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LOP: Depends on the balance between production and removal of aqueous humour
1. Conventional Pathway:
Aqueous humour is secreted by the ciliary processes in the posterior chamber. Then it passes through the pupil into the anterior chamber. It is drained in posterior chamber through the Trabecular meshwork, Schlemms canal, and episcleral veins.
2. Uveo-scleral pathway
choroid
Supra-choroidal space
Drains a small proportion of aqueous (4%). It drains it across the ciliary body into the supra-coroidal space, and into the venous circulation across the sclera.
IOP
y Ischemia of nerve fibers caused by impaired perfusion
Classification of Glaucoma:
1.
1. 2.
Primary glaucoma:
Chronic open angle Acute and chronic closed angle
2.
1. 2. 3.
Congenital glaucoma:
Primary Rubella Seconday to other inherited ocular disorders (e.g. aniridia; absense of iris)
3.
1. 2. 3. 4. 5.
Primary Glaucoma:
Is the iris:
NOT covering the Trabecular meshwork Covering the Trabecular meshwork
Trabecular meshwok, due to: 1. Thickening of Trabecular lamellae (reduces pore size). 2. Reduction in number of lining Trabecular cells. 3. Increased extracellular material in the Trabecular meshwork spaces.
glaucoma. y It causes SLOW damage to the optic nerve, causing gradual loss of vision.
As fluids accumulates in the anterior chamber due to decreased drainage, intra-ocular pressure increases and cases damage to the optic nerve.
Treatment: 1. Even though the IOP is normal but medication to decrease IOP as much as possible are used.
with shallow anterior chambers. y Normally there is some resistance between the pupil margin and the lens.
y But sometimes .
1. The eyes becomes red and painful due to rapid increase in IOP.
Acute angle closure glaucoma (cont.): 3. Patient may notice haloes (circles of light)
around light due to dispersed light in waterlogged cornea.
Acute angle closure glaucoma (cont.): may have similar symptoms in the past y They
that are aborted by going to sleep, because sleeping constricts the pupils pulling it from the lens.