Evaluation of The Optic Nerve Head in Glaucoma
Introduction The diagnosis of primary open-angle glaucoma is based on the triad of increased intraocular pressure, visual field changes and optic nerve head changes. Apart from the glaucomatous changes in the optic nerve head, the other two factors in isolation lack diagnostic sensitivity. In fact, studies have shown that careful evaluation of the optic nerve head has high specificity and that an ...Read More
Optic Disc Evaluation in Glaucoma
Glaucoma, by definition, is chronic, progressive optic neuropathy.[1-3] Structural damage to the optic nerve head (ONH) is a characteristic feature of glaucoma and precedes visual field loss in most cases. Para-papillary changes may also be observed in eyes with glaucoma. The mere presence of raised intraocular pressure is not glaucoma. Hence, the optic disc evaluation is the first and most import...Read More
A 30-year-old male presented to the glaucoma clinic with complaints of gradually progressive diminution of vision in both eyes, left eye more than right, since 5 years. The visual disturbance was not associated with redness, pain, photophobia, or colored haloes. Past Ocular History: He was diagnosed with glaucoma elsewhere 5 years ago and started on anti-glaucoma medications(AGM). His baseline int...Read More
Trials in Glaucoma You Should Know
Ocular Hypertension Treatment Study (OHTS) This multicentric trial recruited 1,632 patients of ocular hypertension (OHT) to answer two questions. First, if early treatment in patients of OHT with topical medication would prevent the onset of primary open-angle glaucoma (POAG). Second, which patients of OHT are more likely to develop POAG, in other words, what are the risk factors for conversion fr...Read More
Primary Angle Closure Glaucoma
Primary Angle Closure Glaucoma is a condition in which elevation of intraocular pressure (IOP) occurs as a result of obstruction of aqueous outflow by partial or complete closure of angle by the peripheral iris. I. Classical Classification: Prodromal Stage Stage of constant instability Acute Congestive Stage Chronic Angle Closure Stage Absolute Stage II. Newer Classification: Recommended by the Am...Read More
Newer Imaging Technology in Glaucoma
Clinical examination of the disc has been the basis of disc and nerve fibre layer evaluation for ages but it is marred by its subjectivity and non-reproducibility, in the diagnosis and detection of glaucoma. Though visual field changes give concrete and reproducible evidence of glaucomatous changes, it becomes manifest only after considerable damage has occurred to the retinal ganglion cells(RGCs)...Read More
Medical Management of Glaucoma
Introduction The primary goal in the treatment of glaucoma is to prevent or retard the loss of visual function caused by damage to the optic nerve. Our therapeutic approaches, however, are currently limited to reducing IOP. This approach of lowering a potentially harmful pressure will apply to patients with documented optic nerve damage and visual field loss as well as those with elevated IOP or o...Read More
Five Things You Should Know About Intracameral Bimatoprost Sustained Release Implant
The Implant Durysta (ALLERGAN) is the first-ever intracameral sustained-release bimatoprost implant. The glaucoma treatment paradigm has shifted towards earlier intervention and targeting the actual pathology. The main problem one faces with glaucoma management is compliance with the medications. The intracameral bimatoprost addresses the problem satisfactorily. Durysta, a 10-microgram bimatoprost...Read More
A Postgraduate's Guide To Tonometry
Tonometry is the procedure for the measurement of intraocular pressure. It is the most important risk factor for the development and progression of glaucoma. It is the only factor that can be treated and modified in the management of glaucoma. Therefore, the need for accurate and reproducible measurement of IOP is of utmost importance. Clinical measurement of IOP has undergone several technical ad...Read More
Glaucoma in Pseudophakia And Aphakia
Glaucoma in pseudophakia and aphakia is secondary glaucoma in which intraocular pressure (IOP) is elevated following cataract removal. This diagnosis is given only if there was no glaucoma prior to cataract removal.[1] The terms aphakic and pseudophakic glaucoma have been previously used in literature. Currently, this terminology is not preferred. Glaucoma in pseudophakia and aphakia refer to cond...Read More