Professional Documents
Culture Documents
Jurnal Glaukoma Eng
Jurnal Glaukoma Eng
GLAUCOMA
Libby, RT, et al: Annu Rev Genomics Hum Genet 6: 15, 2005
GLAUCOMA
GLAUCOMA
What causes it?
There is a dose-response
relationship between intraocular
pressure and the risk of damage to
the visual field.
GLAUCOMA
GLAUCOMA
ADVANCED GLAUCOMA
INTERVENTION STUDY
GLAUCOMA
GLAUCOMA
How do we diagnose it?
skewed tail
• 30-50% of open angle glaucoma patients
have IOP <22 mmHg
• Diurnal flucuation normally < 6 mmHg
• Women have slightly higher pressures
GLAUCOMA
Anatomy of
anterior chamber
angle
GLAUCOMA
Iris bombé
GLAUCOMA
GLAUCOMA
Population distribution of IOP
GLAUCOMA
GLAUCOMA
IOP Variables
Applanation
Tonopen
Schiotz
Air
Non-contact
GLAUCOMA
GLAUCOMA
Tonometry
Schiotz
Applanation
GLAUCOMA
Goldmann applanation
tonometer
GLAUCOMA
Tonopen
GLAUCOMA
GLAUCOMA
Goldmann perimeter Glaucoma visual fields
GLAUCOMA
GLAUCOMA
The normal visual field: an island of
vision in a sea of darkness:
THE VISUAL FIELD
Humphrey automated perimetry
GLAUCOMA
Visual fields in glaucoma
Early
Late
GLAUCOMA
GLAUCOMA
Cup-to-disk ratio
GLAUCOMA
GLAUCOMA
DISK CUPPING
Normal Glaucoma
GLAUCOMA
GLAUCOMA
Glaucomatous cupping
GLAUCOMA
GLAUCOMA
The histology of glaucomatous optic nerve
cupping:
Glaucomatous:
Normal:
GLAUCOMA
GLAUCOMA
Optic nerve signs of glaucoma progression
At 60 months, the
probability of developing
glaucoma was:
9.5% in observation group
4.4% in treatment group
GLAUCOMA
GLAUCOMA
OHTS parameters that
influence the risk of
developing POAG
IOP
Age
Cup-disk ratio
Central corneal thickness
GLAUCOMA
GLAUCOMA
Percentage of OHTS participants in
observation group who developed POAG
(mean follow-up = 72 mo)
IOP vs central
corneal thickness
GLAUCOMA
Symptoms Signs
Irritability Elevated IOP
Photophobia Buphthalmos
Epiphora Haab’s striae
Poor vision Corneal clouding
Glaucomatous cupping
Field loss
Congenital
Congenital Glaucoma
Glaucoma
Buphthalmos and cloudy corneas
Congenital
Congenital Glaucoma
Glaucoma
Buphthalmos,
glaucomatous Normal OS
cupping, and
cloudy cornea
OD
Haab’s striae
Narrow
Narrow Angle
Angle Glaucoma
Glaucoma
Onset: 50+ years of age
Symptoms Signs
Severe eye/headache Red, teary eye
pain Corneal edema
Blurred vision Closed angle
Red eye Shallow AC
Nausea and vomiting Mid-dilated, fixed
Halos around lights pupil
Intermittent eye ache “Glaucomflecken”
at night Iris atrophy
AC inflammation
GLAUCOMA
GLAUCOMA
Angle anatomy
Risk Factors
IOP Diabetes
Age Myopia
Race Gender
Family history Cardiovascular
Central corneal disease
thickness Hormones
Open
Open Angle
Angle Glaucoma
Glaucoma
Onset: 50+ years of age
Symptoms Signs
Usually none Elevated IOP
May have loss of central Visual field loss
and peripheral vision Glaucomatous disk changes
late
Normal Tension Glaucoma
(NPG, LTG, LPB, NTG)
Medical Surgical
Miotics Argon laser trabeculoplasty
Beta-blockers
Trabeculectomy
Carbonic anhydrase
Filtering procedure
inhibitors Cyclocryotherapy
Prostaglandin
Cyclolaser ablation
analogues Iridotomy
Alpha-2 agonists
GLAUCOMA
GLAUCOMA
Treatment
GLAUCOMA
GLAUCOMA
Surgical treatment of glaucoma
Argon laser Filtration
trabeculoplasty procedures
GLAUCOMA
GLAUCOMA
Filtration blebs
THANK YOU ALL FOR LISTENING!