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  • Understanding Glaucoma: Classification, Symptoms and Treatment Options

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    zihniyya471
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    This document discusses glaucoma, including its classification, risk factors, mechanisms, types, symptoms, diagnosis, and treatment. Glaucoma is not a single disease but a group of diseases that share common characteristics like optic nerve and visual field damage. The main types are open-angle glaucoma and angle-closure glaucoma. Treatment involves lowering elevated intraocular pressure through medical or surgical means depending on the type of glaucoma. Screening is important starting at age 40 or in those with risk factors like family history.

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    This document discusses glaucoma, including its classification, risk factors, mechanisms, types, symptoms, diagnosis, and treatment. Glaucoma is not a single disease but a group of diseases that share common characteristics like optic nerve and visual field damage. The main types are open-angle glaucoma and angle-closure glaucoma. Treatment involves lowering elevated intraocular pressure through medical or surgical means depending on the type of glaucoma. Screening is important starting at age 40 or in those with risk factors like family history.

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    7 visualizações51 páginas

    Understanding Glaucoma: Classification, Symptoms and Treatment Options

    Enviado por

    zihniyya471
    This document discusses glaucoma, including its classification, risk factors, mechanisms, types, symptoms, diagnosis, and treatment. Glaucoma is not a single disease but a group of diseases that share common characteristics like optic nerve and visual field damage. The main types are open-angle glaucoma and angle-closure glaucoma. Treatment involves lowering elevated intraocular pressure through medical or surgical means depending on the type of glaucoma. Screening is important starting at age 40 or in those with risk factors like family history.

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    © All Rights Reserved
    Baixe no formato PPTX, PDF, TXT ou leia online no Scribd
    Sinalizar o conteúdo como inadequado
    de 51

    1

    Geriputri, dr., Sp.M


    Fakultas Kedokteran Universitas Mataram
    Introduction
    Classification
    Aqueous humor & IOP
    Optic nerve in glaucoma
    Openangle glaucoma
    Angleclosure glaucoma
    Treatment
    Screening
    Acute angleclosure glaucoma

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    not a single disease
    group of diseases some common characteristics
    hallmarks:
    optic nerve head changes
    typical, often progressive
    visual field loss
    IOP??
    common end point irreversible loss of visual function
    blindness
    no typical glaucoma patient OR single best glaucoma
    treatment
    5
    Advanced age
    Gender
    Race (Caucasian, Asian)
    IOP
    Refractive error (Myopia, Hyperopia)
    Central corneal thickness
    Family history
    Underlying disease (diabetes, cardiovascular disease, retinal
    vein occlusion, migraine)
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    (Choplin NT & Lundy DC, 2007. Atlas of Glaucoma. 2nd ed)
    8
    (Choplin NT & Lundy DC, 2007. Atlas of Glaucoma. 2nd ed)
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    By mechanism
    By age of onset
    By IOP
    By stage of disease
    Based upon ICD 9

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    (Choplin NT & Lundy DC, 2007. Atlas of Glaucoma. 2nd ed)
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    time of day
    heartbeat
    respiration
    exercise
    fluid intake
    systemic medications
    topical medications
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    Generalized depression
    Paracentral scotoma
    Arcuate or Bjerrum scotoma
    Nasal step
    Altitudinal defect
    Temporal wedge

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    Chronic, slowly progressive
    Painless
    Bilateral, quite asymmetric
    Pretrabecular (membrane overgrowth)
    Trabecular
    Posttrabecular

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    Race
    Ocular biometrics small, crowded anterior segments, short AXL
    Age
    Gender
    Family history
    Refraction

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    Medical management
    Surgical

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    topical ocular hypotensive agents

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    (Choplin NT & Lundy DC, 2007. Atlas of Glaucoma. 2nd ed)
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    Open -Angle Glaucoma Other Procedures to Lower lOP
    Laser Trabeculoplasty Aqueous Shunt Implantation
    Incisional Surgery Ciliary Body Ablation Procedures
    Full-Thickness Sclerectomy Cyclodialysis
    Combined Cataract and Filtering Nonpenetrating Glaucoma Surgery
    Surgery Primary Congenital Glaucoma
    Angle-Closure Glaucoma Goniotomy and Trabeculotomy
    Laser Iridectomy
    Laser Gonioplasty or Peripheral
    Iridoplasty
    Incisional Surgery
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    Advanced age 40 yo
    Positive family history

    Measure IOP
    Careful examination of ONH

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    Pain
    Blurred vision
    Colored halos around lights
    Frontal headache
    Nausea
    Vomiting

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    High IOP
    Iris bombe
    Middilated, sluggish, and irregularly shaped pupil
    Corneal epithelial edema
    Congested episcleral and conjunctival blood vessels
    Shallow anterior chamber
    A mild amount of aqueous flare and cells

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    History: risk factors?
    Examination
    Measure IOP
    Gonioscopy both anterior chamber angle
    Examination of fundus
    Bscan US if secondary angle closure glaucoma is suspected

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    Urgent IOP reduction:
    Osmotics agents, oral or i.v
    CAI e.g. acetazolamide 250 500 mg i.v or 2x250 mg tablets
    p.o in one dose
    Topical blocker
    Topical steroid
    Recheck IOP and VA in 1 hour
    Definitive treatment

    49
    Glaucoma is sight threatening

    no typical glaucoma patient OR single best glaucoma

    treatment treatment is individualistic

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