By George A. Cioffi, MD
This part underwent significant revision for the 2008-2009 edition.Topics mentioned contain the epidemiologic elements of glaucoma; hereditary and genetic components; intraocular strain and aqueous humor dynamics; medical overview; clinical administration of and surgical treatment for glaucoma. This variation comprises up-to-date tables and revised pictures, in addition to a number of new photos illustrating either ailment entities and surgical concepts.
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Extra info for 2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009)
Sentinel vessels may be seen in eyes harboring an intraocular tumor. Any thinning or staphylomatous areas should be noted. 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.
Schlemm's canal is completely lined with an endothelial layer that does not rest on a continuous basement membrane. The canal is a single channel, with an average diameter of approximately 370 flm, and is transversed by tubules. The inner wall ofSchlemm's canal contains giant vacuoles that have direct communication with the intertrabecular spaces. The outer wall is actually a single layer of endothelial cells that do not contain pores. A complex system of vessels connects Schlemm's canal to the episcleral veins, which subsequently drain into the anterior ciliary and superior ophthalmic veins.
Corectopia, ectropion uveae, and pupillary abnormalities may also be observed in some forms of secondary open-angle glaucoma and angle-closure glaucoma. In some clinical situations, it is not possible to assess the pupils objectively for the presence of a relative afferent defect. Under those circumstances, it can be useful to ask the patient to make a subjective comparison between the eyes of the perceived brightness of a test light. Biomicroscopy Biomicroscopy of the anterior segment is performed for signs of underlying or associated ocular disease.
2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009) by George A. Cioffi, MD