Beruflich Dokumente
Kultur Dokumente
1. Digital 3.
2. Schiotz
Palpation Aplannation
4. Non contact
tonometer
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
GLAUCOMA CLASSIFICATION1
B. Secondary Glaucoma *
1. Secondary Open Angle Glaucoma
• Mature / hypermature cataract Phacolytic glaucoma
• Infection uveitis
• Drug-induced glaucoma (>>> corticosteroid)
• Neovascularization
2. Secondary Angle Closure Glaucoma
• Lens Dislocation
• Immature Cataract Phacomorphic glaucoma
• Neovascularization
C. Childhood Glaucoma
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
CHILDHOOD GLAUCOMA
CHILDHOOD GLAUCOMA
Classification by Childhood Glaucoma Research Network4
4. Shaarawy, T.M et al. 2015. Childhood Glaucoma. Glaucoma: Medical Diagnosis and Therapy.
Childhood
Glaucoma
PRIMARY CONGENITAL GLAUCOMA4
4. Shaarawy, T.M et al. 2015. Childhood Glaucoma. Glaucoma: Medical Diagnosis and Therapy..
Congenital
Glaucoma
PATHOGENESIS
Unproven
Cellular or membranous abnormality in the
trabecular meshwork:
a. Impermeable trabecular meshwork, or
b. Barkan membrane covering the trabecular
meshwork
4. Shaarawy, T.M et al. 2015. Childhood Glaucoma. Glaucoma: Medical Diagnosis and Therapy..
Congenital
Glaucoma
CLINICAL FEATURES
Triad: epiphora, photophobia,
blepharospasm
High IOP
Reduced in visual acuity
Buphthalmos
Corneal enlargement (diameter >
12 mm)
Corneal edema
“Haab striae” : tears in descemet
membrane
Glaucomatous cupping
4. Shaarawy, T.M et al. 2015. Childhood Glaucoma. Glaucoma: Medical Diagnosis and Therapy..
Congenital
Glaucoma
MANAGEMENT
4. Shaarawy, T.M et al. 2015. Childhood Glaucoma. Glaucoma: Medical Diagnosis and Therapy..
Congenital
Glaucoma
MANAGEMENT
1. Goniotomy
Surgical
1. Goniotomy
2. Trabeculotomy
3. Trabeculectomy
2. Trabeculotomy 3. Trabeculectomy
4. Shaarawy, T.M et al. 2015. Childhood Glaucoma. Glaucoma: Medical Diagnosis and Therapy..
CHRONIC GLAUCOMA
CHRONIC GLAUCOMA
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
CHRONIC GLAUCOMA
Symptoms :
1. Asymptomatic
2. Central vision lost “tunnel vision”
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
POAG CLINICAL MANIFESTATION
Sign:
1. IOP > 22 mmHg
2. Gonioscopy open angle
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
POAG CLINICAL MANIFESTATION
Sign:
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
POAG CLINICAL MANIFESTATION
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
POAG CLINICAL MANIFESTATION
4. Funduscopy / Indirect Ophthalmoscopy Optic Disc Cupping
POAG MANAGEMENT
1. MEDICAL
Purpose :
• Decrease the production of aqueous humor (Beta-
blocker Timol ed, carbonic anhydrase inhibitor
Glaucon, alpha-1 agonist Alphagan ed)
• or Increase the outflow (Prostaglandin analog
Xalatan / travatan ed, miotic Carpin)
2. SURGERY
- Trabeculectomy
Indications:
1. Inadequate IOP control
2. Progression of visual fields
inspite of good IOP control
3. Intolerance of medication
4. Advanced glaucoma
5. Lack of availability &
inability to afford cost of
glaucoma medication
6. Patient preference
PHACOLYTIC GLAUCOMA
• Patogenesis :
Mature / hypermature
cataract Leakage of lens
material through lens capsule
obstruct trabecular
meshwork
• Symptom :
• Unilateral pain, ↓ visual acuity
• Signs :
- ↑ IOP, inflammation reaction
in Anterior Chamber
• Th/ : Lens Extraction
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
PSEUDOEXFOLIATION SYNDROME /
SOAG
EXFOLIATIVE GLAUCOMA
PSEUDOEXFOLIATION (PXF)
• Patogenesis :
Unknown
• Clinical Findings :
• PXF material on lens
capsule & iris
• Phacodonesis
• Lens subluxation • Th/ :
• Exfoliative glaucoma Argon Laser
High IOP Trabeculoplasty
Trabeculectomy +/- Lens
extraction
UVEITIC GLAUCOMA
• Patogenesis :
1) Trabecular meshwork
blocked by inflammatory
cells
2) Trabeculitis
• Clinical Findings:
High IOP Management:
Hyperemic conjunctiva 1. Th/ underlying disease :
Corticosteroid (oral,
Keratic Precipitate (KP) in
topical),
corneal endothel
Immunosuppresive Agent
Mild-moderate inflammation in 2. Mydriatic/cycloplegic
Anterior Chamber (AC) 3. Anti glaucoma medication
5. BCSC Glaucoma. American Academy of Ophthalmology 2015-2016
SOAG DRUG-INDUCED GLAUCOMA
1. Riordan-Eva, P & Whitcher, J.P. 2010. Glaucoma. Vaughan & Asbury’s : General Ophthalmology.
Tugas
• 1. Gambar penampang Sagital Bola Mata lengkap
dengan keterangan
• 2. Jelaskan Fisiologi Aquous Humor
• 3. Jelaskan komplikasi Katarak
• 4. Penatalaksaan Glaukoma Akut