1. ACUTE GLAUCOMAM.R.SHOJA1 M.R Shoja MD Shahid Sadoughi Medical Science Yazd. Iran

2. ACUTE GLAUCOMAM.R.SHOJA2 ANATOMY OF EYE

3. ACUTE GLAUCOMAM.R.SHOJA3 GLAUCOMA Glaucoma is the second leading cause of blindness in the world. In 2000 there were an estimated 66.8 million people with glaucoma, 6.7 million of whom had bilateral blindness secondary to glaucoma. Glaucoma has been definded as a progresssive optic neuropathy

4. ACUTE GLAUCOMAM.R.SHOJA4 Glaucoma classification Closed angle : - Primary - secondary Open angle : - Primary - Secondary

5. ACUTE GLAUCOMAM.R.SHOJA5 Acute angle closure glaucoma - Rapid increase in pressure of eye - In Asia is more common - 2-3 times more common in women than men - Much higher in hyperopic eyes

6. ACUTE GLAUCOMAM.R.SHOJA6

7. ACUTE GLAUCOMAM.R.SHOJA7 Precipitating factors 1-Mydriasis Darkness Medications Emotional upset - 2- Extreme Miosis - 3- Prone position

8. ACUTE GLAUCOMAM.R.SHOJA8 Dramatic symptoms Severe eye pain nausea and vomiting Headache Blurred vision Haloes around light Profuse tearing Fix mid-dilated pupil

9. ACUTE GLAUCOMAM.R.SHOJA9

10. ACUTE GLAUCOMAM.R.SHOJA10 Exams & Tests Gonioscopy Tonometry Biomicroscopy Ophthalmoscopy Perimetry

11. ACUTE GLAUCOMAM.R.SHOJA11 Treatment B-adrenergic antagonist Timolol  -adrenergic agonist : Apraclonidine Acetazolamid Trusopt Hyper osmotic agent Laser iriditomy PI Surgical iridectomy

12. ACUTE GLAUCOMAM.R.SHOJA12

13. ACUTE GLAUCOMAM.R.SHOJA13 Congenital glaucoma 1. Primary 2. Secondary ( Sturg-weber )

14. ACUTE GLAUCOMAM.R.SHOJA14 Primary congenital (Infantile glaucoma) 60% are diagnosed by 6 months 80% within first year 65% are male Bilateral in 70% cases Incidence being 1 in 25000 births

15. ACUTE GLAUCOMAM.R.SHOJA15 Eye exam Buphthalmos Corneal enlargement > 13mm Corneal edema Glaucomatous cupping

16. ACUTE GLAUCOMAM.R.SHOJA16 Symptoms Epiphora Photophobia Blepharospasm

17. ACUTE GLAUCOMAM.R.SHOJA17 Differential diagnosis Birth trauma Obstruction of lacrimal system Congenital syphilis, rubella Mucopolysaccahridoses CHED

18. ACUTE GLAUCOMAM.R.SHOJA18 Treatment Surgical 1. Goniotomy 2. Trabeculotomy