LMMU Ophthalmology Students

Most Glaucoma patients are not aware that they have glaucoma until their vision is affected.
This is because the most common types of glaucoma have no symptoms... Patients only visit the eye clinic when the vision is worse.
Glaucoma causes a gradual peripheral visual loss until it leads to blindness
Remember... The damage caused by Glaucoma is irreversible, but it can be treated to avoid blindness.
Visit your nearest Eye clinic for Glaucoma screening.

COMMON EYE DISORDERS AND DISEASES:
GLAUCOMA
Glaucoma is a disease that damages the optic nerve.The optic nerve supplies visual information to your brain from your eyes. Glaucoma refers to a group of eye conditions that are characterized by increasing the pressure in the eye (Intraocular pressure) when the fluid builds up inside the eye.
CAUSES
Family history of glaucoma. Hereditary predisposition to glaucoma. Underlying conditions like diabetes or high blood pressure. Regular use of certain medications, including steroids. Eye injury or trauma. Thin corneas (the clear layer in front of your pupils). Extreme nearsightedness.
SYMPTOMS
The most common type of glaucoma (open-angle glaucoma) often has no symptoms other than slow vision loss. Angle-closure glaucoma, although rare, is a medical emergency and its symptoms include eye pain with nausea and sudden visual disturbance.
PREVENTION
Get regular dilated eye examinations. Know your family's eye health history. Exercise safely. Take prescribed eye drops regularly. Wear eye protection.
TREATMENT
There are several different treatments for glaucoma, including eyedrops, laser treatment and surgery. The best treatment for you will depend on your circumstances.
Treatment can't reverse any loss of vision that has already occurred, but it can help stop your vision getting any worse.

Pseudoexfoliation:
▪️Pseudoexfoliation syndrome (PXS) is an important ocular manifestation of a systemic disorder and is the commonest cause of secondary open-angle glaucoma.
▪️Not all patients with PXS will develop glaucoma and there is no reliable method of determining which patients with the condition will subsequently develop optic disc damage.
▪️ Clinical features:
➖Cornea: Pseudoexfoliative material may be deposited on the endothelium and scattered pigment deposits are common. A vertical (Krukenberg) spindle may rarely form, similar to that seen in pigment dispersion syndrome. Endothelial cell abnormality, such as low density, is more common than average.
➖Anterior chamber: Pseudoexfoliative material particles are sometimes seen. Mild aqueous flare from an impaired blood aqueous barrier is common.
➖Iris: Granular pseudoexfoliative material deposits, pupillary ruff loss and patchy transillumination defects at the pupillary margin.
➖Lens: The anterior lens capsule typically shows a central disc and a radially indented peripheral layer of pseudoexfoliative material, separated by a clear zone maintained by pupillary abrasion. Peripheral capsular deposition is often visible only with pupillary dilatation. Deposits may be flaky, with scrolled edges. Cataract is more common in an eye with pseudoexfoliative material, probably because of reduced ascorbate levels in the aqueous. Phacodonesis (lens instability) due to zonular weakness may be present, but spontaneous subluxation is rare.
➖Anterior chamber angle.
○ Patchy trabecular and Schwalbe line hyperpigmentation is common, especially inferiorly.
○ A Sampaolesi line, which is an irregular band of pigment running on or anterior to the Schwalbe line, is commonly seen. It is not pathognomonic and can be found in pigment dispersion syndrome.
○ Dandruff-like pseudoexfoliative material deposits may be seen.
○ There is an increased risk of angle closure probably because of zonular laxity.
Credit: Ophthalmology-Notes AndOphthalmology-Notes And Synopses

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