Glaucoma

Description

Disease characterized by elevation of intraocular pressure, optic neuropathy, and progressive loss of vision

Etiology

• Primary glaucoma:
  • Open-angle glaucoma:
    • Normal anterior chamber angle
    • Insidious onset with persistent rise in intraocular pressure
    • Most common type accounting for 90% of glaucomas in the U.S.
    • Leading cause of blindness in African Americans
    • Risk factors include Chinese, African American, age >40 yr, family history, myopia, diabetes, and HTN
  • Acute angle-closure glaucoma:
    • Narrowing or closing of anterior chamber angle precluding natural flow of aqueous humor from posterior to anterior chamber of eye and through its filtering portion of trabecular meshwork
    • Usually abrupt onset with sudden increase in intraocular pressure
    • Risk factors include Asians and Eskimos, hyperopia, family history, increased age, and female gender
• Secondary glaucoma occurs from other diseases, including diseases of eye, trauma, and drugs:
  • Can be either open or closed angle
  • Drugs: Steroids, sertraline, bronchodilators, topiramate
  • Diseases: Neurofibromatosis, uveitis, neovascularization, and intraocular tumors
  • Trauma
  • Rapid correction of hyperglycemia