2008-2009 Basic and Clinical Science Course: Section 10: by George A. Cioffi, MD

By George A. Cioffi, MD

This part underwent significant revision for the 2008-2009 edition.Topics mentioned comprise the epidemiologic points of glaucoma; hereditary and genetic elements; intraocular strain and aqueous humor dynamics; scientific assessment; clinical administration of and surgical treatment for glaucoma. This variation comprises up-to-date tables and revised photos, in addition to various new photographs illustrating either disorder entities and surgical strategies.

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Extra resources for 2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009)

Example text

When found in the upper eyelid, the plexiform neuroma can produce a classic S-shaped upper eyelid deformity strongly associated with risk of glaucoma. In juvenile xanthogranuloma, yellow and/or orange papules are commonly found on the skin of the head and neck. Secondary glaucoma may cause acute pain and photophobia and ultimately significant visual loss. Owlodermal melanocytosis (nevus of Ota) presents with the key finding of hyperpigmentation of periocular skin. Intraocular pigmentation is also increased, which contributes to a higher incidence of glaucoma and may possibly increase the risk of malignant melanoma.

The Goldmann-type goniolens requires a viscous fluid such as methylcellulose for optical coupling with the cornea. In lenses with only 1 mirror, the lens must be rotated to view the entire angle. Posterior pressure on the lens, especially if it is tilted, indents the sclera and may falsely narrow the angle. The combination of the lens manipulation and the use of viscous fluid often temporarily reduces the clarity of the cornea and may make subsequent fundus examination, visual field testing, and photography more difficult.

Williams & Wilkins; 7992. Part B courtesy of Nasreen A. Syed, MOl 20 . 5 llL/min, and its composition is altered as it flows from the posterior chamber, through the pupil, and into the anterior chamber. This alteration occurs across the hyaloid face of the vitreous, the surface of the lens, the blood vessels of the iris, and the corneal endothelium and is secondary to other dilutional exchanges and active processes. BCSC Section 2, Fundamentals and Principles of Ophthalmology, discusses aqueous humor composition and production in detail in Part IV, Biochemistry and Metabolism.

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