glaucoma that can develop years after blunt ocular trauma causes tearing of the ciliary body and recession of the iris root. It is often underdiagnosed due to delayed onset and forgotten injury history. Management involves topical glaucoma medications, with filtering surgeries used if medication fails to control pressure. Early diagnosis and aggressive treatment are important to prevent glaucoma-related vision loss from this condition.
Approach to the case of pacg
This document provides an overview of the approach to primary angle closure glaucoma (PACG). It begins with definitions and epidemiology, noting it is more common in older females and Asians. Risk factors include age, race, hypermetropia and family history. Examination findings include elevated intraocular pressure, shallow anterior chamber, iris apposition or synechiae on gonioscopy. Symptoms range from acute pain and vision loss to being asymptomatic. Management involves medical therapy to lower pressure initially, followed by laser peripheral iridotomy or filtration surgery depending on the degree of angle closure. The primary mechanism is believed to be pupillary block causing increased resistance to outflow between the iris and lens.
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
Angle Recession Glaucoma
The document summarizes several studies on angle recession glaucoma following blunt ocular trauma.
The first study found that ultrasound biomicroscopy is useful for detecting angle pathology when the media is hazy. Surgical treatment resulted in more stable and normal intraocular pressure compared to medical treatment alone.
The second study in Bangladesh found that conservative treatment controlled intraocular pressure in most cases, while a small percentage required surgery.
The third study found that trabeculectomy with antimetabolic drugs was most effective for uncontrolled angle recession glaucoma, but carried a higher risk of late bleb infection.
Angle Closure Glaucoma
This document provides information about angle closure glaucoma from Amity Medical School. It defines glaucoma and discusses the anatomy of the anterior chamber and drainage angle. It describes the differences between open-angle glaucoma and angle closure glaucoma, including causes and risk factors. Treatment options are outlined, including medical management with eye drops and surgical options like laser trabeculoplasty and laser iridotomy.
Lasers in glaucoma.pptx
Lasers are commonly used in the treatment of glaucoma. ND:YAG lasers are well suited for procedures like peripheral iridotomy due to their wavelength of 1064nm which is absorbed by pigment in the iris but transmits through aqueous and lens. Laser trabeculoplasty procedures like ALT and more selectively SLT are used to lower intraocular pressure by modifying outflow pathways in the trabecular meshwork. Other laser applications include iridoplasty/gonioplasty to surgically treat angle closure glaucoma and malignant glaucoma, as well as revision of failed glaucoma surgeries through techniques like suturolysis. While highly effective, lasers require precision to avoid
Argon laser
The document discusses the history and techniques of laser trabeculoplasty for treating glaucoma. It was first introduced in 1961 using light energy on the eye's anterior chamber angle. The first successful protocol in 1979 used argon laser and since then different laser types have been developed. Laser trabeculoplasty works by lowering eye pressure through various mechanical and biological mechanisms of the trabecular meshwork. The technique involves using a gonioscopic lens and laser settings are calibrated to the eye to apply spots treating areas of the angle to increase outflow with minimal complications.
Cataract Surgery Complications for General Practitioners
1. The document discusses various preoperative, intraoperative, and postoperative complications that can occur with cataract and refractive surgery.
2. Intraoperative complications include posterior capsule rupture, dropped nucleus into the vitreous, and zonular dehiscence.
3. Postoperative complications within the first month include infection/endophthalmitis, raised intraocular pressure, cystoid macular edema, and hyphema. Later complications include retinal detachment and posterior capsule opacification.
4. The document provides details on managing many of these complications, such as techniques for vitrectomy, anterior chamber intraocular lens insertion, and treatments for endophthalmitis, cystoid macular edema
Acute visual loss
This document discusses various causes of acute visual loss, categorizing them as ocular or non-ocular. In the ocular category, it describes common causes such as media opacities, retinal issues including vascular occlusions, and optic nerve disorders. It provides details on evaluating and treating specific conditions like acute angle closure glaucoma, retinal detachment, macular diseases, and ischemic optic neuropathies. It emphasizes that many ocular causes of acute visual loss require prompt diagnosis and treatment to prevent permanent vision loss. Non-ocular causes discussed include stroke and functional visual loss.
Secondary glaucoma
This document discusses various types of secondary glaucoma caused by underlying ocular diseases and conditions. It describes the mechanisms of increased intraocular pressure, clinical features, and treatment approaches for different forms of secondary glaucoma including lens-induced glaucoma, inflammatory glaucoma, pigmentary glaucoma, neovascular glaucoma, and steroid-induced glaucoma among others. Management involves treating the underlying condition causing secondary glaucoma as well as lowering intraocular pressure through medical, laser, or surgical means.
Glaucoma 2 primary angle closure glaucoma,dr.k.n.jha,02.11.16
Angle-closure glaucoma is caused by apposition of the peripheral iris to the trabecular meshwork, reducing drainage of aqueous humor from the eye. Primary angle-closure glaucoma (PACG) has no underlying cause and is due to anatomic factors. It is a leading cause of glaucoma worldwide. PACG presents with acute symptoms like eye pain and blurred vision due to sudden rise in pressure from pupillary block. Treatment involves lowering pressure with medications or iridectomy to prevent future attacks. Long-term management focuses on screening and treatment to prevent angle closure in the fellow eye.
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Glaucoma associated with ocular trauma and intraocular haemorrhage,inflammatory
Glaucoma associated with ocular trauma and intraocular haemorrhage,inflammatory
Cataract Surgery Complications for General Practitioners
Cataract Surgery Complications for General Practitioners
Glaucoma 2 primary angle closure glaucoma,dr.k.n.jha,02.11.16
Glaucoma 2 primary angle closure glaucoma,dr.k.n.jha,02.11.16
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The document provides an overview of canaloplasty, a non-penetrating glaucoma surgery technique. Canaloplasty aims to restore normal aqueous outflow by accessing and dilating Schlemm's canal using a microcatheter. This allows placement of a tensioning suture to maintain canal patency. Clinical studies show canaloplasty reduces intraocular pressure by 35-41% at 3 years with a low complication rate, providing an alternative to traditional glaucoma surgeries.
Angle closure glaucoma
This document provides information on angle-closure glaucoma, including its classification, terminology, risk factors, pathogenesis, and clinical presentation. It discusses the three main mechanisms of angle closure - pupillary block, phacomorphic, and plateau iris. Primary angle closure glaucoma progresses from primary angle closure suspects with a narrow angle, to primary angle closure with elevated pressure or synechiae, and eventually to chronic primary angle closure glaucoma if untreated, resulting in optic nerve damage and visual field loss. The clinical presentations include latent, subacute, acute, and chronic forms depending on symptoms.
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This document discusses primary angle closure glaucoma (PACG), a type of glaucoma where the iris occludes the drainage angle of the eye, obstructing aqueous outflow. PACG is a leading cause of glaucoma worldwide and is particularly common in East Asian populations. It is classified based on the degree of iris occlusion and presence of optic nerve damage and vision loss. Risk factors include older age, female sex, Asian ethnicity, family history, hypermetropia, and shorter axial length. Symptoms include blurred vision, halos around lights, eye pain, and headache. Signs include elevated eye pressure, shallow anterior chamber, iris changes, and optic nerve damage. The document outlines methods for diagnosing
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A case presentation on GLAUCOMA..pptx
GLAUCOMA-A case presentation on
GLAUCOMA.
Glaucoma is a group of eye conditions that damage the optic nerve. The optic nerve sends visual information from your eye to your brain and is vital for good vision. Damage to the optic nerve is often related to high pressure in your eye. But glaucoma can happen even with normal eye pressure.
There are four major types of glaucoma:
Open-angle glaucoma(If that system is blocked or isn't functioning well, the pressure inside the eye (intraocular pressure) builds, which in turn damages the optic nerve. With the most common type of glaucoma, this results in gradual vision loss. Glaucoma is a group of eye conditions that damage the optic nerve.
).
Angle-closure glaucoma(This form of glaucoma occurs when the iris bulges. The bulging iris partially or completely blocks the drainage angle. As a result, fluid can't circulate through the eye and pressure increases. Angle-closure glaucoma may occur suddenly or gradually.
), also called closed-angle glaucoma.
Congenital glaucoma.
Secondary glaucoma(Secondary glaucoma is glaucoma caused by any existing condition that raises internal eye pressure enough to damage the optic nerve. It can be treated both by managing the underlying condition that’s causing the issue and by taking medication or having surgery to lower the eye’s pressure.
).
Cataract by Group 3.pptx
The document provides an overview of cataracts including:
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- Describing the four main types: nuclear, cortical, posterior subcapsular, and congenital.
- Listing causes like aging, diabetes, steroid use, sunlight exposure, and nutritional deficiencies.
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Cataracts
Extracapsular cataract surgery involves removing the clouded lens and surrounding capsule from the eye. The most common method is phacoemulsification, which uses ultrasound to break up the lens for removal through a small incision. After removal of the cataract, an intraocular lens implant is typically placed. Surgery is usually quick and has a high success rate in improving vision, but risks include infection, swelling, bleeding or complications that may require further treatment.
CASE SCENARIOS gasaafavhavagagaa UG.pptx
A 28-year-old male presented with diminishing vision over 15 years and has been changing spectacles annually. Examination findings are consistent with keratoconus. Treatment options include rigid gas permeable contact lenses, collagen cross-linking, or corneal transplantation if indicated.
Dr. Madhu Karna Consultant Pediatric Ophthalmologist
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The document discusses guidelines for performing cataract surgery on patients with uveitis. It outlines several challenges including pre-operative and post-operative inflammation control and technical difficulties during surgery. The guidelines recommend thorough pre-operative control of inflammation, careful surgical techniques such as phacoemulsification instead of extracapsular extraction, and strict post-operative anti-inflammatory treatment to minimize complications for these high-risk patients. Special considerations are discussed for different types of uveitis.
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myopia.ppt
This document discusses myopia (nearsightedness) and its various classifications and treatments. It defines myopia as a condition where parallel rays of light focus in front of the retina. There are several types of myopia classified by factors like age of onset, degree of nearsightedness, and presence of degenerative changes. Treatments include optical correction with glasses or contacts, pharmaceutical agents like atropine to slow progression, and surgical options like LASIK, PRK, and phakic IOL implantation. The goal is to fully correct low to moderate myopia while considering risks of overcorrection for higher degrees of myopia.
Cataract surgery
Vision Eye Centre has increased reputation of being center of excellence for facility for services in ophthalmology.
Passive Therapy in Management of Amblyopia (healthkura.com)
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Passive Therapy in Management of Amblyopia
. Passive Therapy
The patient experiences a change in visual stimulation without any conscious effort
- Proper refractive correction
- Occlusion
- Penalization
Eye Disorders.pptx
This document provides information on eye disorders, specifically cataracts and glaucoma. It defines cataracts as a lens opacity and discusses causes, types, symptoms, and treatment including medication and surgery. For glaucoma, it describes the condition as optic nerve damage related to intraocular pressure, lists types, discusses evaluation and treatment with medication, laser procedures, and nursing care post-surgery. The document aims to educate on these common age-related eye conditions.
Glaucoma slides
The document discusses glaucoma, a group of eye disorders characterized by optic nerve damage and vision loss caused by increased intraocular pressure. It defines glaucoma and describes the main types: open-angle glaucoma, angle-closure glaucoma, normal-tension glaucoma, and congenital glaucoma. Risk factors, clinical features, diagnostic evaluation, medical and surgical management, complications, prognosis, and nursing management are outlined. The presentation concludes with a research abstract on glaucoma and a bibliography.
Optometry's Role in Laser Vision Correction
Although optometrists do not perform laser vision correction here in the United States, they can still provide a valuable role in this procedure that is gaining unprecedented popularity.
Traumatic eye injury hypothetical case presentaion
This patient presented with chemical injury to the right eye after being hit with a scraper. The initial treatment of checking the pH and irrigating with 1L saline was not sufficient as chemical injuries require prolonged irrigation. The eye also was not checked for foreign bodies. Going forward, the eye requires patching, antibiotic drops, and monitoring in the hospital for complications like increased pressure or additional bleeding. Long term risks include scarring, glaucoma, and potential retinal detachment.
Cataracts, Dr. Christa Corbett, 11/8/14
This document provides an overview of cataracts in dogs, including:
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- Common causes of cataracts like age, diabetes, trauma, and genetics.
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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
Glaucoma, all what you have to know about.
Glaucoma is a group of progressive disorders characterized by retinal ganglion cell apoptosis and optic neuropathy associated with cupping of the optic disc. There are three main mechanisms that can cause glaucomatous optic neuropathy: high intraocular pressure physically damaging the optic nerve; malfunctioning autoregulatory mechanisms; and genetic factors that induce programmed cell death. Glaucoma is a leading cause of blindness globally and in Qatar it accounts for 39% of bilateral blindness cases and 16% of low vision cases. Risk factors include older age, family history, higher eye pressure, and conditions like diabetes. Treatment involves lowering intraocular pressure through various eye drop medications which can have side effects like superficial punctate keratitis.
Current Trend in Management of Amblyopia (Amblyopia Therapy)/ Amblyopia Treat...
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Current Trend in Management of Amblyopia. Latest as well as old methods of amblyopia management which include active and passive therapies. Amblyopia Therapy/ Amblyopia Treatment
What would be the perfect amblyopia therapy?
Effective
Good compliance
Acceptable to pts. and parent
Quick
Safe
Easy to administer
Cost effective
Well maintained
..............
Summary
Amblyopia occurs due to abnormal visual experience early in life
Proper optical correction alone is necessary for short period of time (6-8 weeks)
before initiation of other therapy
Part time occlusion of better eye is mainstay of treatment since 18th century to till
now
For severe and moderate amblyopia, 6 hrs and 2 hrs of patching is advised
respectively
Atropine is also used in children with poor compliance
Trial of patching can be given in patients as old as 17 yrs
Perceptual learning and pharmacological manipulation have shown areas of
amblyopia treatment beyond the critical period of visual development
Binocular stimulation, software based treatments and other methods do not have
promising result to replace the patching therapy till date
Most of the active therapy methods have good results when used together with
patching therapy
Glaucoma slideshare for medical students
complete information about glaucoma eye disease contain detail of definition ,classification, types, pathophysiology, risk factor, causes, medical management ,nursing management, drug therapy, nursing process . for medical students, made by students of basic bsc nursing RIMS students
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Malignant glaucoma
- 1. MALIGNANT GLAUCOMA Dr. Philip Kuruvilla Aradhana Eye Institute Trivandrum, Kerala, INDIA www.aradhanaeyecare.com
- 2. Mr. M., born in 1950 first seen by me in Sep 2006 He came for a change of glasses. BCVA 6/6 N6 BE (+0.50 D hypermetropia) Ultrasound Scan: Axial length (not taken at this point. Checked later ) 22.4 mm : so, axially shorter than normal. IOP 30.5 BE;Angles narrow, occludable on gonioscopy; Cups : OD 0.7 ; OS 0.9 www.aradhanaeyecare.com
- 3. HFA: Had FD in BE; worse in left.
- 4. Yag PI done BE Angles opened IOP remained high Latanoprost and betaxalol drops Dorzolamide drops were added in Feb 2007 www.aradhanaeyecare.com
- 5. Mr. M. with a combined mechanism glaucoma on 3 drops; IOP still 20 Trabeculectomy RE done on 21 July 2008 www.aradhanaeyecare.com
- 6. Trab done 21 July 2008 Immediate postop : AC formed and IOP 9 in RE by appln. Put on antibiotic-steroid drops. 5 Aug 08: Appln: 20 Releasable apical suture removed – IOP 18-- 16 7 Sep 08:VR surgeon saw : posterior segment stable. www.aradhanaeyecare.com
- 7. Mr. M. who had Trab RE on 21 july 2008: All well: 6/9 BE; IOP 16 RE without any drops 6 Oct 08 : Dim vision (3/60) flat AC; uniformly flat all around the AC; IOP 26 appln. PI patent. Fundus normal www.aradhanaeyecare.com
- 8. Treated with atropine drps QID,Tropicamide with phenylephrine, tab acetazolamide, pad and bandage. Next day AC was formed. www.aradhanaeyecare.com
- 10. When atropine was tapered in 2 weeks AC became shallow. AC Became OK when atropine drops was given QID www.aradhanaeyecare.com
- 11. Malignant glaucoma Feb. 2009: stopped atropine. AC became flat again. Since then he was kept on Atropine at least once in 3 weeks. www.aradhanaeyecare.com
- 12. AC & IOP were normal with Atropine But he was unhappy with: - inconvenience of dilation - need for constant supervision - slow development of cataract - gradual deterioration of vision ( 6/24 ) b/o cataract www.aradhanaeyecare.com
- 13. April 2012: (BCVA 6/24: IC) temporal MSICS IOLI was done: SINCETHENTHERE HAS BEEN NO RECURRENCE OF SHALLOWING OF AC OR RISE IN IOP INTHE RE (NO DROPS WHATSOEVER) www.aradhanaeyecare.com
- 14. The other eye….. LE: Since the beginning he is on 3 antiglaucoma drugs . He has been reticent for any surgery for LE Over the years there has been slight worsening of fields in BE. www.aradhanaeyecare.com
- 15. A Combined mechanism glaucoma pt : developed Malignant Glaucoma 3 mths after Trab. Medical management was successful as long he was on atropine. MSICS IOLI seems to have cured it . 4.5 years follow up. www.aradhanaeyecare.com
- 17. MALIGNANT GLAUCOMA Coined byVon Grafe in 1869 to describe an aggressive type of glaucoma resistant to treatment resulted in blindness www.aradhanaeyecare.com
- 18. Other names Ciliary block glaucoma Aqueous misdirection Direct lens block www.aradhanaeyecare.com
- 19. Malignant Glaucoma Typically happens after a filtration surgery for ACG But it can also happen after filtration surg for POAG, Pseudo exfoliation glaucoma cataract surgery large optic (7 mm) IOLI Yag PI, etc High IOP at the time of surg does not seem to increase the chances of occurrence www.aradhanaeyecare.com
- 20. Malignant Glaucoma Uniform shallowing / flattenning of AC Patent PI IOP high (initially may be normal) Onset immediately after the procedure or months later May be ppted by cessation of cycloplegics or starting pilocarpine. www.aradhanaeyecare.com
- 21. Malignant Glaucoma Vitr face bowing forwards Optically clear areas inVitreous Angles closed www.aradhanaeyecare.com
- 22. Pathophysiology Not well understood Abnormal relationship betweenVitr face, Ciliary body and lens equator Causes the aqueous to flow intoVitr cavity Causes forward movement of lens iris diaphragm and antr hyloid face. Results in complete closure of angles www.aradhanaeyecare.com
- 23. Medical treatment Cycloplegics (tighten zonules and pull lens backwards) Mydriatics (stimulate the longitudinal fibres of ciliary muscle and tighten zonules) Acetazolamide (decreases aq production) Hyperosmotic agents (decreases vitr volume) Topical drops to reduce IOP www.aradhanaeyecare.com
- 24. Interventional NdYag Laser hyloidotomy through an iridectomy : in pseudophakic cases, beyond the haptic of IOL Vitr puncture 4 mm behind the limbus and aspiration Vitrectomy with or without lensectomy PP vitrectomy with an aqueous shunt www.aradhanaeyecare.com
- 25. Argon laser transpupillary (or thru PI ) shrinkage of ciliary processes Transcleral Cyclophotocoagulation for refractory cases (Coagulative necrosis and shrinkage of ciliary processes disrupts the ciliaryV,face interface) www.aradhanaeyecare.com
- 26. In the case presented A simple cataract extraction with PC IOLI seems to have cured Malignant Glaucoma. 4.5 years follow up after cat surg: (total 10 yrs follow up) www.aradhanaeyecare.com
- 27. Conclusion In selected cases, Cataract surgery with IOLI alone could be kept as an option for treatment for Malignant Glaucoma. More aggressive procedures can be taken up if there is no relief. www.aradhanaeyecare.com
- 28. THANK YOU