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Angle closure glaucoma

Angle closure glaucoma. Spectrum of condition Peripheral iris moves forward to block the trabecular meshwork Causing a rise of intraocular pressure. Occurs in. short eye Small corneal diameter Shallow anterior chamber Relative anterior positioning of lens iris diaphragm.

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Angle closure glaucoma

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  1. Angle closure glaucoma

  2. Spectrum of condition • Peripheral iris moves forward • to block the trabecular meshwork • Causing a rise of intraocular pressure

  3. Occurs in • short eye • Small corneal diameter • Shallow anterior chamber • Relative anterior positioning of lens iris diaphragm

  4. Mechanism of closure of anterior chamber angle ?

  5. Relative pupillary block

  6. Impedes forward movement of aqueous

  7. Forward bowing of peripheral iris Closure of trabecular meshwork

  8. Diagnosis • Goniscopy

  9. DR ANUPAMA .B

  10. SCHWALBES LINE TRABECULAR MESHWORK SCLERAL SPUR CILIARY BODY BAND DR ANUPAMA .B

  11. DR ANUPAMA .B

  12. DR ANUPAMA .B

  13. DR ANUPAMA .B

  14. Shaffers grading of angle of anterior chamber DR ANUPAMA .B

  15. 0 SL TM SS CBB 1 2 3 4 DR ANUPAMA .B

  16. Presentation • Sub acute • Acute • Chronic

  17. subacute • Sub acute- sharp rise in intraocular pressure for a short period • Repeated attack • Damage TM • Chronically raised IOP

  18. Peripheral laser Iridotomy

  19. Acute congestive glaucoma • Sudden rise in intraocular pressure to extremely high level • Unilateral headche, nausea • Marked diminution of vision,coloured halos

  20. Acute congestive glaucoma • Visual acuity- reduced to counting fingers • Lid- edema • Conjunctiva Circumcorneal congestion • Corneal -edema • AC-Shallow anterior chamber Cells and flare

  21. Acute congestive glaucoma • Pupil-Mid dilated pupil,non reactive • Lens- anterior subcapsular opacities • Optic disc- acute- edema,hyperaemic • 2-4 weeks- optic disc cupping • Goinioscopy- appositional closure with or withour peripheral anterirosynechiae

  22. Acute congestive glaucoma • Optic disc- acute- edema, hyperaemic • Optic disc-2-4 weeks- optic disc cupping • Gonioscopy- appositional closure with or without peripheral anterior synechiae • IOP- very high 40mmHg

  23. Treatment • Bring down the IOP- Hyperosmoticagnets • After reducing IOP • Gonioscopy • Laser iridotomy/Trabeculectomy • Prophylactic Laser iridotomy in the other eye

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