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Glaucoma is a group of eye diseases that result in damage to the optic nerve and cause vision loss. The most common type is open-angle glaucoma, in which the drainage angle for fluid within the eye remains open, with less common types including closed-angle glaucoma and normal-tension glaucoma. Open-angle glaucoma develops slowly over time and there is no pain. Peripheral vision may begin to decrease, followed by central vision, resulting in blindness if not treated. Closed-angle glaucoma can present gradually or suddenly. The sudden presentation may involve severe eye pain, blurred vision, mid-dilated pupil, redness of the eye, and nausea. Vision loss from glaucoma, once it has occurred, is permanent. Eyes affected by glaucoma are referred to as being glaucomatous.
Uveitis is inflammation of the uvea, the pigmented layer of the eye between the inner retina and the outer fibrous layer composed of the sclera and cornea. The uvea consists of the middle layer of pigmented vascular structures of the eye and includes the iris, ciliary body, and choroid. Uveitis is described anatomically, by the part of the eye affected, as anterior, intermediate or posterior, or panuveitic if all parts are involved. Anterior uveitis (iridocyclitis) is the most common, with the incidence of uveitis overall affecting approximately 1:4500, most commonly those between the ages of 20-60. Symptoms include eye pain, eye redness, floaters and blurred vision, and ophthalmic examination may show dilated ciliary blood vessels and the presence of cells in the anterior chamber. Uveitis may arise spontaneously, have a genetic component, or be associated with an autoimmune disease or infection. While the eye is a relatively protected environment, its immune mechanisms may be overcome resulting in inflammation and tissue destruction associated with T-cell activation.
Latanoprost, sold under the brand name Xalatan among others, is a medication used to treat increased pressure inside the eye. This includes ocular hypertension and open angle glaucoma. It is applied as eye drops to the eyes. Onset of effects is usually within four hours, and they last for up to a day.
Hyphema is the medical condition of bleeding in the front (anterior) chamber of the eye between the iris and the cornea. People usually first notice a loss or decrease in vision. The eye may also appear to have a reddish tinge, or it may appear as a small pool of blood at the bottom of the iris in the cornea. A traumatic hyphema is caused by a blow to the eye. A hyphema can also occur spontaneously.
The anterior chamber (AC) is the aqueous humor-filled space inside the eye between the iris and the cornea's innermost surface, the endothelium. Hyphema, anterior uveitis and glaucoma are three main pathologies in this area. In hyphema, blood fills the anterior chamber as a result of a hemorrhage, most commonly after a blunt eye injury. Anterior uveitis is an inflammatory process affecting the iris and ciliary body, with resulting inflammatory signs in the anterior chamber. In glaucoma, blockage of the trabecular meshwork prevents the normal outflow of aqueous humour, resulting in increased intraocular pressure, progressive damage to the optic nerve head, and eventually blindness.
A glaucoma valve is a medical shunt used in the treatment of glaucoma to reduce the eye's intraocular pressure (IOP).
Hypopyon is a medical condition involving inflammatory cells in the anterior chamber of the eye.
Glaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). There are many glaucoma surgeries, and variations or combinations of those surgeries, that facilitate the escape of excess aqueous humor from the eye to lower intraocular pressure, and a few that lower IOP by decreasing the production of aqueous humor.
Canine glaucoma refers to a group of diseases in dogs that affect the optic nerve and involve a loss of retinal ganglion cells in a characteristic pattern. An intraocular pressure greater than 22 mmHg (2.9 kPa) is a significant risk factor for the development of glaucoma. Untreated glaucoma in dogs leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.
Fuchs heterochromic iridocyclitis (FHI) is a chronic unilateral uveitis appearing with the triad of heterochromia, predisposition to cataract and glaucoma, and keratitic precipitates on the posterior corneal surface. Patients are often asymptomatic and the disease is often discovered through investigation of the cause of the heterochromia or cataract. Neovascularisation is possible and any eye surgery, such as cataract surgery, can cause bleeding from the fragile vessels in the atrophic iris causing accumulation of blood in the anterior chamber of the eye, also known as hyphema.
Primary juvenile glaucoma is glaucoma that develops due to ocular hypertension and is evident either at birth or within the first few years of life. It is caused due to abnormalities in the anterior chamber angle development that obstruct aqueous outflow in the absence of systemic anomalies or other ocular malformation.
Intravitreal injection is the method of administration of drugs into the eye by injection with a fine needle. The medication will be directly applied into the vitreous humor. It is used to treat various eye diseases, such as age-related macular degeneration (AMD), diabetic retinopathy, and infections inside the eye such as endophthalmitis. As compared to topical administration, this method is beneficial for a more localized delivery of medications to the targeted site, as the needle can directly pass through the anatomical eye barrier and dynamic barrier. It could also minimize adverse drug effect to other body tissues via the systemic circulation, which could be a possible risk for intravenous injection of medications. Although there are risks of infections or other complications, with suitable precautions throughout the injection process, chances for these complications could be lowered.
Secondary glaucoma is a collection of progressive optic nerve disorders associated with a rise in intraocular pressure (IOP) which results in the loss of vision. In clinical settings, it is defined as the occurrence of IOP above 21 mmHg requiring the prescription of IOP-managing drugs. It can be broadly divided into two subtypes: secondary open-angle glaucoma and secondary angle-closure glaucoma, depending on the closure of the angle between the cornea and the iris. Principal causes of secondary glaucoma include optic nerve trauma or damage, eye disease, surgery, neovascularization, tumours and use of steroid and sulfa drugs. Risk factors for secondary glaucoma include uveitis, cataract surgery and also intraocular tumours. Common treatments are designed according to the type and the underlying causative condition, in addition to the consequent rise in IOP. These include drug therapy, the use of miotics, surgery or laser therapy.
Schwartz–Matsuo syndrome is a human eye disease characterised by rhegmatogenous retinal detachment, elevated intraocular pressure (IOP) and open angle of anterior chamber.
Uveitis–glaucoma–hyphaema (UGH) syndrome, also known as Ellingson syndrome, is a complication of cataract surgery, caused by intraocular lens subluxation or dislocation. The chafing of mispositioned intraocular lens over iris, ciliary body or iridocorneal angle cause elevated intraocular pressure (IOP) anterior uveitis and hyphema. It is most commonly caused by anterior chamber IOLs and sulcus IOLs but, the condition can be seen with any type of IOL, including posterior chamber lenses and cosmetic iris implants.
Posner–Schlossman syndrome (PSS) also known as glaucomatocyclitic crisis (GCC) is a rare acute ocular condition with unilateral attacks of mild granulomatous anterior uveitis and elevated intraocular pressure. It is sometimes considered as a secondary inflammatory glaucoma.
Ghost cell glaucoma (GCG) is a type of secondary glaucoma occurs due to long standing vitreous hemorrhage. The rigid and less pliable degenerated red blood cells block the trabecular meshwork and increase the pressure inside eyes.
Uveitic glaucoma is most commonly a progression stage of noninfectious anterior uveitis or iritis.
Phacomorphic glaucoma is an eye disease that can occur due to a neglected advanced cataract. In this, the mature cataractous lens cause secondary angle closure glaucoma. The presence of an asymmetric mature cataractous lens, shallow or closed anterior chamber angle, raised intraocular pressure (IOP) and other typical signs and symptoms of angle-closure glaucoma in the eye may lead to a diagnosis of phacomorphic glaucoma. Cataract surgery after initial IOP control with medication is the only treatment.
The crystalline lens inside the human eye has been implicated as a causative factor in many forms of glaucoma. Lens induced glaucomas or Lens related glaucomas are either open-angle or closed-angle glaucomas that can occur due to a neglected advanced cataract or a dislocated lens. It is a type of secondary glaucoma. The angle-closure glaucoma can be caused by a swollen or dislocated lens. The open-angle glaucoma can be caused by leakage of lens proteins through the capsule of a mature or hyper mature cataract or by a hypersensitivity reaction to own lens protein following surgery or penetrating trauma.
References
- 1 2 3 Cioboata, M; Anghelie, A; Chiotan, C; Liora, R; Serban, R; Cornăcel, C (2014). "Benefits of anterior chamber paracentesis in the management of glaucomatous emergencies". Journal of Medicine and Life. 7 (Spec Iss 2): 5–6. ISSN 1844-122X. PMC 4391354 . PMID 25870663.
- ↑ Cheung, C. M. G.; Durrani, O. M.; Murray, P. I. (1 April 2004). "The safety of anterior chamber paracentesis in patients with uveitis". British Journal of Ophthalmology. 88 (4): 582–583. doi:10.1136/bjo.2003.027219. ISSN 0007-1161. PMC 1772115 . PMID 15031183.
- 1 2 Saxena, Sandeep; Lai, Timothy Y.; Koizumi, Hideki; Farah, Michel E.; Ferrara, Daniela; Pelayes, David; Sato, Tomohito; Meyer, Carsten H.; Murray, Timothy; Andrade, Gabriel; Chan, Clement K.; Grover, Sandeep; Farah, Michel E.; Fauser, Sascha; Ferrara, Daniela; Ferrara, Vincenco; Hiller, Roxane J.; Ichiyama, Yusuke; Inoue, Makoto; Garfella, Marisa Hernandez; Karimi, Saeed; Koizumi, Hideki; Koss, Michael; Lai, Timothy Y.; Liu, Fung; Meyer, Carsten H.; Muni, Rajeev; Murray, Timothy; Natarajan, Sundaram; Neri, Piergiorgio; Ohji, Masahito; Park, Dong Ho; Pelayes, David; Sabrosa, Nelson A.; Riemann, Christopher; Sakurada, Yoichi; Sato, Tomohito; Saxena, Sandeep; Takeuchi, Massaru; Yang, Sung Jae; Zhang, Han; Zhang, Yingnan (6 March 2019). "Anterior chamber paracentesis during intravitreal injections in observational trials: effectiveness and safety and effects". International Journal of Retina and Vitreous. 5 (1): 8. doi: 10.1186/s40942-019-0157-z . ISSN 2056-9920. PMC 6402161 . PMID 30873293. S2CID 76663934.
- ↑ Schaftenaar, E.; Lecuona, K. A.; Baarsma, G. S.; Meenken, C.; Verjans, G. M. G. M.; McIntyre, J. A.; Peters, R. P. H. (August 2015). "Anterior chamber paracentesis to improve diagnosis and treatment of infectious uveitis in South Africa". SAMJ: South African Medical Journal. 105 (8): 628–630. doi: 10.7196/SAMJNEW.7816 . ISSN 0256-9574. PMID 26449700.
- 1 2 3 Hersh, Peter S. (2009). "Anterior chamber paracentesis". Ophthalmic surgical procedures (2nd ed.). New York: Thieme. ISBN 978-0-86577-980-8.
- ↑ Wertheim, M. S.; Connell, P. P.; Majid, M. A.; Dick, A. D. (June 2009). "The minim technique for diagnostic anterior chamber paracentesis". Eye. 23 (6): 1491. doi: 10.1038/eye.2008.231 . ISSN 1476-5454. PMID 18688263. S2CID 39054487.
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