Shubhada More

V/13/157
 *
* Glaucoma is defined as increased pressure within the eye (called
intra-ocular pressure or IOP) that causes degenerative changes in
the optic nerves and retina with subsequent blindness

* frequent cause of blindness in both humans and animals.

 *
*Mild to severe eye pain (rubbing eye
on the wall, floor or with paw)
*blepharospasm
*Appearance of vessels in the white of
the eye
*Redness of the eye
*Cloudy cornea
*Fluttering eye lid
*Squinting
* Epiphora – increased production of tears
* Appetite loss and anti-social behaviour
(due to pain)
* Light avoidance
* Weak blink response
* No response of pupil to light
* Vision problems (bumping into objects,
difficulty finding toys, walking gingerly)
* Bulging swollen eye
* Green or yellow eye discharge
* Dilated pupil with loss pupillary reflex.
 *
* Primary glaucoma
* commonly seen in pure bred dogs
* causes an increased of pressure in both eyes, without the
presence of a primary eye disease.
* caused by a hereditary defect where the filtering
mechanism is partially or completely blocked off.
* Secondary glaucoma
* Secondary glaucoma refers to increased pressure in the
eye due to other ocular diseases
* Diseases commonly cause secondary glaucoma include
ocular inflammation , lens discoloration , intraocular tumor ,
injury to eye .
 *
Based on
* History and symptoms
* Perform an ophthalmological examination

* Tonometry
Intraocular pressure is measured with a tonometer. A
drop of anaesthetic may be put on the eye first.
* X-ray
To rule out the presence
of an eye abscess, injury or
tumour. An x-ray or ultrasound
will allow the space around the
eye to be visualized.

* Gonioscopy
Technique use to evaluate
drainage angle by placing
goniolens on corneal surface.
This lens allow directly
visualizing
drainage angle
can be done under sedation or
under tropical anaesthesia.
 *
Depend on several factors ,
 type of glaucoma
 degree of elevation of iop
 visual impairment.

Glaucoma can be treated by

1. Medical management
2. Surgical Management

In some cases glaucoma can be controlled only medication and

sometimes along with medication surgery is required.
 Medical management

* Ophthalmic beta blocker- lower pressure by reducing aqueous

production
Eg . titmol, betaxolol.
* Carbonic anhydrase inhibitor – lowers pressure in eye
1. Tropical – dorzolamide, brinzolamide
2. Oral – acetazolamide, methazolamide

* Alpha agonist - it lower aqueous production and increase rate

of drainage of aqueous humour
alpha 2 agonist – apraclonidine, brimonidine
* Miotic - These medications reduce eye pressure by increasing
the drainage of intraocular fluid through the trabecular
meshwork.
eg . Pilocarpine(1%) , carbacol
* Hyperosmotic gents - quick reduction on IOP
mannitol i/v 1-2 mg/ kg ,
glycerol(50%) orally 2 ml / kg

* Epinephrine useful in OAG use in conjunction with miotics

Dipiverine HCL @ 1 drop twice day
 *
If still vision present

* Cyclophotocoagulation –
Treatment of choice in primary
glaucoma.
A laser instrument destroys the
secretory epithelium of the eye’s
ciliary body (responsible for fluid
production within the eye).
* Cyclocryothermy
Involves freezing of ciliary body with small probe placed
on the outside of eye under anesthesia to kill the cells that
produce the aqueous humor.
Disadvantage- redness of sclera, swelling , retinal
detachment. Permanent blindness , shrinkage of eye.
 Anterior chamber shunt

small valve like device implanted just under sclera and

small tube is placed through tiny incision in anterior chamber
provide alternate drainage pathway for aqueous fluid
If vision is lost

* Evisceration and implantation of intrascleral silicon prosthesis-

Removal of contents of eye, leaving outer shell or sclera

and implanting silicon implant within wall of the eye so the shape
of eye is maintained
Ciliary ablation

Intravitreal injection of gentamycine

can be administered
The injection destroys the ciliary
body (where aqueous is produced),
and permanently reduces the
intraocular pressure.

Enuleation

Removal of whole eye ball along with

its content except muscle and
conjunctiva.
 *
* Surgery patients will need to wear an Elizabethan collar
(e-collar or cone) to prevent rubbing the eye.
* Breeds predisposed to developing glaucoma should have
the eyes checked every 6 months so that cases can be
detected and treated as early as possible