Resume Glaucoma

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GLAUCOMA

The Process of Glaucoma


 Include of eye disease which cause by intraocular hypertension inside the eye.
 The pressure inside the eye increased so that it make the damage at the optic nerve and cause
blindness.
 There are grained and fluid part inside the anterior of eye.
 The fluid part is fluids by ciliary venous system to send the light stimulus easily to the optic
nerve at the posterior part.
 The glaucoma can happen when the drained part are getting block (drained directly) and
increase the anterior part pressure of the eye (up to 21mmHgor up to 2.8kPa).
 This condition also can make the optic nerve can’t get enough fluids and stimulus of the
light, also the pressure condition can cause the optic nerve damage and the vision loss.
 The glaucoma can’t be cured, but can be treated.
1. Open Angle Glaucoma
 The most common glaucoma.
 It happened when the distance of the part between iris and cornea is increased.
 This condition can cause the gradual pressure and initially the atrophy at the outer rim
part.
 The atrophy caused the peripheral vision loss.
 This condition also damaged the optic nerve and cause the central vision loss.
 The risk factors of the glaucoma are :
o Age
Commonly affected to elderly
o Family history
o Black ethnic origin
o Near sightedness/myopia
 Signs and symptoms :
o Asymptomatic
o Peripheral vision decreased
o Fluctuating pain
o Headaches
o Blurred vision
o Halos surrounding lights (worst at night)
 Measure the ocula-pressure :
o Non-contact tonometry
Use machine to measure the cornea response of the stimulus. If the cornea don’t
react properly, in can indicate as glaucoma. Less accurate measurement but
estimate for screening
o Goldmann Applanation Tonometry
Using Gold-standard device at the cornea to make contact with the cornea and
applies pressure directly inside the cornea.
 Diagnose of the glaucoma
o Using the Goldmann applanation tonometry to measure the intraocular pressure.
o Fundoscopy to check the cupping of the optic nerve behind.
o Visual fields assessment to check peripheral vision loss.
o Using loop and flashlight to check the cornea’s reflect of light
o Using slit lamp biomicroscopic to see if there any blockage near the conjunctiva.
o Gonioscopy to see the reaction of the corner-part of the eye
o Anterior Segment Optical Coherence Tomography (ASOCT) to detect the reaction
of the eye-corner part
o Schceimpflug photography to evaluate the quantity from the front angle of the eye.
o Ocular-biometric to analyze eye’s size.
o Ultrasound Bio Microscope to evaluate the front part of the eye to detect the
anterior segment of the eye.

 Management
o Using prostaglandin analogs (ex. : latanoprost) to increase the aqureous humor)
The side effects are the disturbing at eyelash growth, eyelid pigmentation and the
iris pigmentation.
o Topical beta-blockers (ex. : timolol)
To decrease the producing of aqueous humor
o Sympathomimetics (ex. : brimonidine)
Reducing the aqueous humor production and an increase the uveoscleral outflow.
o Trabeculectomy
Making new channel at the anterior chamber, under the conjunctiva to flow the
fluids using laser so it can reach more atomic part of the blockage tissue.
2. Close Angle Glaucoma (Narrow Angle Glaucoma)
 This type of glaucoma can happen because the decreasing distance between iris and the
cornea.
 This condition caused the lens should pushing against iris to clearance the vision.
 But, from this condition also cause the blockage at the drainage part and increase the
buildup of pressure rapidly.
 The abrupt onset of eye pain followed with redness eye, blurry vision, headache, nausea,
and visual halo.
3. Normal Tension Glaucoma
 Cause by other reasons, not by pressure inside the anterior of the eye.
 The part that damaged at this condition should be hypoperfusion or low blood flow or
genetically hypersensitivity.

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