By American Academy of Ophthalmology, George A. Cioffi MD
Presents a complete dialogue of glaucoma, together with epidemiology and the social and financial affects of the ailment; hereditary and genetic components; intraocular strain and aqueous humor dynamics; and medical evaluate and surgical remedy. a number of the sessions of clinical treatment for glaucoma are defined when it comes to efficacy, mechanism of motion and security. includes quite a few photographs illustrating affliction entities and surgical techniques.
Upon of entirety of part 10, readers will be capable to:
Identify the epidemiologic positive aspects of glaucoma, together with the social and financial affects of the disease
Describe the scientific overview of the glaucoma sufferer, together with background and common exam, gonioscopy, optic nerve exam, and visible field
Describe the scientific good points, evaluate, and therapy of fundamental open-angle glaucoma and normal-tension glaucoma
List a number of the scientific positive factors of and healing techniques for the first and secondary open-angle glaucomas
Read or Download 2014-2015 Basic and Clinical Science Course (BCSC): Section 10: Glaucoma PDF
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Additional resources for 2014-2015 Basic and Clinical Science Course (BCSC): Section 10: Glaucoma
However, caution must be used not to induce artificial opening or closing of the anterior chamber angle with these techniques. Gonioscopic Assessment and Documentation In performing both direct and indirect gonioscopy, the clinician must recognize the landmarks of the anterior chamber angle. It is important to perform gonioscopy with dim room light and a thin, short light beam in order to minimize the amount of light entering the pupil. An excessive amount of light could result in increased pupillary constriction and a change in the peripheral angle appearance that could falsely open the angle, thereby preventing the correct identification of a narrow or occluded angle.
Axenfeld-Rieger syndrome, an autosomal dominant disorder with variable penetrance, is associated with microdontia (small, peglike incisors), hypodontia (decreased number of teeth), and anodontia (focal absence of teeth): Maxillary hypoplasia may also be present. Glaucoma occurs in 50% of cases in late childhood or adulthood. Several entities are associated with signs of increased episcleral venous pressure. The presence of a facial cutaneous angioma (nevus flammeus, or port-wine stain) can indicate encephalofacial angiomatosis (Sturge-Weber syndrome).
The inner wall of the Schlemm canal contains giant vacuoles that have direct communication with the intertrabecular spaces. The outer wall is actually a single layer of endothelial cells that do not contain pores. A complex system of vessels connects the Schlemm canal to the episcleral veins, which subsequently drain into the anterior ciliary and superior ophthalmic veins. These, in turn, ultimately drain into the cavernous sinus. When IOP is low, the trabecular meshwork may collapse, or blood may reflux into the Schlemm canal and be visible on gonioscopy.