Glaucoma ppt

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SILENT THIEF OF THE SIGHT: GLAUCOMA *Rathore K.S., Nema R.K., Bhati C.P.S. BN Girls College of Pharmacy, Udaipur-Raj. Rishiraj college of Pharmacy, Indore, MP BN College of Physical Education, Udaipur August 23,2009 Multidisciplinary International Conference, Aishwariya College of Management, Udaipur “Emerging issue and global economic scenario”

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Glaucoma A group of diseases with- *characteristic optic nerve damage. *visual field loss. *elevated IOP; variable in early stage often asymptomatic (Insidious in nature);. Damage is irreversible. Effective treatment is available. Glaucoma is sometimes called the silent thief because it can slowly steal our sight before we realize anything's wrong. It's a leading cause of vision loss.

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EPIDEMIOLOGY In the world, glaucoma is the second leading cause of blindness-(cataract, glaucoma, diabetic retinopathy, AMD), (word glaucoma is originate from Latin word ‘glaukos’ mean ‘gray-blue’ an estimated 13.8 million people may have glaucoma and 5.2 million of those may be blind. till 2020 it may rise up to 16m (prevalence rate is 4.17% in rural & 5.4% in urban), 3-5% Indians are at the risk (over 90% are yet to be diagnosed) (66.8m world wide)

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Glaucoma: what is happening Either:the drain blocks here Or poor blood supply here Damages the optic nerve..looks ‘caved in’, called ‘cupped’ Clear liquid called aqueous humor circulates inside the front portion of the eye. • To maintain a healthy level of pressure within the eye, a small amount of aqueous humor is produced constantly, while an equal amount flows out of the eye through a microscopic drainage system—the trabecular meshwork. With glaucoma, aqueous humor does not flow through the trabecular meshwork properly. • Over time, eye pressure increases, damaging the optic nerve fibers.

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NORMAL IOP Normal IOP range is 12-21mmHg Mean= 15.9mmHg ± 2 SD IOP > 21.7 is abnormal. Factor affect IOP *Age *Sex *Race *Heredity *Diurnal & Seasonal variation *Blood pressure *Obesity *Drugs *Posture *Exercise *Neural *Hormone *Refractive error *Eye movement *Eyelid closure *Inflammation *Surgery

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Risk factors of glaucoma Family history (3%), sex (women ) High IOP Being over the age of 40 (6%) Diabetes Nearsightedness (Myopia) Previous eye injuries, thin cornea Steroidal use History of CVD Migraine African, Hispanic or Asian ancestry

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Types of glaucoma Congenital Primary Chronic open angle Acute closed angle Secondary (injury, drug induced) Juvenile Many different types: normal tension, absolute,

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Diagnosis of Glaucoma  The diagnosis of glaucoma is based upon; 1. Intraocular pressure ( IOP ) and its measurement. (tonometry) 2. Optic disc or fundus examination.(ophthalmoscope) 3 Visual Field examination ( perimetry ) 4. Gonioscopy-for check angle (open/closed)

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Chronic open angle glaucoma Painless, common in elderly (95%) Don’t notice anything wrong • Trabecular meshwork becomes less efficient at draining aqueous humor. • Intraocular pressure (IOP) builds up, which leads to damage of the optic nerve. • Damage to the optic nerve occurs at different eye pressures among different patients. • Typically, glaucoma has no . symptoms in its early stages.

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Acute glaucoma Less common, Emergency Can be more gradual Red eye Achy, abdominal pain, NV Misty vision Go from light into dark Small eye, shallow anterior chamber, pupil mid dilated, Iris lens contact Push the iris forward Eye feels hard Halos around light

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Characteristic pattern to loss of visual field Rim of optic nerve becomes thinner as disc caves in and becomes more cupped

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Commonly prescribed Anti-glaucoma drugs Beta-blockers Timoptol (Timolol maleate), Levobunolol (Betagan) Betaxalol ( Betoptic ) Carteolol ( Teoptic) Other Common Medications Brimonidine (Alphagan) Dorzolamide (Trusopt) Latanaprost (Xalatan) Pilocarpine Dipivefrin (Propine)

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Treatment Laser Trabeculoplasty Sclerostomy Cycloablation, cyclophotocoagulation Surgical Goniotomy for congenital Trabeculotomy (filtering surgery) for congenital glaucoma's Trabeculectomy for adult glaucoma's Implants for difficult non responsive

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Economic impact of glaucoma Due to Glaucoma15m patients go to hospitals every year, this cost to Rs.200 crores to Indian government, also affect working hours and health index of nation.

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Conclusion Prevention is only the cure, so at proper time detection, diagnosis and treatment are only way to prevent vision impairment and blindness by glaucoma.

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THANK YOU For your attention and your openness to challenge “the silent thief of sight”