Glaucoma

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Epidemiology 4 Pathology 5 Clinical-manifestations 6 Laboratory 7 Management 8 More General Terms 9 Additional Terms 10 References

More Specific Terms

• acute angle-closure glaucoma
• closed (narrow)-angle glaucoma (NAG)
• combined mechanism glaucoma (CMG)
• infantile glaucoma
• open-angle glaucoma (OAG)

Introduction

• Although most forms of glaucoma occur with increased intraocular pressure, normal-pressure glaucoma is a recognized entity. The pathophysiology is not well understood.

Epidemiology

• prevalence: 2-5% age > 60, 10% age > 80
• risk factors:

• increased intraocular pressure
• age > 60
• most common cause of blindness in African-Americans
• family history - 40 % prevalence among 1st degree relatives
• diabetes mellitus
• myopia
• previous eye surgery or trauma
• history of cataracts
• alcohol consumption
• prolonged mechanical ventilation - uncommon
• glucocorticoids

Pathology

• increased pressure of the fluid in the eye
• damage to the small internal blood vessels &/or optic nerve fibers
• optic nerve fiber destruction & partial or complete loss of vision

Clinical-manifestations

• onset is insidious & often not recognized by the patient until late in the course of the disease
• peripheral vision is lost 1st as the optic nerve degenerates

Laboratory

• ophthalmoscopy

• increases in cup/disk ratio of > 0.6 consistent with glaucoma
• asymmetry in size or contour of the cup is suspicious for glaucoma

• gonioscopy
• tonometry
• perimetry
• image analysis

• aids in evaluating optic disk to neuroretinal rim area changes seen before loss of vision
• diagnosis of low & normal tension glaucoma
• equipment is expensive

Management

• see more specific type

• open-angle glaucoma
• closed-angle glaucoma
• acute angle-closure glaucoma
• infantile glaucoma

More General Terms

• chronic eye disease (chronic ophthalmopathy)

Additional Terms

• ophthalmoscopic findings suggestive of glaucoma

References

1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 66-67
2. Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998, 2009
3. Mangione C. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
4. Prescriber's Letter 18(11): 2011 Drugs That Cause or Exacerbate Glaucoma Detail-Document#: [1] (subscription needed) [2]
5. Glaucoma: NIH Institute and Center Resources [3]

glaucoma