GalucomaThe most of important factor which cause rise of intraocular pressure is obstruction to the drainage of the aqueous humor

Infantile Glaucoma(Buphthalmos) Incidence :

i. Age : present since birth , symptoms may manifest within 1-3 years of life .

ii. Sex : Boys > Girls

iii. It’s usually bilateral

Symptoms :

1- Lacrimation

2- Photophobia

3- DV

4- enlargement of the cornea

Signs :

1- enlargement of the eyeball

2- corneal oedema

3- deep anterior chamber

4- Lens is flattened and displaced backward

5- Sclera becomes thin and bluish

Diagnosis :

1- Raised intraocular pressure

2- Measurement of corneal diameter

3- Fundus examination

4- Gonioscopy

Open Angle Glaucoma

Central Visual Field Defects

Peripheral Field Defects

Treatment

Surgical treatment ( Trabeculectomy )

Argon or Diode Laser Trabeculoplasty

Acute congestive glaucoma

Closed Angle Glaucomacondition which the intraocular tension is raised due to the narrow or closed angle of the anterior chamber .

Etiology -genetic base-

1- small eyes

2- anatomically narrow angle

3- shallow A/C

4- iris is pushed forward

Incidence

1- Age : 5th to 6th decade

2- Sex : Women more effected

3- Bilateral but one’s eye is evolved first

Symptoms :

1- sudden onset & intense unbearable pain

2- Severe headache , nausea , & vomiting

3- marked deminshition of vision

4- redness , lacrimation , & photophobia

Signs :

1- chemosis

2- cilliary congestion

3- Cornea is cloudy

4- A/C very shallow

5- iris discolored , Atrophic patches

6- pupil is dilated and vertically oval

7- Glaucoma flakens (Psudu xexophalations )

8- markedly raised intocular pressure

9- fundus examn – difficult to see ( no cupping )

10- Gonioscopy narrow angle of A/C

11- the other eye has shallow A/C and narrow angle

Treatment : initial treatment is always medical & after controlling of IOP surgical peripheral iridectomy or laser iridotomy .

Absolute Glaucomathe eye is completely blind with markedly increased IOP

Treatment :

1- trabeculectomy

2- Cyclodialysis

3- Cyclocryopexy

4- to relive pain by retro bulbar alcohol injection