-IBIS-1.5.0-
tx
eyes/ears/nose/throat
glaucoma: non-acute
diagnoses

definition and etiology

definition: A problem of gradually increasing intraocular pressure causing at first a slow loss of peripheral vision, but leading to late loss of central vision and complete blindness if uncontrolled.

etiology: This is the most common type of glaucoma, usually seen in patients over 30, though it may develop in childhood. It is usually familial and affects both eyes.

The reason glaucoma develops is unknown, although the physiology is recognized. There is in imbalance between the production and drainage of the aqueous humor, usually due to an obstruction of outflow, although in chronic open angle there is usually no clear reason for this to occur, as the anterior chamber appears anatomically normal.

Glaucoma is the second leading cause of blindness in the U.S. Approximately 1 in 50 people over the age of 35 have the disorder, and it is estimated that about 1 million more people have it and do not know it.

signs and symptoms

The condition is rarely painful.

• Frequent need to change prescription for glasses or contact lenses.
• Impaired dark adaptation.
• Sees halos around lights.
• Mild headaches or undefined visual disturbances.
• May be asymptomatic.

lab findings:
• Ophthalmosopic: possible cupping of the optic disc.
• Gonioscopy: intraocular pressure greater than 22 mg. on three successive testings.

course and prognosis

Without treatment, the patient will slowly become blind. Treatment includes eyedrops, tablets, and/or surgery to keep the aqueous fluid draining.

differential diagnosis

• Vitamin A deficiency.


footnotes