Primary open angle glaucoma
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Primary open angle glaucoma (POAG) is the most common type of glaucoma. It is characterized by a gradual, painless rise in intraocular pressure (IOP) due to impaired drainage of aqueous humor through the trabecular meshwork. Over time, this leads to progressive damage to the optic nerve and characteristic visual field defects. Risk factors include age, family history, high myopia, and conditions like diabetes. Treatment aims to lower IOP through medications like prostaglandin analogs or surgery like trabeculectomy to slow disease progression and preserve vision.
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1. Glaucoma is the second leading cause of blindness worldwide and is characterized by increased intraocular pressure, optic nerve damage, and visual field defects.
2. There are two main types - open angle glaucoma, which has no pain and slow vision loss, and angle closure glaucoma, which causes sudden, painful vision loss.
3. Treatment involves medications like prostaglandin analogs to lower pressure or surgery like trabeculectomy if medications are not effective. New gene therapies are also being explored to treat glaucoma at the cellular level.
Glaucoma
This document discusses glaucoma, including facts about its prevalence, symptoms, detection, treatment, and risk factors. Glaucoma is one of the leading causes of blindness worldwide and occurs when fluid builds up in the eye, increasing pressure and damaging the optic nerve. It often has no symptoms in early stages, so regular eye exams are important for detection. Treatment options include eye drops, oral medications, and surgery to improve fluid drainage or decrease fluid production. African Americans and those over age 60 are at higher risk.
Poag 28.04.16 - dr.a.r.rajalakshmi
Primary open angle glaucoma (POAG) is the most common type of glaucoma. It is characterized by a raised intraocular pressure, optic nerve damage, and visual field loss. Early signs include increased cupping of the optic nerve head and visual field defects like paracentral scotomas. Treatment aims to lower intraocular pressure through medications, laser therapy, or surgery to prevent further optic nerve damage and vision loss.
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.
Clinical features of glaucoma
This document discusses the clinical features of various types of glaucoma. It describes the etiological classification of glaucoma as primary or secondary. Primary glaucoma in children includes congenital, infantile, and juvenile glaucoma, while in adults it includes primary open angle glaucoma and primary angle closure glaucoma. Secondary glaucoma can be caused by conditions like aniridia, inflammation, tumors, or other diseases. The clinical features of different types of glaucoma are then outlined, including symptoms, signs, and characteristics seen on examination for conditions such as congenital glaucoma, primary open angle glaucoma, angle closure glaucoma, and others.
Primary Angle Closure Glaucoma- Saral
Primary angle closure glaucoma is caused by blockage of the aqueous humor outflow due to closure or narrowing of the anterior chamber angle. It progresses through stages from primary angle closure suspect to acute angle closure to angle closure glaucoma, where glaucomatous optic nerve damage and visual field defects are present. Risk factors include hyperopia, smaller anterior chamber angle, older age, and Asian ethnicity. Treatment begins with intravenous mannitol or glycerol to lower pressure urgently, followed by topical eye drop medications like beta-blockers or pilocarpine. The definitive treatment is laser iridotomy or trabeculectomy surgery to permanently open the drainage angle.
GLAUCOMA PPT
This presentation summarizes glaucoma, including its etiology, pathophysiology, classification, clinical manifestations, diagnosis, and treatment. Glaucoma refers to a group of eye disorders characterized by optic nerve damage and vision loss due to increased intraocular pressure. It is classified as primary open-angle glaucoma or primary angle-closure glaucoma. Clinical features may include loss of peripheral vision, optic nerve cupping, and visual field defects. Diagnosis involves measuring intraocular pressure, examining the anterior chamber angle and optic disc. Treatment options include non-pharmacological methods as well as topical eye drops to lower pressure such as beta-blockers, alpha-2 agonists, prostaglandins, and
Primary open angle glaucoma (poag)
Primary open angle glaucoma (POAG) is the most common type of glaucoma. It is characterized by an open anterior chamber angle, increased intraocular pressure (IOP), and glaucomatous optic nerve damage and visual field loss. Elevated IOP is the primary risk factor. Treatment involves medical therapy to lower IOP through various drug classes, laser trabeculoplasty to increase outflow, and surgeries like trabeculectomy or newer minimally invasive procedures if medication is insufficient. The goal is to lower IOP enough to prevent further optic nerve damage and vision loss.
Glaucoma-Presentation new.pptx
This document provides an overview of glaucoma, including:
1. Definitions of glaucoma, classifications, examination methods, primary open angle glaucoma, primary angle closure glaucoma, and glaucoma surgeries.
2. Details on the anatomy of the eye related to aqueous humor production and drainage, as well as the causes and mechanisms of increased intraocular pressure in glaucoma.
3. Risk factors, clinical features, and management approaches for primary open angle glaucoma and primary angle closure glaucoma. Surgical management via trabeculectomy and laser trabeculoplasty is also discussed.
POAG AND PACG
POAG and PACG are two major types of glaucoma. POAG is caused by increased intraocular pressure due to improper drainage of fluid from the eye. It progresses slowly and causes damage to the optic nerve and visual field loss over time. PACG occurs when the iris blocks the drainage angle, often in hyperopic eyes, and can progress more rapidly. Treatment options include medications, laser therapy, and surgery to lower pressure and prevent further vision loss. Regular eye exams are important for early detection and management of glaucoma.
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.
Glaucoma
Glaucoma is a disorder caused by increased intraocular pressure damaging the optic nerve. It has two main types - open angle glaucoma where the angle remains open, and angle closure glaucoma where the angle becomes narrow or closed. Angle closure glaucoma occurs when the iris blocks the drainage angle, commonly due to pupillary block or narrowing of the angle with age. It presents with sudden severe eye pain, blurred vision, headache, and eye redness. Gonioscopy is used to examine the angle structure and grade its width.
Primary open angle glaucoma (poag)kalpy
Primary open angle glaucoma (POAG) is the most common type of glaucoma. It is characterized by an open anterior chamber angle, optic nerve damage indicative of glaucoma, and visual field loss in the absence of a secondary cause. The major risk factor for POAG is elevated intraocular pressure (IOP) above 21 mmHg. Other risk factors include older age, African ancestry, family history of glaucoma, diabetes, and high myopia. Treatment aims to lower IOP through medications, laser therapy, or surgery to prevent further optic nerve damage and vision loss.
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Glaucoma 3 primary open angle glaucoma,dr.k.n.jha, 03.11.16
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This document discusses vascular occlusions of the retina, including retinal artery occlusions and retinal vein occlusions. Retinal artery occlusions can be central or branch retinal artery occlusions caused by emboli or atherosclerosis. Central retinal artery occlusion results in sudden vision loss and a milky white retina seen on examination. Branch retinal artery occlusion causes pale retina distal to the occlusion. Retinal vein occlusions are more common and can be central or branch retinal vein occlusions. Ischemic central retinal vein occlusion leads to severe vision loss and hemorrhages throughout the retina. Non-ischemic central and branch retinal vein occlusions cause milder vision loss and hemorrhages limited to the affected area. Treatment depends on the severity
Bacterial conjunctivitis
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Tubercular Intermediate Uveitis
This document describes a case of a 27-year-old Asian Indian female presenting with recurrent redness, blurry vision, floaters and photophobia in both eyes. Examination revealed signs of intermediate uveitis including vitritis and focal vascular sheathing. Systemic workup found enlarged lymph nodes and a positive tuberculosis test. Histopathology of a lymph node biopsy showed acid-fast bacilli consistent with tuberculosis. The patient was diagnosed with tubercular intermediate uveitis and showed improvement with antitubercular treatment and steroids. The document discusses the importance of thorough systemic workup to accurately diagnose infectious causes of uveitis like tuberculosis that may be overlooked.
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Primary Angle Closure Glaucoma
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. Risk factors include older age, female sex, Southeast Asian or Chinese descent, hyperopia, anatomically narrow anterior chamber angles, and heredity. Primary angle closure can progress to primary angle closure glaucoma if untreated, causing increased intraocular pressure and optic nerve damage. Treatment options include laser peripheral iridotomy, medications, filtration surgery, and lens extraction depending on the stage and severity of the condition.
Sclera
The sclera is the opaque outer layer of the eyeball. It is thickest posteriorly at 1 mm and thinnest at the insertion of the extraocular muscles at 0.3 mm. It has several apertures for vessels and nerves. Episcleritis is a benign inflammation of the outer layer involving the episclera and Tenon's capsule, usually seen in young adults and more commonly in females. Scleritis is a potentially serious inflammation of the sclera proper, often associated with autoimmune or infectious diseases. It can cause severe pain and vision loss. Treatment involves topical and oral steroids as well as immunosuppressants depending on severity.
Paralytic strabismus ( third cranial nerve )
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Phacodynamics
This document provides an overview of phacoemulsification, the standard method of cataract extraction. Key points include:
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Pediatric glaucomas
Developmental glaucomas are caused by improper development of the aqueous outflow system in infancy or childhood. They can significantly impact visual development if not recognized and treated early. The main types are primary congenital glaucoma, glaucomas associated with other ocular or systemic anomalies, and secondary glaucomas from pediatric conditions affecting the eye. Primary congenital glaucoma is the most common and is usually caused by isolated maldevelopment of the trabecular meshwork without other ocular anomalies. It has a hereditary component and males are more commonly affected.
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Preperimetric glaucoma
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PUK
Peripheral ulcerative keratitis (PUK) is a degenerative condition affecting the peripheral cornea. It is characterized by peripheral corneal thinning and ulceration that spreads circumferentially. PUK can be caused by infection, autoimmune diseases like rheumatoid arthritis, or idiopathic factors. Diagnosis involves examining for signs of peripheral epithelial defects, stromal infiltration, and thinning. Treatment depends on the underlying cause but may include topical antibiotics, steroids, or systemic immunosuppressants to reduce inflammation and prevent worsening of the condition. Prognosis depends on severity and associated systemic diseases, with mild-moderate PUK having a good prognosis generally.
Corneal Ectasias
Corneal ectasias are disorders affecting the shape of the cornea. The main types are inflammatory and non-inflammatory. Keratoconus is a non-inflammatory ectasia with progressive thinning and protrusion of the cornea leading to irregular astigmatism. Diagnosis involves corneal topography showing an asymmetric bowtie pattern. Treatments include rigid contact lenses, collagen cross-linking to strengthen the cornea, and keratoplasty for severe cases. INTACS inserts are also used to flatten the cornea in mild to moderate keratoconus.
Retinitis Pigmentosa
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Keratometry
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Primary open angle glaucoma
- 1. PRIMARY OPEN ANGLE GLAUCOMA DR.PRAKRITI YAGNAM.K
- 2. DEF: -A type of primary glaucoma with no ocular or systemic causes of rise in IOP - AKA Chronic simple glaucoma of adult onset FEATURES: -Slowly progressive raised IOP -Open normal appearing anterior chamber angle -Characteristic optic dis cupping -Special visual field defects
- 3. RISK FACTORS: -Rise in IOP -Family history -Age -Race -Myopes -Central corneal thickness -Diabetes -Cigarette smoking -High B.P-Diastolic perfusion pressure -Endocrine
- 4. PATHOGENESIS: RISE IN IOP: -Due to decrease in aqueous outflow facility -Due to failure of aqueous outflow facility because of -Thickening and sclerosis of trabecular meshwork -Narrowing of inter trabecular spaces -Deposition of amorphous material in inter trabecular spaces -Collapse of schlemms canal -All these may happen due to immunogenic reaction
- 5. OPTIC NEUROPATHY: PRIMARY INSULTS: -Rise in IOP-mechanical stretch on lamina cribrosa -Vascular insufficiency-Failure of auto regulatory mechanism -Vasospasm -Systemic hypotension -Acute blood loss SECONDARY INSULTS: Excitotoxic theory due to glutamates , nitric oxide , oxygen free radicles
- 6. EPIDEMIOLOGY: -1 in 100 population above 40 years -Forms one third of all glaucomas -In INDIA ratio of POAG:PACG is 1:1
- 7. SYMPTOMS: -Asymptomatic -Headache and eyeache -Difficulty in reading and close work -Delayed dark adaptation -Significant loss of vision and blindness
- 8. SIGNS: Anterior segment: -Sluggish pupillary reflex -Corneal haze -Low central corneal thickness(<555microns) IOP changes: Diurnal variation test: -Morning rise-20% -Afternoon rise-25% -Biphasic-55% Variation over 5mm-suspicious >8mm-Diagnostic Later stages permanently btwn 30-45mm Hg
- 9. Optic disc changes: Early: -Vertically oval cup -Asymmetry of cups -Large cup->0.6 -Splinter haemorrhages -Pallor area on disc -Atrophy of retinal fibre layer
- 10. Advanced: -Marked cupping -Thinning of neuroretinal rim -Notching of rim upto disc margin -Nasal shifting of blood vessels-BAYONETTING SIGN -Pulsation of retinal arterioles at disc margin - Lamellar dot sign Optic atrophy: -Optic head is white and deeply excavated
- 19. VISUAL FIELD DEFECTS: -Isopter contraction -Baring of blind spot -Wing shaped paracentral scotoma -Seidels scotoma -Bjerrums scotoma -Double arcuate scotoma -Roennes central nasal step -Peripheral field defects -Central tubular vision and temporal island of vision
- 23. INVESTIGATIONS: -Tonometry -Central corneal thickness -Diurnal variation test -Gonioscopy -Slit lamp examination -Optic disc changes -Perimetry -Nerve fibre layer analyzer -Provocative test-Water drinking test
- 24. MANAGEMENT: -Medical: Decrease aqueous production Increase outflow 1.Beta blockers 1.Prostaglandin analogues 2.CA inhibitors 2.Alpha agonists Others-Pilocarpine -Oral CA inhibitors -Hyperosmotic agents -Neuroprotective agents
- 25. -Trabeculoplasty: -Argon laser -Diode laser -Selective laser -Surgery: -Filtration surgeries-Trabeculectomy
- 26. OCULAR HYPERTENSION: -IOP more than 21mm without optic disc or field changes -Risk factors must be carefully monitored and -With high risks patients treated as POAG-IOP reduced by 20% -Without high risks annual follow up
- 27. NORMAL TENSION GLAUCOMA: -AKA Low tension glaucoma -IOP less than 21mm Hg with optic disc changes and visual field defects -May be due to vasculogenic theory -Raynaud phenomenon -Migraine -Nocturnal systemic hypotension -Reduced blood flow to ophthalmic artery
- 28. DD: -POAG -Glaucoma with intermittent rise of IOP -Previous episodes of glaucoma -Congenital optic disc anamolies -Acquired optic neuropathies
- 29. TREATMENT: -Aim – To reduce IOP by 30% -DOC is Betoxalol -Others brimonidine and prostaglandin analogues -Peripheral vasospasm-Calcium channel blockers -Systemic HTN monitoring -Trabeculectomy
- 30. THANK YOU