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ZALDI
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH SUMATERA UTARA
MEDAN
2014
ACUTE GLAUCOMA
(Acute angle closure)
occurs when sufficient
iris bomb develops to
cause occlusion of the
anterior chamber angle
by the peripheral iris.
DEFINITION :
Occurs when sufficient iris bomb
develops to cause occlusion of the
anterior chamber angle by the peripheral
iris.
This blocks aqueous outflow, and the
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OCLUSION AC ANGLE
BLOCKS AQUEOUS
OUTFLOW
INTRAOCULAR PRESSURE
SUDDEN ONSET OF
VISUAL LOSS
PHOTOPHOBIA
HALOS
NAUSEA AND VOMITING
INCREASED
INTRAOCULAR PRESSURE
STEAMY CORNEA
CILIARY INJECTION
SHALLOW ANTERIOR
CHAMBER
MODERATELY DILATED
PUPIL
1. ACUTE IRITIS
o more photophobia ,
o pupil is constricted or
irregular in shape
o cornea not edematous.
2. ACUTE CONJUNCTIVITIS
bilateral
cornea is clear.
no photophobia ,
no visual loss
no ciliary injection
discharge
pupillary responses
IOP normal
2. IRREVERSIBLE OCCLUSION AC
3. OPTIC NEUROPATHY
REDUCING IOP :
1. Intravenous and oral acetazolamide
2. Topical agents : beta-blockers and apraclonidine,
3. Hyperosmotic agents : mannitol 20% , glicerol 50 %
4. Pilocarpine 2% , 4% ( by which time reduction of iris
ischemia and lowering of intraocular pressure allow
the sphincter pupillae to respond to the drug.
RGC death
Mechanical Neuroprotection
damage
Neutrophin Retina
withdrawal ISCHEMIA
ONH
Stop
axoplasmic
flow Vascular dysregulation
IOP OBF
24 ZALDI ACUTE GLAUCOMA 13/09/2017 07.41
REFERENCES
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