GLAUCOMAGlaucoma is a progressive optic neuropathy (a disease of the optic nerve) characterized by a optic nerve-head

atrophy with cupping & arcuate nerve-fibre bundle visual field defects.There is death of the retinal ganglion cells, the axons of which comprise the optic nerve and

carry the visual impulses from the eye to the brain. Glaucoma represents a final common pathway resulting

from a number of different conditions that can affect the eye, many of which are associated with elevated IOP. It is important to realize that elevated IOP is not synonymous with glaucoma, but rather is the most

important risk factor we know of for the development and/or progression of glaucomatous damage.

OTHER PRESSURE-INDEPENDENT: “PERFUSION-PRESSURE”=BALANCE B/W IOP VS BP 0F THE RBV OF THE OPTIC NERVE HEAD*

MAJOR RISK FACTORS+ PRESSURE-DEPENDENT=HiGH IOP=I/O PRESSURENR=14—20 mmHg. 21=Border-Line. 22mmHg & above=liable to cause Ischaemic compression of optic nerve head & arcuate nerve-fiber bundles.

TYPiCAL GLAUCOMA & VARiANTS AT 2 ENDS = OCULAR

HYPERTENSIVES=^IOP but Normal VFs & NORMAL TENSION

GLAUCOMA=Normal ‘IOP’ but abnormal VFs!

TYPES 0F GLAUCOMA:*CONGENiTAL= BUPHTHALMOS

**ACQUiRED= OPEN-ANGLE= Classical POAG & Sec.Open-

Angle.ANGLE-CL0SURE= PACG &

Sec.Angle-Closure.

CLINICAL PARAMETERS= 1*VISUAL FIELDS; 2*FUNDOSCOPY;

3*IOP; 4*GONIOSCOPY; 5*RETINAL NERVE-FIBRES

PH0T0GRAPHY; 6*OCT= OPTiCAL C0HERENCE T0M0GRAPHY.

TREATMENTS:*BUPHTHALMOS= GONIOTOMY;

TRABECULOTOMY.**POAG=Anti-Glaucoma Drugs;

ALT; TRABECULECTOMY.***PACG= IV MANNIT0L & TRABE.****SEC.TYPES=N0RMALiZE IOP &

TREAT The PRiMARY CAUSE eg. PHAC0M0RPHiC GLAUC0MA!

GLAUCOMATOUS ViSUAL-FiELD DEFECT$:

1.Baring of the Blind-Spot.2.Para-Central Scotoma.

3.Seidel’s Scotoma.4.Arcuate Scotoma.

5.Double-Arcuate Scotoma.6.Roenne’s Nasal-Step

7.Temporal Wedge.8.Generalized Contraction of Overall Visual-Field