REFERAT

GLAUCOMA
Oleh : Ghina Efrilia Roza
Pembimbing : Dr. Rahmat Syuhada, Sp.M
(K)
Anatomy of Angulo Iridocornealis
Is the anatomical angle
created by the root of
the iris and the
peripheral corneal vault.
Within it lie the
structures involved in the
outflow passage of the
aquoes, namely
trabecular meshwork
and the Schlemm’s
canal.
Glaucoma
Glaucoma is a condition that causses optic nerve damage.
It often associated with : the increase of Intraocular
pressure, optic nerves papil atrophy, and narrowing of
visual field.
Etiology

Glaucoma occurs due to increased intraocular

pressure which can be caused by increased
production of humor aquos by the sillier body or
reduced production of aquos humour in the
corner of the eye chamber or in pupillary gap.
Risk factor
1. High Blood pressure
2. Age (> 45 yo)
3. Family history of glaucoma
4. Myopia or hypermetropia
5. Post surgery hifema or infection
6. Autoimun phenomenon
7. Primary degeneration of ganglion cells
Classification
1. Primary Glaucoma : Open Angle and Closed Angle
Open-angle Glaucoma
The most common type of glaucoma. this is called open-
angle glaucoma because of there is a tunnel in trabecular
meshwork. Usually bilateral, not necessarily symmetrical.
Open-Angle glaucoma
• Characterized by :

1. Adult onset
2. Progressive deacrease
of Vision
3. IOP > 21 mmHg
4. Glaucomatous optic
nerves damage
5. Visual field loss
6. Open angle of normal
appearance
Open-angle Glaucoma
Pathogenesis : Elevated IOP in POAG results from
increased resistance within this aquos drainage system.
Symptoms :
1. Commonly asymptomatic, detected incidentally.
2. Rarely, headache and ocular pain with mild blurring of
vision due to transient corneal oedema
3. Occasionally, early visual defects can be discovered by
chance.
Closed-Angle Glaucoma
Closed angle glaucoma is a condition in which the pressure
inside the eye becomes too high. In closed angle
glaucoma, the trabecular meshwork is obstructed and
damaged. The fluid can’t flow easily through this drainage
pathway.
Closed-Angle Glaucoma
Symptoms :
1. Sudden decrease of vision ( till 1/300)
2. Headache
3. Redness of eye, swelling, and lacrimation
4. There is “halo” or rainbow look a like in vision
5. Narrowing of visual field
6. Mid dilatation of pupil
7. Pupil reflex (-)
Secondary glaucoma
This condition Causes by :
• Pigmentation glaucoma
• Lense abnormality
• Uveal tract abnormality
• Trauma
• Iridocorneoendothelial syndrom
• Post eye surgery
• Neovascular glaucoma
• Episklera pressure increase
• Steroid compsumption
Congenital Glaucoma
Appear at birth or first year of life. The clinical
manifestations are :
1. Excessive watery eyes
2. Increase of cornea diameter (buftalmos)
3. Cloudy cornea because of ephitel oedema
4. Photophobia
5. Increase of IOP
6. Increase of COA depth
7. Optic disc curved
Absolute Glaucoma
This condition is the end stage of glaucoma. Where it
happened total blind. Clinical manifestations are :
1. Total blind
2. Cloudy cornea
3. Shallow COA
4. Papil atrophy with glaucomatosa excavatation
5. Periorbital pain
6. eyestrain
Ophtalmology physical examination
1. Visus, can be normal, progresively deacrease, sudden
deacrease.
2. Cornea, edema and cloudy
3. Camera oculli anterior
POAG : normal
PCAG : shallow
Kongenital : very deep
4. Pupil reflex
5. iris, Shadow test
Supporting assesment
1. Tonometri
- Tonometri palpation
- Tonometri Schiotz
- Tonometri aplanasi goldman
2. Gonioscopy
3. Ophtalmoscopy
4. Visual field examinaation
5. Provocation test
Differential Diagnosis
• Acute Glaucoma
- Uveitis anterior
- Keratitis
- Cornea ulcers
• Chronic glaucoma
- Catarac
- Refraction abnormalities
- Diabetic retinopathy
- Pigmentation retinitis
management
1. Medication
- Beta blocker
- Karbonik anhydase inhibitor
- Agonis alfa adrenergic
- Parasimpatomimetik (miotik)
- Analog prostaglandin
2. Surgery
- Trabeculopaty laser
- Iridektomy or pheriperal iridotomy
- Drainage
- siklodestructive
Thankyou 