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    Primary Angle-Closure Glaucoma: 1. Pathogenesis 2. Classification

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    khadzx
    This document describes the different types of primary angle-closure glaucoma, including latent, subacute, acute congestive, postcongestive, and chronic. It outlines the pathogenesis involving anatomical predispositions like a shallow anterior chamber and narrow chamber angle that can lead to pupil block and angle closure. Signs, classification, and treatments are provided for each type.

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    Primary Angle-Closure Glaucoma: 1. Pathogenesis 2. Classification

    Uploaded by

    khadzx
    69 views9 pages
    This document describes the different types of primary angle-closure glaucoma, including latent, subacute, acute congestive, postcongestive, and chronic. It outlines the pathogenesis involving anatomical predispositions like a shallow anterior chamber and narrow chamber angle that can lead to pupil block and angle closure. Signs, classification, and treatments are provided for each type.

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    29Primary AngleClosure Glau

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    This document describes the different types of primary angle-closure glaucoma, including latent, subacute, acute congestive, postcongestive, and chronic. It outlines the pathogenesis involving anatomical predispositions like a shallow anterior chamber and narrow chamber angle that can lead to pupil block and angle closure. Signs, classification, and treatments are provided for each type.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    69 views9 pages

    Primary Angle-Closure Glaucoma: 1. Pathogenesis 2. Classification

    Uploaded by

    khadzx
    This document describes the different types of primary angle-closure glaucoma, including latent, subacute, acute congestive, postcongestive, and chronic. It outlines the pathogenesis involving anatomical predispositions like a shallow anterior chamber and narrow chamber angle that can lead to pupil block and angle closure. Signs, classification, and treatments are provided for each type.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 9

    PRIMARY ANGLE-CLOSURE GLAUCOMA

    1. Pathogenesis

    2. Classification

    3. Intermittent

    4. Acute congestive

    5. Post congestive
    6. Chronic
    Anatomical predispositions

    • Convex iris-lens • Shallow anterior • Narrow entrance to


    diaphragm chamber chamber angle
    Pupil block

    • Increase in physiological
    pupil block

    • Dilatation of pupil renders peripheral


    iris more flaccid
    • Increased pressure in posterior
    chamber causes iris bombe

    • Angle obstructed by peripheral iris


    and rise in IOP
    Classification
    1. Latent - asymptomatic
    • IOP may remain normal
    • May progress to subacute, acute or chronic
    angle closure
    2. Subacute - intermittent angle closure
    • May develop acute or chronic angle closure
    3. Acute
    • Congestive - sudden total angle closure
    • Postcongestive - follows acute attack

    4. Chronic - ‘creeping or latent’ angle closure


    • Follows intermittent angle closure
    5. Absolute
    • No PL following acute attack
    Intermittent angle-closure glaucoma
    Signs Treatment

    • Epithelial oedema and closed angle • Treatment - bilateral YAG laser


    during attack iridotomy
    Acute congestive angle-closure glaucoma
    Signs

    • Severe corneal oedema • Ciliary injection • Complete angle closure


    (Shaffer grade 0)
    • Dilated, unreactive, • Shallow anterior
    vertically oval pupil chamber
    Treatment of Acute Congestive
    Angle-Closure Glaucoma
    1. Acetazolamide 500 mg i.v.
    2. Hyperosmotic agents - if appropriate
    • Oral glycerol 1-1.5 g/kg of 50% solution in lemon juice
    • Intravenous mannitol 2g/kg of 20% solution

    3. Topical therapy
    • Pilocarpine 2% to both eyes
    • Beta-blockers
    • Steroids

    4. YAG laser iridotomy


    • To both eyes when cornea is clear
    Signs of postcongestive angle-closure glaucoma

    • Folds in Descemet • Stromal iris atrophy with


    membrane spiral-like configuration

    • Posterior synechiae • Fixed dilated pupil


    • Fine pigment on iris • Glaukomflecken
    Chronic angle-closure glaucoma
    Signs

    • Easily missed unless routine


    • Similar to POAG with gonioscopy performed
    cupping and field loss
    • Variable amount of angle closure

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