Vivi:Yuli:ca:

l11100.-
Case Presentation
Patient identity
O auc . \:s. l
O cx . lcualc
O Agc . o ,ca:s olc
O Acc:css . l. llau|o,a: a:ggau lc:uai
O kcligio: . lslau
latic:t was cxaui:cc o: a:ua:, 1-t|, !011
\ai: coulai:t .
watc:, c,c i: |ot| c,cs
listo:, oi ccscasc .
O lcualc, o ,ca:s olc cauc to t|c ol, c,c occa:so losital
wit| s,utous oi |ot| c,cs iclt watc:,. I|is is al:cac, iclt |,
atic:ts aitc: a:oxiuatcl, o:c uo:t| ago. s acuittcc
t|at it was :ot a|lc to scc agai: wit| |ot| c,cs si:cc o:c ,ca:
ago. I|c :ccuccc iu:ctio: oi c,csig|t |as |cc: iclt si:cc !00
a:c gctti:g wo:sc i: !00-. l: |ot| c,cs also iclt ai:. s
i:itiall, cic :ot iccl it as it is cistu:|i:g. Iwo ,ca:s ago,
acuittcc t|at t|c os cxc:ic:ci:g :cc c,cs, so:c a:c watc:,.
Past olinioal history
l,c:tc:sio: ;,
Dia|ctcs \cllitus ;,
t|c:s c,c ciscasc ;,
Glasscs wca:i:g ;,
l,c oc:atio: ;,
lauil, |isto:, .
|c cocs:`t |:ow a|out w|at t|c ucu|c: oi |c: iauil, |avc
cvc: |ac sauc coulait wit| |c:.
eneral Physioal assesment
Vital sig: .
O llooc l:cssu:c . cic :ot ucassu:cc
O kk . cic :ot ucassu:cc
O Icuc:atu:c . cic :ot ucassu:cc
5hthalmologyoal status
'isual aouity
O D . 0
O . 0
5htalmologyoal status

MovemenL(+) pLosls ()
lagofLalmos () oedem()
alpebra MovemenL (+) pLosls ()
lagofLalmos () oedem ()
redness () dlscharge ()
ln[ecLlon() ulcer ()
con[ungLlva redness () dlscharge ()
ln[ecLlon() ulcer ()
hazy oedem (+) cornea hazy oedeme (+)
noL clear shallow AnLerlor
chamber
noL Clear shallow
Slrcular pupll reflex () pupll Slrcular pupll reflex ()
CannoL be descrlbed Lensa CannoL be descrlbed
CannoL be descrlbed vlLreous CannoL be descrlbed
CannoL be descrlbed lundus CannoL be descrlbed
5htalmologyoal status
$
lala|lc ai:
A|:o:ual uass
lala|lc c,c tc:sio: Iig|t Iig|t
O lsc|i|a:a tcst .ca:`t |c co:c
O Visual iiclc tcst ;co:i:o:tatio:,. ca:`t |c co:c
O l:t:a cula: :cssu:c ;to:ouct:,, .
D !- uulg
! uulg
#$&
O lcualc, o ,ca:s olc cauc to t|c ol, c,c occa:so losital wit|
s,utous oi |ot| c,cs iclt watc:,. I|is is al:cac, iclt |, atic:ts
aitc: a:oxiuatcl, o:c uo:t| ago. s acuittcc t|at it was :ot
a|lc to scc agai: wit| |ot| c,cs si:cc o:c ,ca: ago. I|c :ccuccc
iu:ctio: oi c,csig|t |as |cc: iclt si:cc !00 a:c gctti:g wo:sc i:
!00-. l: |ot| c,cs also iclt ai:. s i:itiall, cic :ot iccl it as it is
cistu:|i:g. Iwo ,ca:s ago, acuittcc t|at t|c os os cxc:ic:ci:g :cc
c,cs, so:c a:c watc:,.
O |taluolog, status. visual acuit, D 0, . 0, ll iccls
i:c:casc wit| alatio: wit| to:ouct:i D !- uulg, !
uulg, |ic:cuis |o:|u:gtiva ;,, cilia: i:|cctio: ;,, cisc|a:gc;,,
co::ca cccua ;, a:c |az,, i: a:tc:io: c|au|c: s|allow, i:is,
lc:sa, a:c iu:cus a:c ciiiicult to ccsc:i|c |ccausc oi t|c clouccc
oi co::ca, uil :cilcxD;, ca: ;,.
iagnose
O o:|i:g Diag:osc .
O Glaucouc a|solutc D ct causa susicious glaucouc a:glc
closu:c
Plan of amination
O l:ci:cct o|t|aluosco,
O lit lau
O Go:iosco,
%reatment
lc: o:al .
O Acctazolauicc!.0 ug ta|!x1
Ioi|al .
O Iiuolol 0,. cc! cc gtt 1 ;D,
Prognosis
O D .
O Ac vitau . |o:au
O Ac iu:ctio:au . cu|ia ac ualau
O Ac sa:atio:au . cu|ia ac ualau
iterature #eview
lauooma
I|c wo:c glaucoua :cic:s to t|c aa:c:t g:c,g:cc: colou:
oi t|c c,c suiic:i:g i:ou a: attac| oi acutc :a::owa:glc
glaucoua. owaca,s t|c tc:u |as couc to covc: a g:ou oi
c,c ciscascs c|a:actc:iscc |, :aiscc i:t:aocula: :cssu:c.
I|c glaucouas a:c t|c scco:c couuo:cst causc oi |li:c:css i:
t|c wo:lc, a:c t|c couuo:cst causc oi i::cvc:si|lc
|li:c:css. I|c uost ciicctivc wa, oi :cvc:ti:g t|is cauagc
is to lowc: t|c i:t:aocula: :cssu:c.
#isk faotor
1. lo: colc lcss t|c: +0 ,ca:s oi agc, t|c i:t:a ocula: :cssu:c
;ll,is ~ !1 uulg.
!. lo: colc olcc: t|a: +0 ,ca:s oi agc t|c ll is ~ !1
uulg.
!. lig| |,c:uct:oia o: u,oia ;scvc:c lo:gs|o:t
sig|tcc:css,
+. listo:, oi glaucoua i: t|c iauil,.
.. listo:, oi ocula: t:auua.
o. lo:g |isto:, oi |,c:tc:sio: a:co: cia|ctcs ucllitus.
. u:|:ow: causcs oi c|:o:ic |cacac|cs.
$igns and $ym5toms
O ro..1 .-.o..o!o. ..o..
O uo!.. o..o-1 !.| o-1 o .!.o1, ...-.o
O to.-
O .oo! ..!1 !.
O o.. 1.. .|o-.
O .-.o ...!o..-
O i-!o...- . |. .,.
Classifioation
O o:gc:ital Glaucoua
O l:iua:, Glaucoua
O cco:ca:, Glaucoua
O A|solutc Glaucoua
ormal iso
Cu55ed iso
iagnosing glauooma
O 1he 1onometer
O Visuai Iieid 1est
O 5hthaimosco5
%reating lauooma
O l,c c:os to :ccucc :cssu:c
O \ccicatio:s lcta |loc|c:s
O lcta |loc|c: c,cc:os
O \iotic c:ugs :ccucc t|c sizc oi t|c uil oi t|c c,c
O Acctazolauicc :is| ii |avc |ac |ic:c, sto:cs
O ulia c:ugs
O lasc: c,c su:gc:, iu:ovc t|c c:ai:agc tissuc i: t|c c,c so
uo:c iluic ilows out uo:c casil,, :ccuci:g :cssu:c
O lasc: t:a|cculolast, a io:u oi lasc: c,c su:gc:,
O o:vc:tio:al c,c su:gc:, :o:lasc: su:gc:,
O I:a|ulcctou,
Case e5lanation
5lanation of 5atient oom5laints
O l, |:owi:g t|c atic:t coulai:t oi watc:, c,c i: |ot| oi |c:
c,cs, :o visio: a:,uo:c a:c t|c:c is i:c:cascuc:t oi i:t:a ocula:
:cssu:c, it ca: |c co:clucc as glaucouc a|solutc
O \cc|a:isu oi low visio: i: glaucouc
O At:oii oi ciiusc ga:glio: ccll t|i::i:g oi :c:vc ii|c: la,c: a:c a:c t|c co:c
a:t oi t|c :cti:a a:c otic :c:vc axo: loss.
O lasic :a::owi:g oi visual iiclc ccicct is t|c :c:vc ii|c:s iilc.
O Discus otic |ccouc at:o|ic, accoua:icc |, c:la:gcuc:t oi t|c
otic cavit, ;i:c:casi:g cucisc :atio,.
O l:is a:c co:us silia:is also |ccouc at:o|ic, a:c t|c :occssus silia:is
s|owcc |,ali:c ccgc:c:atio:.
iagnose
O latic:t coulai:t, cli:ical ii:ci:g
O o t:auuatic |isto:,, slowl, :og:cssio: oi lossi:g visio:
O last uccical |isto:, . t|c:c is :o |,c:tc:sio:, D\
O ll t|at i:c:cascc, D !- uulg, ! uulg
O l, go:iosco,, wc ca: |:ow t|c causa oi glaucouc a|solutc
i: t|is atic:t
%hank ou