glacuma

• Aqueous humor helps in maintaining intra-ocular pressure and provides metabolic support to the lens and cornea
• Ciliary processes of the ciliary body secrete the aqueous humor
• 90% of the aqueous flows via the pupil to the anterior chamber, while the remaining 10% exits the eye through the uveo-scleral pathway
• The main bulk of the aqueous passes through the trabecular meshwork at the drainage angle into Schlemm’s canal to the scleral venous plexus
• Glaucoma is an increase in intra-ocular pressure above normal, leading to optic nerve damage and visual field defects
• Normal intra-ocular pressure ranges from 10 to 21 mm Hg
• Characteristic features of glaucoma include high tension, changes in the peripheral field, and large cupping
• Classification of glaucoma includes primary glaucoma, secondary glaucoma, congenital glaucoma, adult primary glaucoma, acute congestive glaucoma, and chronic simple glaucoma
• Congenital primary glaucoma (buphthalmos) is characterized by raised intra-ocular pressure in infancy or early childhood, commonly affecting both eyes and more prevalent in boys than girls
• Symptoms of congenital glaucoma include photophobia, lacrimation, blepharospasm, enlargement of the globe, and defective vision
• Signs of congenital glaucoma include hazy cornea due to edema, bluish sclera, deep anterior chamber, possible lens dislocation, late cupping, and usually raised intra-ocular pressure
• Differential diagnosis for buphthalmos includes megalocornea, keratoglobus, and anterior staphyloma
• Management of glaucoma involves examination under anesthesia, including measuring intra-ocular pressure, fundoscopy, corneal diameter, and refraction, followed by treatment with trabeculectomy
• Acute congestive glaucoma is characterized by increased intra-ocular pressure leading to optic nerve damage due to angle closure with a shallow anterior chamber
• Predisposing factors for acute congestive glaucoma include small hypermetropic eyes, lens enlargement, and accommodation, while precipitating factors include mydriasis, darkness, and congestion of the iris and ciliary body
• Symptoms of acute congestive glaucoma include pain, haloes around light, defective vision, lacrimation, photophobia, blepharospasm, nausea, and vomiting
• Signs of acute congestive glaucoma include eyelid edema, ciliary congestion, hazy cornea, shallow anterior chamber, semi-dilated pupil, and very high intra-ocular pressure
• Treatment for acute congestive glaucoma involves admission, frequent pilocarpine, beta-blockers, mannitol, acetazolamide tabs, and trabeculectomy after lowering intra-ocular pressure
• Chronic simple glaucoma is characterized by an open angle, slowly progressive elevation of intra-ocular pressure, and eventual optic nerve damage, often asymptomatic with a genetic tendency
• Symptoms of chronic simple glaucoma include a vague ache around the eye, early presbyopia, and tubular vision
• Signs of chronic simple glaucoma include elevated intra-ocular pressure, cupping, and visual field defects
• Medical treatment and surgery are options for managing chronic simple glaucoma, with surgery indicated in cases of treatment failure, poor compliance, patient living at a distance, or poor patient condition
• Secondary glaucoma is an increase in intra-ocular pressure due to ocular disease, with causes including keratitis, hyphema, hypopyon, lens matter, iridocyclitis, rebeosis iridis, anterior lens dislocation, intumescent cataract, traumatic cataract, and steroid therapy
• Treatment for secondary glaucoma involves addressing the underlying cause