Glaucoma

Posted by e-Medical PPT Sunday, December 12, 2010
Glaucoma is a disease in which the optic nerve is damaged, leading to progressive, irreversible loss of vision. It is often, but not always, associated with increased pressure of the fluid in the eye.
Intraocular pressure is a function of production of liquid aqueous humor by the ciliary processes of the eye and its drainage through the trabecular meshwork. Aqueous humor flows from the ciliary processes into the posterior chamber, bounded posteriorly by the lens and the zonules of Zinn and anteriorly by the iris. It then flows through the pupil of the iris into the anterior chamber, bounded posteriorly by the iris and anteriorly by the cornea. From here the trabecular meshwork drains aqueous humor via Schlemm's canal into scleral plexuses and general blood circulation.
The nerve damage involves loss of retinal ganglion cells in a characteristic pattern.Raised intraocular pressure is a significant risk factor for developing glaucoma (above 21 mmHg).Glaucoma can be divided roughly into two main categories, "open angle" and "closed angle" glaucoma. In angle closure glaucoma, the iris is apposed to the lens resulting in the inability of the aqueous fluid to flow from the posterior to the anterior chamber and then out of the trebecular network.Closed angle glaucoma can appear suddenly and is often painful; visual loss can progress quickly but the discomfort often leads patients to seek medical attention before permanent damage occurs.In open angle glaucoma there is reduced flow through the trabecular meshwork.Open angle, chronic glaucoma tends to progress at a slower rate and the patient may not notice that they have lost vision until the disease has progressed significantly.Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.

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