ANGLE CLOSURE GLAUCOMA SIMPLE REVIEW.pptx

Angle-closure glaucoma is a type of glaucoma where the drainage angle in the eye, formed by the cornea and iris, becomes blocked or closes, leading to a rapid increase in intraocular pressure. This can cause sudden and severe symptoms such as eye pain, headaches, blurred vision, and nausea. If left untreated, angle-closure glaucoma can result in permanent vision loss, making it a medical emergency that requires prompt treatment.

1. Angle Closure Glaucoma ABUBAKAR AMEER ROLL NO. 140

2. LEARNING OBJECTIVES

3. DEFINITION Closed-angle glaucoma are characterized by closure of angle between iris and cornea at the periphery, obstructing the drainage of aqueous humor and thereby increasing the intraocular pressure . Groups at Risks Age >60 years Gender: females > males (4:1) Race: Asians Family history: increased risk with 1 st degree relatives

4. CLASSIFICATION

5. PREDISPOSING FACTORS

6. PHYSIOLOGICAL PUPILLARY BLOCK 1. Iris has large arc of contact with anterior surface of lens 2. Resistance to aqueous flow from posterior to anterior chamber ( relative pupil block ) 3. Pupil dilates, peripheral iris becomes more flaccid and pushed anteriorly 4. Iris lies against trabecular meshwork  impede aqueous humor drainage  ↑ IOP

7. SYMPTOMS Rapidly progressive impairment of vision Painful eye Red eye Nausea, vomiting Photophobia Haloes, transient blurring – indicate previous intermittent attacks Hx of similar attacks in the past ** CACG: usually asymptomatic due to slow onset of disease

8. SIGNS Reduced visual acuity Cornea cloudy and oedematous Pupil oval, fixed and moderately dilated Ciliary injection Eye feels hard on palpation Elevated IOP (50-100 mmHg) Narrow chamber angle with peripheral iridocorneal contact Gonioscopy – complete peripheral iridocorneal contact

9. MANAGEMENT 1. Acetazolamide 500mg IV followed by 250mg orally after every 6 hours Emergency treatment is required – preserve the sight! SYSTEMIC THERAPY 2.Mannitol 2.5 to 10ml of 20% solution per Kg of body weight orally 3. Analgesics for relief of pain 4. Antiemetics for control of vomiting

10. MANAGEMENT TOPICAL THERAPY 1. Pilocarpine 2% four times a day 2. Beta blockers ( Timolol 0.5% twice a day) 3. Corticosteroids can be used to treat inflammation of anterior segment

11. SURGICAL MANAGEMENT Peripheral laser iridotomy To establish the communication between the posterior and anterior chambers by making an opening in the peripheral iris This will be successful only if less than 50% of the angle is closed Peripheral Iridectomy

12. SECONDARY ANGLE CLOSURE GLAUCOMA Angle-closure secondary to a variety of ocular disorders Lens abnormalities (thick cataract) Lens dislocation Inflammation ( uveitis , scleritis , extensive retinal photocoagulation) Signs and symptoms Same as PACG

13. TAKE HOME MESSAGE…

14. THANK YOU! …