Glaucoma

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Basics

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

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Basics

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

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