Galucoma The most of important factor which cause rise of intraocular pressure is obstruction to the drainage of the aqueous humor

Infantile Glaucoma(Buphthalmos)  Incidence : i. Age : present since birth, symptoms may manifest within 1-3 years of life. ii. Sex : Boys > Girls iii. It’s usually bilateral  Symptoms : 1- Lacrimation 2- Photophobia 3- DV 4- enlargement of the cornea

 Signs : 1- enlargement of the eyeball 2- corneal oedema 3- deep anterior chamber 4- Lens is flattened and displaced backward 5- Sclera becomes thin and bluish  Diagnosis : 1- Raised intraocular pressure 2- Measurement of corneal diameter 3- Fundus examination 4- Gonioscopy

Open Angle Glaucoma

Central Visual Field Defects

Peripheral Field Defects

Treatment

 Surgical treatment ( Trabeculectomy )  Argon or Diode Laser Trabeculoplasty

Acute congestive glaucoma

Closed Angle Glaucoma condition which the intraocular tension is raised due to the narrow or closed angle of the anterior chamber.  Etiology -genetic base- 1- small eyes 2- anatomically narrow angle 3- shallow A/C 4- iris is pushed forward  Incidence 1- Age : 5 th to 6 th decade 2- Sex : Women more effected 3- Bilateral but one’s eye is evolved first

 Symptoms : 1- sudden onset & intense unbearable pain 2- Severe headache, nausea, & vomiting 3- marked deminshition of vision 4- redness, lacrimation, & photophobia  Signs : 1- chemosis 2- cilliary congestion 3- Cornea is cloudy 4- A/C very shallow 5- iris discolored, Atrophic patches 6- pupil is dilated and vertically oval 7- Glaucoma flakens (Psudu xexophalations ) 8- markedly raised intocular pressure 9- fundus examn – difficult to see ( no cupping ) 10- Gonioscopy narrow angle of A/C 11- the other eye has shallow A/C and narrow angle

 Treatment : initial treatment is always medical & after controlling of IOP surgical peripheral iridectomy or laser iridotomy.

Absolute Glaucoma the eye is completely blind with markedly increased IOP  Treatment : 1- trabeculectomy 2- Cyclodialysis 3- Cyclocryopexy 4- to relive pain by retro bulbar alcohol injection