By George A. Cioffi, MD
This part underwent significant revision for the 2008-2009 edition.Topics mentioned comprise the epidemiologic features of glaucoma; hereditary and genetic components; intraocular strain and aqueous humor dynamics; medical overview; scientific administration of and surgical treatment for glaucoma. This variation comprises up-to-date tables and revised photos, in addition to a number of new photos illustrating either disorder entities and surgical innovations.
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Extra info for 2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009)
36 . Glaucoma Cornea Enlargement of the cornea associated with breaks in Oescemet's membrane (Haab striae) is commonly found in developmental glaucoma patients. Glaucomas associated with other anterior segment anomalies are described in the following discussions. Punctate epithelial defects, especially in the inferonasal interpalpebral region, are often indicative of medication toxicity. Microcystic epithelial edema is commonly associated with elevated lOP, particularly when the lOP rise is acute.
Current evidence indicates that ~rreceptors are the most prevalent adrenergic receptors in the ciliary epithelium. The significance of this finding is unclear, but ~-adrenergic antagonists may affect active transport by causing a decrease either in the efficiency of the Na+/K+ pump or in the number of pump sites. For a detailed discussion and illustration of the sodium pump and pump-leak mechanism, see BCSCSection 2, Fundamentals and Principles of Ophthalmology. Rate of Aqueous Formation The most common method used to measure the rate of aqueous formation is fluorophotometry.
Heavy pigmentation of the trabecular meshwork should suggest pigment dispersion or exfoliation syndrome. Exfoliation syndrome may appear clinically similar to pigment dispersion syndrome, with pigment granules on the anterior surface of the iris, increased pigment in the anterior chamber angle, and secondary open-angle glaucoma. Pigmentation of the angle structures is usually patchy in exfoliation syndrome, as compared with the more uniform pigment distribution seen in pigment dispersion syndrome.