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GLAUCOMA

GLAUCOMA. DR HASNAIN UL HAQ MBBS MCPS EYE SURGEON. ANATOMY. Glaucoma is a group of eye diseases that gradually steal sight without warning. In the early stages of the disease, there may be no symptoms. Experts estimate that half of the people affected by glaucoma may not know they have it.

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GLAUCOMA

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  1. GLAUCOMA DR HASNAIN UL HAQ MBBS MCPS EYE SURGEON

  2. ANATOMY

  3. Glaucoma is a group of eye diseases that gradually steal sight without warning. In the early stages of the disease, there may be no symptoms. Experts estimate that half of the people affected by glaucoma may not know they have it. DEFINITION

  4. DRAINAGE OF AQUOUS

  5. PHYSIOLOGY

  6. PHYSIOLOGY

  7. Vision loss is caused by damage to the optic nerve. This nerve acts like an electric cable with over a million wires. It is responsible for carrying images from the eye to the brain. CAUSE OF VISUAL LOSS

  8. CD .2

  9. ADVANCED CUPPING

  10. The front part of the eye is filled with a clear fluid called intraocular fluid or aqueous humor, made by the ciliary body. The fluid flows out through the pupil. It is then absorbed into the bloodstream through the eye’s drainage system. This drainage system is a meshwork of drainage canals around the outer edge of the iris. Proper drainage helps keep eye pressure at a normal level. The production, flow, and drainage of this fluid is an active continuous process that is needed for the health of the eye. AQUEOUS PATHWAY

  11. The inner pressure of the eye (intraocular pressure or IOP) depends upon the amount of fluid in the eye. If your eye’s drainage system is working properly than fluid can drain out and prevent a buildup. Likewise, if your eye’s fluid system is working properly, then the right amount of fluid will be produced for a healthy eye. Your IOP can vary at different times of the day, but it normally stays within a range that the eye can hand CONTINUE

  12. DRAINAGE

  13. In most types of glaucoma, the eye’s drainage system becomes clogged so the intraocular fluid cannot drain. As the fluid builds up, it causes pressure to build within the eye. High pressure damages the sensitive optic nerve and results in vision loss. PATHOPYSIOLOGY

  14. PATHOLOGY

  15. The two main types of glaucoma are primary open angle glaucoma (POAG), and angle closure glaucoma. These are marked by an increase of intraocular pressure (IOP), or pressure inside the eye. When optic nerve damage has occurred despite a normal IOP, this is called normal tension 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. TYPES

  16. Primary Open Angle Glaucoma • Angle Closure Glaucoma • Normal Tension Glaucoma (NTG) • Secondary Glaucoma • Pediatric Glaucoma TYPES

  17. This is the most common form of glaucoma, affecting about three million Americans. It happens when the eye’s drainage canals become clogged over time. The inner eye pressure (also called intraocular pressure or IOP) rises because the correct amount of fluid can’t drain out of the eye. With open angle glaucoma, the entrances to the drainage canals are clear and should be working correctly. The clogging problem occurs further inside the drainage canals, similar to a clogged pipe below the drain in a sink. POAG

  18. Most people have no symptoms and no early warning signs. If open angle glaucoma is not diagnosed and treated, it can cause a gradual loss of vision. This type of glaucoma develops slowly and sometimes without noticeable sight loss for many years. It usually responds well to medication, especially if caught early and treated. POAG

  19. NORMAL VISION

  20. VISION OF PT WITH GLAUCOMA

  21. This type of glaucoma is also known as acute glaucoma or narrow angle glaucoma. It is much more rare and is very different from open angle glaucoma in that the eye pressure usually rises very quickly. • This happens when the drainage canals get blocked or covered over, like a sink with something covering the drain. AAGG

  22. AAGC

  23. AAGC

  24. With angle closure glaucoma, the iris is not as wide and open as it should be. The outer edge of the iris bunches up over the drainage canals, when the pupil enlarges too much or too quickly. This can happen when entering a dark room. • A simple test can be used to see if your angle is normal and wide or abnormal and narrow. Treatment of angle closure glaucoma usually involves surgery to remove a small portion of the outer edge of the iris. This helps unblock the drainage canals so that the extra fluid can drain. Usually surgery is successful and long lasting. However, you should still receive regular check-ups. AAGG

  25. Normal tension glaucoma is also known as low-tension glaucoma or normal pressure glaucoma. In this type of glaucoma, the optic nerve is damaged even though intraocular pressure (IOP) is not very high. Doctors do not know why some people’s optic nerves suffer damage even though pressure levels are in the “normal” range (between 12-22 mm HG NTG

  26. 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. SECONDRY GLAUCOMA

  27. This form of secondary open angle glaucoma 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. • Pseudoexfoliative Glaucoma is common in those of Scandinavian descent. Treatment usually includes medications or surgery. PEUSODOEXFOLIATIVE GLAUCOMA

  28. PXF

  29. IT IS CAUSED BY HYPER MATURE LENS IT COULD BE PHACOLYTIC OR PHACOMORPHIC LENS INDUCED GLAUCOMA

  30. LEN INDUCED

  31. A form of secondary open angle glaucoma, this occurs when the pigment granules in the back of the iris (the colored part of the eye) break into the clear fluid produced inside the eye. These tiny pigment granules flow toward the drainage canals in the eye and slowly clog them, causing eye pressure to rise. Treatment usually includes medications or surgery. PIGMENTRY GLAUCOMA

  32. PIGMENTRY GLAUCOMA

  33. Injury to the eye may cause secondary open angle glaucoma. This type of glaucoma can occur immediately after the injury or years later. • It can be caused by blunt injuries that “bruise” the eye (called blunt trauma) or by injuries that penetrate the eye. • In addition, conditions such as severe nearsightedness, previous injury, infection, or prior surgery may make the eye more vulnerable to a serious eye injury. TRAUMATIC GLAUCOMA

  34. TRAUMATIC GLAUCOMA

  35. GLAUCOMA DUE TO HYPHAEMA

  36. The abnormal formation of new blood vessels on the iris and over the eye’s drainage channels can cause a form of secondary open angle glaucoma. • Neovascular glaucoma is always associated with other abnormalities, most often diabetes. It never occurs on its own. The new blood vessels block the eye’s fluid from exiting through the trabecular meshwork (the eye’s drainage canals), causing an increase in eye pressure. This type of glaucoma is very difficult to treat. NEO VASCULAR GLAUCOMA

  37. NVG

  38. IT IS DUE TO INFLAMMATION IN EYE SECONDRY TO UVIETIS. INFLAMMATORY GLAUCOMA

  39. INFLAMMATORY GLAUCOMA

  40. INFL GLAUCOMA

  41. This rare form of glaucoma usually appears in only one eye, rather than both. Cells on the back surface of the cornea spread over the eye’s drainage tissue and across the surface of the iris, increasing eye pressure and damaging the optic nerve. These corneal cells also form adhesions that bind the iris to the cornea, further blocking the drainage channels. • Irido Corneal Endothelial Syndrome occurs more frequently in light-skinned females. Symptoms can include hazy vision upon awakening and the appearance of halos around lights. Treatment can include medications and filtering surgery. Laser therapy is not effective in thes ICE SYNDROMES

  42. ICE SYDROME

  43. The pediatric glaucomas consist of congenital glaucoma (present at birth), infantile glaucoma (appears during the first three years), juvenile glaucoma (age three through the teenage or young adult years), and all the secondary glaucomas occurring in the pediatric age group. • Congenital glaucoma is present at birth and most cases are diagnosed during the first year of life. Sometimes symptoms are not recognized until later in infancy or early childhood. • The range of treatment is very different from that for adult glaucoma. It is very important to catch pediatric glaucoma early in order to prevent blindness. Pediatric Glaucoma

  44. BUPTHALMOS

  45. ADVANCED BUPTHALMOSE

  46. PO A Glaucoma is an insidious disease because it rarely causes symptoms.  Detection and prevention are only possible with routine eye examinations.  HOW EVER CERTAIN PATIENTS COMPLAIN OF DULL ACHE IN EYE OR WATERING. Signs and Symptoms

  47. Angle Closure (emergency) • Sudden decrease of vision • Extreme eye pain • Headache • Nausea and vomiting • Glare and light sensitivity S/S OF AACG

  48. Tearing • Light sensitivity • Enlargement of the cornea BUPH THALMOSE S/S OF CONGENITAL GLAUCOMA

  49. Anyone can develop glaucoma. Some people are at higher risk than others. They include: • African Americans over age 40. • Everyone over age 60, especially Mexican Americans. • People with a family history of glaucoma. • Among African Americans, studies show that glaucoma is: • Five times more likely to occur in African Americans than in Caucasians. • About four times more likely to cause blindness in African Americans than in Caucasians. • Fifteen times more likely to cause blindness in African Americans between the ages of 45-64 than in Caucasians of the same age group. RISK FACTORS

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