secondary glaucoma

27
Secondary glaucoma Secondary glaucoma associated with lens disorders associated with lens disorders glaucoma capsulare glaucoma capsulare Pseudoexfoliation Pseudoexfoliation syndrome syndrome Exfoliative material Exfoliative material Glaucoma due to Glaucoma due to deposits of deposits of fibrillar basement fibrillar basement membrane material on membrane material on TBM TBM Treatment as in POAG Treatment as in POAG

Upload: khemrajkaini12

Post on 18-Jan-2017

33 views

Category:

Healthcare


4 download

TRANSCRIPT

Page 1: Secondary glaucoma

Secondary glaucomaSecondary glaucomaassociated with lens disordersassociated with lens disorders

glaucoma capsulareglaucoma capsulare

Pseudoexfoliation Pseudoexfoliation syndromesyndrome

Exfoliative materialExfoliative material Glaucoma due to Glaucoma due to

deposits of fibrillar deposits of fibrillar basement membrane basement membrane material on TBMmaterial on TBM

Treatment as in POAGTreatment as in POAG

Page 2: Secondary glaucoma

Secondary glaucomaSecondary glaucomalens disorderslens disorders

phacomorphic glaucomaphacomorphic glaucoma

Swollen intumescent Swollen intumescent lens causes pupillary lens causes pupillary block block

Control of IOP followed Control of IOP followed by lens extractionby lens extraction

Page 3: Secondary glaucoma

Secondary glaucomaSecondary glaucomalens disorderslens disorders

phacolytic glaucomaphacolytic glaucoma

Due to micro leak of lens Due to micro leak of lens protein in hypermature / protein in hypermature / mature cataractmature cataract

Lens particle loaded Lens particle loaded macrophages block the macrophages block the TBMTBM

Control of IOP and lens Control of IOP and lens extractionextraction

Page 4: Secondary glaucoma

Secondary glaucomaSecondary glaucomalens disorderslens disorders

phaco anaphylacticphaco anaphylactic

Associated with latent Associated with latent period during which period during which sensitization to lens sensitization to lens protein occursprotein occurs

Seen more commonly in Seen more commonly in young patientsyoung patients

Control of IOP and uveitisControl of IOP and uveitis

Page 5: Secondary glaucoma

Secondary glaucomaSecondary glaucomalens disorderslens disordersectopia lentisectopia lentis

Secondary glaucoma due Secondary glaucoma due to congenital, traumatic or to congenital, traumatic or spontaneous lens spontaneous lens subluxation or dislocation.subluxation or dislocation.

Mechanism: pupillary Mechanism: pupillary block, angle closure or block, angle closure or phacolytic phacolytic

Page 6: Secondary glaucoma

Secondary glaucomaSecondary glaucomapigmentary glaucomapigmentary glaucoma

Young myopic patientsYoung myopic patients Secondary open angle Secondary open angle

glaucoma due to pigmentary glaucoma due to pigmentary obstruction of TBMobstruction of TBM

Krukenburg’s spindleKrukenburg’s spindle Retroillumination: radial spoke Retroillumination: radial spoke

like defects in the irislike defects in the iris Treatment as in POAGTreatment as in POAG

Page 7: Secondary glaucoma

Secondary glaucomaSecondary glaucomaNeovascular glaucomaNeovascular glaucoma

Rubeosis iridis associated with Rubeosis iridis associated with glaucomaglaucoma

Seen in conditions:Seen in conditions:Diabetic retinopathyDiabetic retinopathyCRVOCRVOSickle cell retinopathySickle cell retinopathyROPROP

Treatment: Control of IOP, Treatment: Control of IOP, photocoagulation with Trabphotocoagulation with Trab

Page 8: Secondary glaucoma

Secondary glaucomaSecondary glaucomaneovascularisationneovascularisation

Page 9: Secondary glaucoma

Secondary glaucomaSecondary glaucomainflammatoryinflammatory

Page 10: Secondary glaucoma

Secondary glaucomaSecondary glaucoma uveitisuveitis

Due to plasmoid aqueous and Due to plasmoid aqueous and cells obstructing the anglecells obstructing the angle

In chronic due to posterior In chronic due to posterior synechia/goniosynechiasynechia/goniosynechia

TreatmemtTreatmemtcontrol of IOPcontrol of IOPcontrol of uveitiscontrol of uveitis

Page 11: Secondary glaucoma

Secondary glaucomaSecondary glaucomauveitisuveitis

Page 12: Secondary glaucoma

Secondary glaucomaSecondary glaucomaafter cataract surgeryafter cataract surgery

Page 13: Secondary glaucoma

Secondary glaucomaSecondary glaucomacorneal ulcercorneal ulcer

Page 14: Secondary glaucoma

Secondary glaucomaSecondary glaucomacataract surgerycataract surgery

epithelial downgrowthepithelial downgrowth

Page 15: Secondary glaucoma

Secondary glaucomaSecondary glaucomacataract surgerycataract surgery

Page 16: Secondary glaucoma

Secondary glaucomaSecondary glaucomacataract surgerycataract surgerypupillary blockpupillary block

Page 17: Secondary glaucoma

Secondary glaucomaSecondary glaucomatraumatic hyphematraumatic hyphema

Page 18: Secondary glaucoma

Secondary glaucomaSecondary glaucomatraumatic lens dislocationtraumatic lens dislocation

Page 19: Secondary glaucoma

Secondary glaucomaSecondary glaucomaSturge-Weber syndromeSturge-Weber syndrome

Page 20: Secondary glaucoma

Secondary glaucomaSecondary glaucomahigh episcleral venous pressurehigh episcleral venous pressure

Page 21: Secondary glaucoma

Secondary glaucomaSecondary glaucomahyperthyroidhyperthyroid

Page 22: Secondary glaucoma

Secondary glaucomaSecondary glaucomahigh episcleral venous pressurehigh episcleral venous pressure

Page 23: Secondary glaucoma

Secondary glaucomaSecondary glaucomaSteroid inducedSteroid induced

Secondary open angle glaucomaSecondary open angle glaucoma Usually following topical therapy in high responders (marked rise of Usually following topical therapy in high responders (marked rise of

IOP after about 6 wks of steroid therapy), occasionally occurs after IOP after about 6 wks of steroid therapy), occasionally occurs after systemic therapy alsosystemic therapy also

Deposition of mucopolysaccharides in the TBMDeposition of mucopolysaccharides in the TBM Typically resembles POAGTypically resembles POAG Judicious use of steroids is advocated to avoid above complicationJudicious use of steroids is advocated to avoid above complication Discontinue steroids, IOP will get down in 10days-4 wks periodDiscontinue steroids, IOP will get down in 10days-4 wks period Timolol maleate may be used if requiredTimolol maleate may be used if required Surgery in intractable casesSurgery in intractable cases

Page 24: Secondary glaucoma

Secondary glaucomaSecondary glaucomacauses of high episcleral venous pressurecauses of high episcleral venous pressure

Page 25: Secondary glaucoma

Secondary glaucomaSecondary glaucoma venous drainagevenous drainage

Page 26: Secondary glaucoma

Secondary glaucomaSecondary glaucomaICE syndromeICE syndrome

Page 27: Secondary glaucoma

Secondary glaucomaSecondary glaucomaInflammatory glaucomaInflammatory glaucoma