Glaucoma.pptx

Glaucoma

1. GLAUC MA

2. Anatomy Of The Eye

3. Physiology

4. Flow Of Aqueous Production : Ciliary Body Secreted Into Posterior Chamber Via Pupil Anterior Chamber Angle Of Anterior Chamber (Iridocorneal angle) Uveoscleral Outflow Supraciliary Space Trabecular Meshwork Schlemm's Canal

5. Pathology Definition : Glaucoma refers to group of diseases with progressive and characteristics Optic disc changes, leading to irreversible Visual field changes, which may or may not be associated with increased IOP (Normal = 11 – 21 mmHg) Glaucoma is seen in two clinical forms i.e. Open angle (Chronic simple glaucoma) and Angle closure (Acute congestive glaucoma)

6. Pharmacotherapy AIM

7. Drugs PGF2 α analogues Latanoprost/Bimatoprost/Travoprost M.O.A : Increase Uveoscleral outflow Route : Topical S/E : Hyperpigmentation of Iris, Hypertrichosis, Uveitis, Macular Edema . *Drug Of Choice ( Bimatoprost is FDA approved drug for Hypotrichosis )

8. 2. β -Blockers Timolol/Betaxolol/Levobunolol M.O.A : Reduces the Aqueous formation by blocking the β 2 receptors in the Ciliary blood vessels Route : Topical Ocular S/E : Blepharoconjuctivitis, NLD Blockage, Corneal Anesthesia (Propranolol) C/I : A rrythmia B ronchospasm C ongestive Heart Failure D iabetes Mellitus

9. 3. α -Agonists Dipiverfin/Apraclonidine/Bromidine M.O.A : Decreases aqueous formation by acting on α 2 receptors in Ciliary blood vessles Dipiverfin is a prodrug of Adrenaline, It acts on α 1 receptors and causes vasoconstriction and acts on β -receptors and Increases Uveoscleral and Trabecular outflow. S/E : Follicular conjunctivitis, Eyelid retraction ( Apraclonidine ) Drowsiness, Depression, Apnea ( Bromidine )

10. 4. Carbonic anhydrase inhibitors Acetazolamide/Brinzolamide/Dorzolamide M.O.A : Inhibit C.A enzyme thereby decreasing the formation of Aqueous S/E : Hypokalemia/ Acidosis/ Anorexia (Acetazolamide) Ocular stinging, burning, itching etc. (Dorzolamide)

11. It is an Ophthalmological emergency precipitated by mydriasis (Dim light). Presenting symptoms include severe eye pain, redness, blurred vision, seeing haloes around lights, and nausea and vomiting. Intraocular pressure (IOP) is usually very high (>40 mm Hg). On eye examination :