GLAUCOMA

REFERAT PRESENTATION
BY : ILMA AMALIA, S.KED
Anatomy
Aqueous Humor ?
• A transparent fluid that fills the
anterior and posterior chambers of the
eye
• Continuously produced by the ciliary
epithelium of the ciliary processes
projecting from the ciliary body
 Functions of Aqueous
Humor
• Brings oxygen and nutrients to cells of lens, cornea, iris
• Removes products of metabolism and toxic substances from
those structures
• Provides optically clear medium for vision
• Hydrostatic pressure due to aqueous humor establishes the
IOP, which inflates the eye to maintain proper alignment of the
optical structures
• May serve to transport ascorbate in the anterior segment to
act as an antioxidant agent.
• Presence of immunoglobulins indicate a role in immune
response to defend against pathogens.
 The
main • ciliary body
the site of aqueous humor
ocular production
structure • the trabecular meshwork
s related the principal locations of
aqueous humor outflow
to
• the uveoscleral pathway the
aqueous principal locations of
humor aqueous humor outflow
dynamics
are
 Aquoeous humor flows into the
posterior chamber and through the
pupil, enters the anterior chamber.
Aqueous outflow through the
anterior chamber occurs through the
following probable routes:

The ‘conventional
pathway’ through the
trabekular
meshwork and
Schlemm’s canal.

The ‘unconventional
pathway’ through the
ciliary muscle and
other downstream
tissues.
The aqueous humor flows through this
drainage structure and mixes with venous
blood
 Glaucoma is is
an eye disease
that is often
associated with
What is elevated intraoc
Glauco ular pressure
ma?

The increased
intraocular
It can result in pressure can
vision loss and it damage the optic
is one of the nerve, which
leading causes transmits images
of blindness to your brain
 What Causes Glaucoma?

Clear fluid
flows in and
out of a small
the fluid
space at the Drainage pressure damages the
drains too Glaucoma
front of the canal bloked builds up optic nerve
slowly
eye called the
anterior
chamber
Who Is at
Risk for
Glaucom - are over age 40
- have family members with glaucoma
a? - are of African or Hispanic heritage
- have high eye pressure
- are farsighted or nearsighted
- have had an eye injury
- have corneas that are thin in the center
- have thinning of the optic nerve
- have diabetes, migraines, poor blood
circulation or other health problems affecting
the whole body
In these cases, you may have
sudden
Vision loss : the first sign is often a loss of peripheral, or side vision
Redness in the eye
Eye pain
Eye that looks hazy (particularly in infants)
Seeing halos around lights
Nausea or vomiting
Headache

If you have any of the following symptoms,

seek immediate medical care
Open-angle glaucoma
• “Open-angle” means that the angle
where the iris meets the cornea is as
wide and open as it should be
• Open-angle glaucoma is also called
primary or chronic glaucoma
•Open-angle glaucoma, the most
common form of glaucoma, accounting
for at least 90% of all glaucoma cases
•Is caused by the slow clogging of the
drainage canals, resulting in increased
eye pressure
•Has a wide and open angle between
the iris and cornea
•Develops slowly and is a lifelong
condition
•Has symptoms and damage that are not
noticed
Closed-angle glaucoma
• Unlike open-angle glaucoma, closed
angle glaucoma is a result of the angle
between the iris and cornea closing
• It is also called acute glaucoma or
narrow-angle glaucoma
• Closed angle glaucoma, a less common
form of glaucoma
•Is caused by blocked drainage canals,
resulting in a sudden rise in intraocular
pressure
• Has a closed or narrow angle between
the iris and cornea
• Develops very quickly
• Has symptoms and damage that are
usually very noticeable
• Demands immediate medical attention
Normal-Tension Glaucoma (NTG)
• Also called low-tension or
normal-pressure glaucoma
• In normal-tension
glaucoma the optic nerve is
damaged even though the
eye pressure is not very high
• still don't know why some
people’s optic nerves are
damaged even though they
have almost normal pressure
levels
Congenital Glaucoma
•This type of glaucoma occurs in
babies when there is incorrect or
incomplete development of the
eye's drainage canals during the
prenatal period
• This is a rare condition that may
be inherited
•When uncomplicated,
microsurgery can often correct
Signs of Childhood
Glaucoma the structural defects
o Unusually large eyes • Other cases are treated with
o Excessive tearing medication and surgery
o Cloudy eyes
o Light sensitivity
Secondary Glaucoma

• Secondary glaucoma refers to any case in which another

disease causes or contributes to increased eye pressure,
resulting in optic nerve damage and vision loss
• Secondary glaucoma can occur as the result of an eye injury,
inflammation, tumor, or in advanced cases of cataract or
diabetes. It can also be caused by certain drugs such as
steroids.
•This form of glaucoma may be mild or severe
•The type of treatment will depend on whether it is open-
angle or angle-closure glaucoma.
Secondary Gloucoma

Pigmentary Glaucoma – It occurs when the pigment granules that are in the back
of the iris (the colored part of the eye) break into the clear fluid produced inside the
eye and block the drainage system
Pseudoexfoliative Glaucoma – It occurs when a flaky, dandruff-like material peels
off the outer layer of the lens within the eye. The material collects in the angle
between the cornea and iris and can clog the drainage system of the eye, causing eye
pressure to rise
Traumatic Glaucoma – Injury to the eye may cause secondary open-angle
glaucoma. Traumatic glaucoma can occur immediately after the injury or years later
Neovascular glaucoma – This occurs due to iris neovascularisation (rubeiosis iridis).
This can occur after ischaemic retinal vein occlusion, advanced diabetic eye
disease, central retinal artery occlusion, intraocular tumours, long-standing retinal
detachment and where there has been chronic intraocular inflammation
A Comprehensive Glaucoma Exam

Tonometry
The inner eye pressure

Ophthalmoscopy (dilated eye exam)

The shape and color of the optic
nerve

Perimetry (visual field test)

The complete field of vision
A Comprehensive Glaucoma Exam

Gonioscopy
The inner eye pressure

Pachymetry
Thickness of the retina cornea
Regular glaucoma check-ups
include two routine eye tests:
tonometry and ophthalmoscopy
What Does Vision With Glaucoma Look Like?
Optic Nerve in Glaucoma
Treatment

Medications
Non Medication
to lower pressure
• Decrease Production of • Trabeculoplasty
Aqueous Humor - open trabecular meshwork
- beta adrenergic receptor - open angle
antagonists • Iridotomy
- carbonic anhydrase inhibitors - punches hole in iris
• Increase Outflow of Aqueous - closed angle
Humor
- prostaglandin analogs
• Decrease Production and
Increase Outflow
- alpha adrenergic agonists
THANKYOU