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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