Beruflich Dokumente
Kultur Dokumente
January 2009
What is glaucoma?
Disease of the optic nerve. When damage to the optic nerve fibers occurs, blind spots develop; blind spots usually go undetected until optic nerve is significantly damaged. Leading cause of blindness in the United
Normal vision
Anatomy of glaucoma
Clear liquid called aqueous humor circulates inside the front
Anatomy of glaucoma
With glaucoma, aqueous humor does not flow through the trabecular meshwork properly. Over time, eye pressure IOP increases, damaging the optic nerve fibers.
Types of glaucoma
Two main categories of glaucoma: Open-angle glaucoma: the most common form of glaucoma - (the most
common form that affects approximately 95% of individuals)
Secondary glaucoma
5
Open-angle glaucoma
High eye pressure (IOP) Family history of glaucoma Age 40 and older for African Americans
Age 60 and older for the general population, especially Mexican Americans
Thin cornea
Suspicious optic nerve appearance with increased cupping (size of cup, the space at the center of optic nerve, is larger than normal)
Continued
High myopia (severe nearsightedness) Diabetes Eye surgery or injury High blood pressure Use of corticosteroids (for example, eye drops, pills*, inhalers and creams)
10
11
Age
Family history Poor short-distance vision (farsightedness) Eye injury or eye surgery
12
Types of glaucoma
Normal-Tension Glaucoma
Cardiovascular disease Family history of glaucoma Japanese ethnicity Low eye pressure IOP
Normal-tension glaucoma occurs when eye pressure is normal, yet the optic nerve is damaged and peripheral vision is lost. Lowering eye pressure through medication sometimes slows the progress of the disease, but this type of glaucoma may worsen despite low pressure. Treatment is generally the same as for open-angle glaucoma with high eye pressure.
13
Types of Glaucoma
Congenital glaucoma affects infants born with defects that prevent the normal drainage of fluid from the eye. Juvenile glaucoma is open-angle glaucoma that affects children, adolescents and young adults. Secondary glaucoma can be open-angle or closed-angle, and is the result of some other medical condition in the eye or the body.
Pigmentary glaucoma, a rare form, in which pigment granules from the iris flake off into the eye fluid (aqueous humor) and clog the eyes drainage system (trabecular meshwork).
Pseudoexfoliation Syndrome occurs when white material appears to flake off the lens of the eye and block normal flow of the aqueous humor. Neovascular glaucoma occurs when abnormal blood vessel growth blocks the eyes fluid drainage channels and leads to increased eye pressure. This abnormal growth can be caused by low blood supply to the eye due to diabetes, insufficient blood flow to the head because of blocked neck arteries, or blood vessel blockage in the back of the eye.
Iridocorneal Endothelial Syndrome (ICE) has a number of features, including the breaking off of cells from the cornea, which blocks the drainage channels in the eye and leads to increased eye pressure. Scars may also connect the iris to the cornea.
14
Detecting Glaucoma
Regular glaucoma check-ups include two routine eye tests: 1. Tonometry eye pressure test IOP 2. Ophthalmoscopy is a test that allows a health professional to see inside the
back of the eye (called the fundus) and other structures using a magnifying instrument (ophthalmoscope) and a light source.
Additional tests:
15
Detecting Glaucoma
Tonometry:
The tonometry eye test measures the inner pressure of the eye also known as Intraocular Pressure or IOP.
16
Types of Tonometry:
Applanation tonometry measures intraocular pressure either by the force required to flatten a constant area of the cornea (e.g. Goldmann tonometry) or by the area flattened by a constant force.
Goldmann tonometer: Stationary device requires anesthesia drops, requires contact with cornea and is attached to a slit lamp usually is used by an Ophthalmologist.
17
Types of tonometry
non-contact tonometry or air-puff tonometry:
This type of tonometer uses a rapid air pulse to applanate the cornea. Intraocular pressure is estimated by detecting the force of the air jet at the instance of applanation.
18
Types of tonometry
Tono-pen - is a portable electronic, digital pen-like instrument that determines IOP by making contact with the cornea, after use of topical anesthetic eye drops tip covers are used between the patients.
19
Types of tonometry
The newest Advancement in tonometry is DIATON TONOMETER It measures intraocular pressure (IOP) through the Eyelid.
DIATON Requires No Contact with Cornea No Anesthetic Drops, No Risk of Infecting
Diaton Tonometer is intended for use by Inpatient & Outpatient Clinics such as Hospitals, Emergency Rooms, Nursing & Elderly Homes, General & Specialty Practitioners as well as Ophthalmologists and Optometrists.
20
Diaton Tonometry
Safe Quick Efficient Painless Noninvasive
21
Young adults can get glaucoma, too. African-Americans in particular are susceptible at a younger age.
22
The most common form, Open Angle Glaucoma, accounts for 19% of all blindness among AfricanAmericans compared to 6% in Caucasians. (4)
Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted. Estimates put the total number of suspected cases of glaucoma at around 65 million worldwide. (5)
23
Statistics About Glaucoma cont Prevent Blindness America Survey found that:
Blindness ranked third (after cancer and heart disease) as peoples major fear. 20% of people knew that glaucoma was related to elevated pressure within the eye. Most of them mistakenly thought people could tell if they had glaucoma due to symptoms, or that it was easily cured, or that it did not lead to blindness. 50% had heard of glaucoma, but werent sure what it was. 30% had never heard of glaucoma.
24
Sources: (1) Prevent Blindness America; (2) National Eye Health Program/National Institutes of Health; (3) American Academy of Ophthalmology; (4) Racial differences in the cause-specific prevalence of blindness in east Baltimore. N Engl J Med. 1991 Nov 14;325(20):1412-7; (5) Quigley, Number of people with glaucoma worldwide, 1996; (6) NEI, Report of the Glaucoma Panel, Fall 1998
25
26
National
% National
105480101 6% 24672708 7.9% 9722857 7.3% 14949851 8.3% 37677952 5.5% 13469237 6.1% 10805447 6.8% 18390986 7.9% 12361180 8.3% 4239587 7.8%
Not Alone 1233453 45 to 54 years 55 to 59 years 60 to 64 years 65 to 74 years 75 to 84 years 85 years and over 2069479 821517 737496 1452176 1024134 331287
Thank you for your attention and your openness to challenge the silent thief of sight!
28