Index

A

Abraham iridotomy lens, 440 aceclidine, 424

action/dosage, 422 acetazolamide, 199, 410

aqueous humor formation, 14

chemical and pharmacologic properties, 410 structure/dose, 408

acetylcholine, 422 structure, 422

acidosis

carbonic anhydrase inhibitors, 413 decreased IOP, 408

active transport, formation of aqueous humor, 12 Acumap unit, 138–9

acute central retinal artery occlusion, hyperosmotic agents, 434

adenomas of pigment epithelium, 284 adenylate cyclase, nonadrenergic activators, 381 adrenergic agents

combined alpha-1 and beta-antagonists, 402 types/effects, 382

adrenergic agonists, 376–91 alpha-1, alpha-2, 378–9, 385 beta-, 380

chemical structures, 379

adrenergic antagonists see beta-adrenergic antagonists (beta-blockers); beta-adrenergic antagonists (betablockers), 392-406

adrenergic potentiators, 380–2 adrenergic receptors

5 types, 376 locations/functions, 377

adrenergic system, 376–91

Advanced Glaucoma Intervention Study (AGIS), 3, 345 advanced low-tension glaucoma, 149

afferent pupillary defect, 248 age

IOP

factors influencing, 59 prevalence of raised IOP, 58

age-related atrophic POAG, (senile sclerotic), 165, 167 Ahmed valve, 484–5

albuterol, 380 alcohol, 432

effects on IOP, 62 retrobulbar injection, 540

alpha-adrenergic agonists, 199, 378–9, 385–6 decrease of aqueous humor production, 41 increase of IOP, 61

side effects, alpha-2, 386 alpha-adrenergic antagonists, 401–5 alpha-chymotrypsin glaucoma, 274 amosulalol, 402

amyloidoses, 284 anesthesia, 464

angle of anterior chamber

angle contour, deep/shallow-chambered eye, 68–9 angle recession, ciliary muscle tears, 277–8 developmental mechanics of angle, 305

grading, 78

estimated angulation, 79 miotics, 84

Shaffer classification, 78–9 Spaeth classification, 80–2 structures, 26

ultrasonic biomicroscopy (UBM), 80 wide/narrow angles, 68–9

angle-closure glaucoma (ACG), 188–211 cholinergic drugs, 420

classification, 5, 188–9

mechanisms in anterior segment, 192–3

PAC suspect; closure (PAC); glaucoma (PACG), 189 phacomorphic glaucoma (lens-induced obstruction),

192

plateau iris, configuration and syndrome, 193 pupillary block glaucoma, 192–3

epidemiology, 1–2, 68 imaging, 191–2

indentation (compression) gonioscopy, 75–6, 84, 189–90 iridectomy, 86

presentations, 191

Shaffer assessment of 20° irido-trabecular angle, 189 treatment/ of acute PACG, 199–200

use, beta-adrenergic antagonists, 397

see also primary angle-closure (PAC) disease aniridia, 312–13

genetics, 336 inferior angle, 89

aniridic glaucoma, 312–13 ankylosing spondylitis, 283

anterior chamber cleavage syndrome, 318 anterior ciliary arteries, 11

anterior segment anatomy, 2, 26–34

depth and angle width, 68 anterior segment laser surgery, 385

anterior segment ocular coherent tomography (AS-OCT), 191–2

anterior subcapsular lens opacities, 198 anticholinesterase drugs

cataract, 426

and organophosphorus insecticides and pesticides, 427 use, 427

see also cholinergic drugs antifibrinolytic agents, 279

antimetabolites, 202, 282–3, 476, 480, 495, 496–7 cataract surgery, 494

aphakia and pseudophakia glaucoma in, 274

with pupillary block, 444 aphakic glaucoma

children/infants, 321 status after cyclodialysis, 90

apostilb, 92

applanation tonometry, 47–53 disposable shields or tips, 48 Draeger tonometer, 50 Goldmann tonometer, 47–50

MacKay-Marg and Tono-Pen tonometers, 50 Maklakow tonometer, 53

non-contact tonometer, 52 Ocuton tonometer, 52–3 Perkins tonometer, 50 pneumatic tonometer, 50–2 potential errors, 49

Reichert Ocular Response Analyzer, 52

summary, 57–8 appositional angle closure, 76

apraclonidine, 282, 356, 376, 380, 385–7 acute pressure management, 386 structure/dose, 379

aqueous humor, 8–17 blood—aqueous barrier, 15–16 circulation, 8

composition, 14–15

anterior vs posterior chamber, in rabbit and man, 13 factors affecting formation rate, 18–20

age and sex, 18

blood flow to ciliary body, 18–19 circulating hormones, 19

clinical conditions/drugs, 20 diurnal variation, 18

intracellular secretory processes, 20 IOP/pseudofacility, 18

neural control, 19 flow rate, 16

glaucomatous eyes, 19 formation, 12–14

active transport, 12–14 diffusion, 14

effect of carbonic anhydrase inhibitors, 407–9 ultrafiltration, 12

formation rate, 16–17

pressure-dependent methods of measurement, 16–17, 39–40

tracer methods of measurement, 17–18 functions, 8

transport systems, movement of substances out of eye, 15

aqueous outflow and POAG, 243–4

resistance by endothelial cells of Schlemm’s canal, 35–6 aqueous outflow pathway, 25–46

adaptations to lower pressure lumen of Schlemm canal, 25

as biomechanical pump, 38–9

boundary conditions (low/neutral/high IOP), 36 facility of outflow

clinical implications, 40–1 diurnal fluctuation, 41 factors, 40–1

in glaucoma, 41 measurement, 39–40

functions, 25–6

pressure-dependent methods of measurement, 16–17, 39–40

resistance location and mechanism, 34–8 compliant trabecular meshwork and valves, 38–9 limited trabeculotomy, 37

uveoscleral flow, 38 aqueous veins, 34

argon laser see laser iridotomy; laser trabeculoplasty arterial blood flow to ciliary body, 11, 18–19

autoregulation, 11–12 arteriovenous fistulas, 285–6

arteritic anterior ischemic optic neuropathy, 146 Association of International Glaucoma Societies

(AIGS), 189 asthma

beta-adrenergic antagonists, 400

asthma (continued )

corticosteroid inhalers, 271, 324 atenolol, 396

automated white-onwhite threshold perimetry (SAP), 131 Axenfeld-Rieger’s syndrome, 316, 318

genetics, 335–6

Axenfeld’s anomaly, with dense iris adhesions, 89 Axenfeld’s syndrome, 299, 317

axial length, A-scan ultrasonography, 302

B

Baerveldt implant, 485 Barbados Eye Study, 59, 60, 243 Beaver Dam Eye Study, 243, 330 Behçet’s syndrome, 283

benzalkonium chloride, 363, 400 and contact lenses, 400

beta-adrenergic agonists ciliary muscle tone, 41

stimulating formation rate of aqueous humor, 20–1 beta-adrenergic antagonists (beta-blockers), 199, 392–406

action, 392–4 children/infants, 311, 398 contraindications, 397 neuroprotection, 398

neuroprotection and blood flow, 398 pharmacologic properties, 394

reducing formation rate of aqueous humor, 20–1 side effects, 399–401

ocular, 399–400 systemic, 400–1

structures, 393 use, 397–9

angle-closure glaucoma, 397 open-angle glaucoma, 397 secondary glaucoma, 397–8

betaxolol, 395 structure/dose, 393

bicarbonate ion, active secretion into aqueous humor, 14 bilateral—genetic vs unilateral—acquired, 1 bimatoprost, 363–4

and cystoid macular edema, 367 side effects, 369–70

bimatoprost/timolol fixed combination, 364, 369 bioavailability, 348

Bjerrum’s area (arcuate area), 91 blebs

cataract surgery with pre-existing filtering bleb, 503–4 compression, 511

dellen, 527 diffuse, 526

encapsulated or encysted filtering bleb, 519–20 Indiana Bleb Grading System, 478

migration onto cornea, 526 Moorfields Bleb Grading System, 477 ocular massage, 517

overfunctioning, 525–7

Pederson needling technique, 520 progressive scarring of the filtering bleb, 520 thin-walled bleb, 522

blood flow assessment, 550

beta-adrenergic antagonists, 398 blood pressure

high/low, in POAG, 243

and prevalence of raised IOP, 60–1 blood—aqueous barrier, 15–17

breakdown, 16

Blue Mountain Eye Study, 61, 62, 242, 330 bowl perimetry, 103–5

brimonidine, 376, 380, 385–7 combination, 386

contraindications in children/infants, 311 structure/dose, 379

brinzolamide, 409–10 broad thumb syndrome, 320 bromocriptine, 380

brovincamine, normal-tension glaucoma, 258 bunazosin, 402

buphthalmos, 294

buttonholes, filtering surgery complications, 508

C

calcium channel blocking agents, normal-tension glaucoma, 258

carbachol, 424 action/dosage, 422

carbonic anhydrase, types I and II, 407

carbonic anhydrase inhibitors, 14, 199, 356, 407–19 action, 407

indirect effects, 408–9

reduction of aqueous formation, 407–8 chemical structures, 408 contraindications, 412–14

retinal-choroidal blood flow and neuroprotection, 414 side effects, 411–13

systemic agents, 410–11, 412–13 teratogenic effects, 414

topical agents, 408–9 use, 414–17

acute angle-closure glaucoma, 415 children/infants, 415

open-angle glaucoma, 415 secondary glaucoma, 415

carotid-cavernous fistulas, 285 carteolol, 396

cataract

anticholinesterase drugs, 426 developing, visual field, 99 post laser iridotomy, 443

cataract with filtration surgery, 202 cataract with glaucoma shunt, 202 cataract surgery, 491–507

aphakic glaucoma in children/infants, 321 combined cataract and glaucoma surgery, 494–6 corneoscleral incision, 501–2

extracapsular cataract extraction (ECCE), 491–2, 499–500

flap closure, 498 glaucoma after, 273–4 IOL selection, 498 miotic pupil, 499–500 phacoemulsification, 498

postoperative medical management, 498–9 pre-existing filtering bleb, 503–4

small pupil, 498

small-incision combined surgery, 494–6 sphincterotomies, 501

trabeculectomy stoma, 498

type of glaucoma and effects on management, 491–2 historical, 493–4

selection of approach, 492–3 catechol-O-methyltransferase, 380 central retinal artery (CRA), 143, 145

central retinal artery occlusion, hyperosmotic agents, 434 chemical burns, 276–7

childhood glaucomas, 294–329

see also developmental glaucomas children/infants

beta-blockers, 398

corneal measurements, diameter and central thickness, 301–2

cup-to-disc ratios at birth to 3 years, 304 gonioscopy, 303

ophthalmoscopy, 303 postural changes and IOP, 61

trauma, causing glaucoma, 324 chlorpromazine, 540

cholinergic drugs, 41, 286, 420, 420–30 action, 420–1

angle-closure glaucoma, 420 lowering of IOP, 61 open-angle glaucoma, 421

in combination, 428 contraindications, 428 examination, 427–8

and organophosphorus insecticides and pesticides, 427 side effects, 425–7

use, 427

cholinesterase inhibitors, 420 chondroitin sulfate, 275 choriocapillaris perfusion, 150 choroidal drainage, 512 choroidal perfusion, 150

chromosomal defects, 319–20, 331

chronic granulomatous uveitis, extensive angle closure, 87 chronic macular edema, COIs, 415

chymotrypsin glaucoma, 274

cilary body melanoma, narrowing of segmental cycle angle, 86

ciliary block glaucoma, 513–14 diagnosis, 513

filtering surgery complications, 513–14 hyperosmotic agents, 434

laser treatment, 445

occurrence during surgery, 515–16 treatment, 513–14

ciliary body anatomy, 9–12, 70

arterial blood flow, 11, 18–19

laser cyclophotocoagulation, 456–8 pre-capillary arterioles, 11 ultrastructure, 9–11

ciliary channel, 10

ciliary epithelium, pigmented and non-pigmented, 13 ciliary muscle

increased tone, 41

tears, angle recession, 277–8 ciliary processes, SEM, 10 classification, 4–7, 551

angle-closure glaucoma, 5 developmental glaucoma, 6 open-angle glaucoma, 4–5

clonidine, 378–9, 385–8 structure/dose, 379

colforsin, 381

Collaborative Initial Glaucoma Treatment Study (CIGTS), 3

Collaborative Normal Tension Glaucoma Study (CNTGS), 3, 256, 345

collagen implant, 544 collector channels, 34 color vision tests, 132

combination drugs, 364, 369, 386

combined cataract and glaucoma surgery, 494–6 compliance or adherence, 343, 350, 355 compressive optic neuropathy, 146 computerized bowl perimetry, 106–8

confocal scanning laser ophthalmoscopy (CSLO), 171–5 congenital anomalies, associated with glaucomas, 311–20 congenital glaucomas, 294–329

see also developmental glaucomas congestive heart failure, 401 conjunctival flap, 467–9

comparisons, 469–70, 495 fornix-based, 468–90, 499 limbus-based, 467–8

contact devices, Zeiss four-mirror and Goldmann macular lens, 154

contact lenses

and benzalkonium chloride, 400 for gonioscopic methods, 73–7 preservatives, 352

suture lysis contact lenses, 477

cornea, central corneal thickness (CCT), 302 cornea guttata, 83

corneal barriers to medical treatment, 348–9 corneal birefringence

foveal, Henle’s layer, 183

variable corneal compensator, 183–4 corneal edema, and gonioscopy, 84 corneal injury, post laser iridotomy, 443 corneal measurements

children/infants, 301–2

diameter and central thickness, children/infants, 301–2 corneal stroma, post laser iridotomy, 443 corneodysgenesis, 298–9, 316–17

corneoscleral meshwork anatomy, 27–8 ultrastructure, 27, 29

corticosteroid glaucoma, 270–1 children/infants, 324

corticosteroid inhalers, asthma, 271 corticosteroids

glycosaminoglycans in trabecular meshwork, 271 raised IOP, 62, 244–5

recommendations for treatment, 271

stimulating formation rate of aqueous humor, 20–1 cup-to-disc ratios, at birth to 3 years, 304 cyclocryotherapy, 539

children/infants, 310 cyclodialysis, 39, 84, 540

aphakic glaucoma status after, 90 shunts into suprachoroidal space, 547 with trabeculectomy, 459

cyclodialysis clefts laser treatment, 459 undetected, 528

cyclophotocoagulation with lasers see laser cystoid macular edema (CME), 366–7

D

dapiprazole, 401–2

deep sclerectomy with collagen implant (DSCI), 544–6 demecarium, 424

action/dosage, 422 structure, 425

denervation supersensitivity, 376 Descemet’s membrane

after surgery, inferior scroll, 90 Haab’s striae, 296, 299 inadequate opening, 519

desmosomes, 10

developmental glaucomas, 294–329

associated with other congenital anomalies, 311–20 classification, 6, 294–5

clinical anatomic classification, 295–9 clinical presentation, 299–304

evaluation of goniotomy and trabeculotomy, 538 examination, 299–301

external trabeculotomy, 535–8 goniotomy, 532–5

infantile glaucomas, 294

primary congenital glaucomas, 294, 304–11 secondary, in infants, 320–4

syndromes, 295 terminology, 294

trabeculectomy with/without mitomycin-C combined with trabeculotomy, 538–9

trabeculodialysis, 539 dexamethasone

steroid glaucoma, 324 trabecular meshwork, 271

Diabetes Audit and Research in Tayside Study (DARTS), 242–3

diabetes mellitus

and cataract surgery, 492 and IOP, 62

and POAG, 243

diabetic macular edema, 270 diagnosis, 340, 551

see also examination dichlorphenamide, 410, 411

chemical and pharmacologic properties, 410 structure/dose, 408

differential light sensitivity, 91, 95 diffusion, formation of aqueous humor, 14 dipivefrin, 378, 379, 382–5

Disc Damage Likelihood Scale (DDLS), 155–6 dislocated lens, 271

disposable shields or tips, 48

diurnal variation, rate of formation of aqueous humor, 18 dopamine, 376

dopaminergic agonists, 380 dorzolamide, 409

Draeger tonometer, 50 drainage devices, 481–7 Ahmed valve, 484–5

Baerveldt implant, 485 complications, 485–7 ExPress shunt, 484 Krupin valve, 483–4 Molteno implant, 481–3 Shocket procedure, 483

drugs see medical treatment dural fistulas, 286

dynamic contour tonometer, 56–7

E

Early Manifest Glaucoma Trial (EMGT), 3, 345 echothiophate

action/dosage, 422 structure, 425

electric injury, 277 electroretinography, 137–9 embryotoxon, 298, 316, 318 encephalofacial angiomatosis, 313 endophthalmitis, 517

endoscopic photocoagulation, children/infants, 310 endothelial damage, post laser iridotomy, 443 endothelial dystrophy, 83, 307

endothelial mosaic, 84 epidemiology

distribution of IOP, in normal population, 58–60 distribution of IOP in normal population, 58–60 POAG, 1–2, 239–41

prevalence rate of POAG, and ethnicity, 3 prevalence rate of raised IOP, and age, 58

epinephrine, 381–5 action, 377–8, 381–5

epiphora, 307 episclera, 9 episcleral veins, 34

episcleral venous pressure, 284–5 measurement, 41–2 prevalence of raised IOP, 61

epsilon-aminocaproic acid, 279 ethnicity

prevalence rates for POAG, 3 and raised IOP, 60

ethoxzolamide, 411

chemical and pharmacologic properties, 410 structure/dose, 408

ethyl alcohol, 432 retrobulbar injection, 540

examination, 340

developmental glaucomas, 299–301 documentation, 343

frequency, 343

excimer laser photoablation, 452–3 exercise, and IOP, 61

exfoliative syndrome, 69, 79, 268–70 genetics, 268, 334–5

exophthalmos, 285 ExPress shunt, 484

extracellular matrix (ECM), materials, laser trabeculoplasty, 34

eyeball, size and shape, genetics, 68 eyedrop solutions

administration, 351 patient education, 354–5 preservatives, 350 punctal occlusion, 354

eyelid closure, effect on IOP, 62

F

facility of outflow, measurement, 39–40

familial hypoplasia of the iris with glaucoma, 311 fetal vasculature, persistent, 320–1

filtering surgery, 466–87 conjunctival flap, 467–9 drainage devices, 481–7 excision of Tenon’s capsule, 470

external filtration, guarded vs full thickness, 467 full thickness filtration procedure, 480–1 general considerations, 466

guarded filtration procedure, 470–80 normal-tension glaucoma, 258

filtering surgery complications, 508–31

bleb complications and management, 521–2 buttonholes, 508

choroidal detachment, 510 ciliary block glaucoma, 513–14 delayed hypotony, 527–8 filtration failure, 517–20

bleb complications, 521–7

encapsulated or encysted filtering bleb, 519–20 inadequate opening of Descemet’s membrane, 519

no bleb, 521–2 ocular massage, 517

plugged sclerostomy site, 518 retained viscoelastic material, 518–19 tightly sutured flap, 519

hyphema, 516

hypotonous maculopathy, 527

hypotony with aqueous suppression therapy, 528 hypotony with a flat anterior chamber, 508–13 hypotony from iritis or ischemia, 528–9 hypotony with occult filtering bleb, 528 hypotony with retinal detachment, 528

hypotony with undetected cyclodialysis clefts, 528 infection, 516–17

intraoperative flat anterior chamber, 515–18 normal pressure with a flat anterior chamber, 513 point leaks vs aqueous oozing, 508

progressive scarring of the filtering bleb, 520 reoperation, 520–4

suprachoroidal hemorrhage, 514–15 sympathetic ophthalmia, 517

fixation, 91

flash electroretinography, 137–9

flat anterior chamber see filtering surgery complications fluorescein

formation rate of aqueous humor, 17 uveoscleral flow, 38

fluorescein angiography, optic disc, 150 fluoresceinated dextrans, 17 5-fluorouracil (5-FU), 282, 283

focal normal pressure (focal ischemia), 165, 166 foreign bodies, glass in inferior angle, 89 forskolin, 381

Framingham Eye Study, 59

frequency-doubling perimetry or technology (FDP, FDT), 131–2, 134–6

Fuchs’ heterochromic iridocyclitis, 282 neovascularization, 87

G

ganglion cells see retinal ganglion cells ganglionic blocking drugs, increased IOP, 61 gap junctions, 10

GDX variable corneal compensator (GDX VCC), 183–6 GEMSS syndrome, 322

genetics, 330–8

chromosomal defects, 319–20, 331 gene locations and phenotypes, 332 locus name, 331

primary congenital glaucoma, 304–5 raised IOP, 60

ghost-cell glaucoma, 278–9 giant vacuoles, 30–1 Gibbs-Donnan equilibrium, 12

glaucoma in association with intraocular hemorrhage, 278–80

Glaucoma Laser Trial, 347

glaucoma probability score (GPS), 174–5 glaucoma screening, 551

glaucoma suspects, 250, 340–1 types I—IV, 341

glaucomatocyclitic crisis, 282 glaucomatous optic neuropathy, 143–4 glaukomflecken of Vogt, 198

GLC loci, 333–4

glucocorticoid creams, and ointments, 270 recommendations for treatment, 271

glycerol, 432 glycosaminoglycans

physiologic component of juxtacanalicular space resistance, 34–5

in trabecular meshwork, 271 Goldmann equation

facility of outflow, 39

rate of aqueous humor formation, 8, 16 Goldmann fundus lens, 440

Goldmann lens (indirect gonioscopic method), 73–4 Goldmann perimetry, 103

Goldmann tonometer, 47–8 Goldmann visual field chart, 96 goniophotocoagulation, 460

goniopuncture, 540 gonioscopic anatomy, 68–72 gonioscopic methods, 73–7

children/infants, 303 contact lenses, 73–7

direct gonioscopic lenses, 77 direct vs indirect gonioscopy, 74 flashlight test, 84

indentation (compression) gonioscopy, 75–6, 84, 189–90 indirect gonioscopic lenses, 73–4

management of corneal edema, 84 retroillumination of angle structures, 84 simultaneous bilateral, 84

slit lamp, 84 gonioscopic results, 78–90

artifacts and misinterpretation, 82 diagramming with concentric circles, 80 grading anterior chamber angle, 78 open-angle glaucoma, 83

peripheral tumors or cysts, 84 slit-lamp estimation of angle width, 80 Spaeth grading system, 80

ultrasonic biomicroscopy (UBM), 80

van Herick estimate of angle width from anterior chamber depth, 80

gonioscopy, and corneal edema, 84 goniosynechialysis, 539 goniotomy, children/infants, 532–5 Graves’ disease, 285

guanethidine, 381

H

Haab’s striae, 296, 299 Hallermann—Streiff syndrome, 316 halos, around lights, 83

Heidelberg retina tomography (HRT), 171–5 new developments, 175

see also optical coherence tomography (OCT) hemolytic glaucoma, 279

hemosiderosis, 279

Henle’s layer, fovea, corneal birefringence, 183 herpes simplex virus, 282, 283

activation, 365 herpes zoster virus, 283

high myopia eyes with open-angle glaucoma, 163–5 high-pass resolution perimetry (HRP), 136–7 history, 339–40

homocystinuria, 322

hormone replacement therapy, no effect on IOP, 62 hormones, effects on IOP, 62

Horner’s syndrome, 392

Human Genome Organization/Genome Database, 331–2 genes, 304

hyaluronidase, 275 hydrophthalmia, 294 6-hydroxydopamine, 381 hyperosmotic agents, 200, 431–5

action, 431

intravenous agents, 432–3 oral agents, 432

side effects, 433 topical, 434 use, 433–4

hyphema, 279

complications of laser treatment, 452 filtering surgery complications, 516 intraocular hemorrhage, 279

post laser iridotomy, 443 hypopyon, 517

hypotonous maculopathy, 527

I

imaging, 171–87 impact—rebound tonometer, 55–6

indentation (compression) gonioscopy, 75–6, 84, 189–90 indentation tonometry, 53–6

impact—rebound tonometer, 55–6 Schiotz, 53–5

transpalpebral tonometry, 56 Indiana Bleb Grading System, 478

infantile glaucoma, primary, in 15-y-o, 88 infection, filtering surgery complications,

516–17 inflammation

and Argon laser trabeculoplasty (ALT), 282 effect on IOP, 62

inflammatory disease, and glaucoma, 281–2 inflammatory glaucoma, children/infants, 323–4 inflammatory precipitates, trabecular

meshwork, 283

intraocular hemorrhage, 278–80 ghost-cell glaucoma, 278 hemolytic glaucoma, 279 hemosiderosis, 279

hyphema, 279 re-bleed rate, 279–80

intraocular lenses (IOLs)

glaucoma from viscoelastic substances, 274–5 glaucoma in pseudophakic eyes, 274 pigment dispersion and elevated IOP, 275 uveitis-glaucoma-hyphema syndrome, 275

intraocular pressure (IOP), 240–2 after cats, 273–4 children/infants

examination, 300–1 normal awake children, 301 sedated children, 301

in classification, 1 continuous monitoring, 57 corticosteroids, 62, 244–5 damage levels, 342–3

distribution in normal population, 58–60 diurnal variation, 60

epidemiology, 240–1 factors influencing IOP, 59

and glaucoma, prevalence, 251 Goldmann equation, 8 idiopathic elevations, 286 levels, 246

measurement, 47–67 in pathology, 1 pseudofacility, 18 seasonal variation, 60 stability, 25

target IOP, 257, 345–6, 351 see also ocular hypertension

intraocular tumors, 283–4

iodide, formation rate of aqueous humor, 18 iridectomy

angle-closure, 86 peripheral, 268

irido-corneo-endothelial syndromes, 70, 459 irido-trabecular angle, Shaffer assessment, 189 iridocyclitis, neovascularization, 87 iridodonesis, 69, 83

iridodysgenesis, 297–8 iris

angulation, 70 aniridia, 312–13

anterior stromal defects, 297–8 colour/pigment density, 441 contour, 69–70

familial hypoplasia of the iris with glaucoma, 311

hyperplasia, 297 plateau iris, 444–5

site of iris insertion, 70 thin area, 441

wandering superficial iris vessels, 311–12 iris adhesions, laser lysis, 459–60

iris bombé, 86, 190

iris bowing and lens—iris channel, 194–5 iris cysts, 206

iris processes, 70 covering angle, 71

vs peripheral anterior synechiae, 70 iris—lens channel, 195

isoflurophate, 424 action/dosage, 422 structure, 425

isoproterenol, 380 isosorbide, 432

J

Japan,Tanjong Eye Study, 61 juvenile glaucomas, 294 Juvenile OAG, 165, 167

juvenile rheumatoid arthritis, 283, 324 trabeculodialysis, 539

juvenile xanthogranuloma, 323 juxtacanalicular cell processes, 27–8 juxtacanalicular space, 29

resistance, 34–5

K

kinetic perimetry, 93, 93–4, 102 Kniest syndrome, 316

Koeppe contact lens, 71

direct gonioscopic method, 73–4 Krukenberg’s spindle, 83, 267 Krupin valve, 483–4

L

labetolol, 397 lamina cribrosa, 147 lamina fusca, 9

laser cyclophotocoagulation, 456–8 children/infants, 310

contact trans-scleral cyclophotocoagulation, 457 endocyclophotocoagulation, 457

laser energy, 436–7 carbonization of tissue, 436 photoablation, 437 photocoagulation, 436, 456–7 photodisruption, 436–7 safety, 437–8

laser goniophotocoagulation, 460 laser iridoplasty (gonioplasty), 444–5

nanophthalmos, 445 and pupilloplasty, 202

laser iridotomy, 70, 199–202, 385–6, 439–44 benign/harmful, 190–1

complications, 442–3 failure to perforate, 444 indications, 439

iris color, 441–2 laser types, 439–40

treatment, PAC glaucoma, 200, 201–2

laser ophthalmoscopy see confocal scanning laser ophthalmoscopy; scanning laser polarimetry (SLP)

laser sclerostomy, 453–4

laser suture lysis, 458, 479, 519 laser synechialysis, 459–60

laser trabeculoplasty, 356, 436, 447–9 alterations of ECM materials, 35

aphakic/pseudophakic open-angle glaucoma, 451 complications, 451–2

contraindications, 451 and inflammation, 282 as initial therapy, 451

lowers IOP without increase in aqueous humor formation, 18

normal-tension glaucoma, 257 outcomes, 451

outflow facility increase, 41 postoperative treatment protocols, 450–1 repeat argon LTP, 448

selective photothermolysis, 448, 449–50 success rate, 447–8, 450

laser trabeculostomy, excimer laser, 452–3 laser treatment, 436–46

cyclodialysis clefts, 459

excimer laser photoablation, 452–4 Glaucoma Laser Trial, 347

internal flow block, 439–46 malignant glaucoma, 445 Nd:YAG laser

children/infants, 310 glaucoma following, 275–6 iridotomy, 385, 439–41

posterior capsulotomy, 386 outflow obstruction, 447–55 patient preparation, 437–8 procedures, laser type, 436 reopening closed filtering sites, 458

laser types, 454

laser-assisted in-situ keratomileusis (LASIK), 271 latanoprost, 361–3

chemical structure, 360 iridial pigmentation, 368 preservative, 364

side effects, 365, 369–70 hypertrichosis, 365

lens

calcium oxalate crystals, 272–3 intumescent and swollen lens, 206

lens removal, and intraocular lens (IOL) implantation, 202 lens subluxation, 322

and pupillary block, 322 lens-induced glaucoma, 271–2 lens-particle glaucoma, 271 lenses, dislocated lens, 271 leprosy, 283

leukemia, 284 levobunolol, 395–6

structure/dose, 393 lifestyle

and IOP, 61

and IOP treatment, 351–2 Lisch nodules, 315

lLaser suture lens, 458

long posterior ciliary artery, 11 low-pressure glaucoma, 239 low-tension glaucoma, 239

Lowe’s oculocerebrorenal syndrome, 319 LOXL1, exfoliative syndrome, 268, 334–5 luminance (SI), 92

lymphoma, 284

M

MacKay-Marg tonometer, 50, 276

macular edema associated with retinal vein occlusion, 270 macular scan, 177

magnocellular pathway, motion detection, 137 major arterial circle, 11

Maklakow tonometer, 53

malignant glaucoma see ciliary block glaucoma management, 339–44

see also treatment mannitol, 432, 433 Marcus Gunn’s sign, 247

Marfan syndrome and glaucoma, 324 matrix metalloproteinases (MMPs), 270 medical treatment, 345–58, 346

bioavailability, 348 comparisons, 355

compliance or adherence, 343, 350 corneal barriers, 348–9

effects on IOP, 62 elimination, 350 formulation, 349–51 instillation of eyedrops, 348 pharmacology, 347–9 preoperative, 433

stimulating/reducing formation rate of aqueous humor, 20

substitution of drugs, 353–4 therapeutic index, 347 therapeutic trial in one eye, 352–3 turnover rate of tear film, 348

see also drugs specific treatments megalocornea, 306, 308 melanocytomas, of iris, 284 melanomas, 284

melanosis oculi, 284 metaprolol, 397 methacholine, 423–4

action/dosage, 422 methazolamide, 410–11

aqueous humor formation, 14

chemical and pharmacologic properties, 410

structure/dose, 408 metipranolol, 396

Meyer-Schwickerath syndrome, 316 Michel syndrome, 316 microcornea, 319

microphthalmia, 319 miotic drugs, 420

miotic pupil, cataract surgery, 499–500 miotics

angle of anterior chamber, 84 lack of response to, 200

mitomycin-C, 282, 283 see also antimetabolites

Molteno implant, 481–3 monoamine oxidase, 380

Moorfields Bleb Grading System, 477 Moorfields regression analysis (MRA), 172, 174

Moorfields Safer Surgery System, trabeculectomy, 473–5 motion detection perimetry, 137

multifocal electroretinography (mfERG), 138 multifocal visual evoked potentials (mfVEP), 138–40 mumps, 283

muscarinic receptors, 420

musical (wind) instruments, and IOP, 61 MYOC, 332

myocilin, 332 myopia

effects on IOP, 62

with open-angle glaucoma, 163–4

N

nadolol, 396

naftidrofuryl, normal-tension glaucoma, 258 nail patella syndrome, 336

napradilol, 402

narrow angled eye, anatomy, 69–70 neckties, 62

neostigmine, 424–5 action/dosage, 422 structure, 425

neovascular glaucoma, 324–5

neovascularization, Fuchs’ heterochromic iridocyclitis, 87 nerve fiber indicator (NFI), 184

nerve fiber layer defects, ONH, 161 neural control of IOP, 61 neurofibromatosis, 314–15

neuroprotection, beta-adrenergic antagonists, 398 neuroretinal rim (NRR), 154–60

size and shape, 157–8 nevus of Ota, 284

new procedures, 542–9 nicotinic receptors, 420 nimodipine, 258 noisefield perimetry, 95

non-contact tonometer, 52 non-penetrating glaucoma surgery, 542–4

advantages/disadvantages, 543 deep sclerectomy, 544–5

nonadrenergic activators of adenylate cyclase, 381 norepinephrine, 376–7, 379

normal visual field, 91 normal-pressure glaucoma, 239 normal-tension glaucoma, 239, 255–8

clinical features, 256 differential diagnosis, 256–7 pathogenesis, 255 treatment, 257–8

Norries disease, 324

O

obstetric trauma, 307

Octopus computerized bowl perimetry, 106–8 ocular hypertension

epidemiology, 251 prospective follow-up, 251 risk factors, 252–3 treatment, 254–5

see also intraocular pressure (IOP)

Ocular Hypertension Treatment Study (OHTS), 3, 175, 251, 551

Ocular Response Analyzer, 52

ocular surgery, and inflammation, effect on IOP, 62 ocular tumors, 283–4

children/infants, 323–5 oculocerebrorenal syndrome of Lowe, 319 oculodentodigital syndrome, 316

Ocusert alternative drug delivery systems, 423 Olmsted County, Minnesota, study, 250 onchocerciasis, 283

OPA1, 334

opacity of the ocular media, 99

open-angle glaucoma, beta-adrenergic antagonists (betablockers), 397

operative care, 463–4 ophthalmoscopy, children/infants, 303

optic cup configuration and depth, changes in glaucoma, 158–9

optic disc

in advanced low-tension glaucoma, 149 changes in glaucoma, 156–60

cup:disc ratios, 159

Nerve fiber layer defects, 161–2 NRR changes, 157–8

oOptic cup size in relation to optic disc sizen relation to optic disc size, 158–9

optic cup configuration and depth, 158–9 optic disc hemorrhages, 160

optic disc size, 156–7 peripapillary disc changes, 160–1

pPosition of central retinal vessels and branches, 159–60

cupping and atrophy, 245–6 fluorescein angiography, 150 size changes in glaucoma, 156–7 Vascular nutrition, 148

optic nerve head (ONH) anatomy, 143

superficial nerve fiber layer, 143–4 clinical evaluation, 154–70

disc drawings, 154–5

ONH changes and subtypes of glaucoma, 163–5 photographic slides, 154

connective tissue structures, 146–7

Disc Damage Likelihood Scale (DDLS), 155–6 excavational cupping, 146–7

imaging, 171–87 IOP level, 146–7

primary site of glaucomatous axonal injury, 144 Subtypes of glaucoma by ONH appearance, 165

optic nerve infarction, 146

optical coherence tomography (OCT), 171, 175–83 limitations, 181

quality assessment, 180 report, 178–80

topographic change analysis (TCA), 182 optineurin (optic neuropathy-inducing protein), 333 OPTN, 333–4

ora serrata, 9

organophosphorus insecticides and pesticides, 427 outflow obstruction

laser treatment, 447–55 surgical procedures, 466–90 see also filtering surgery

outflow system anatomy, 2, 26–34

anterior chamber, structures of angle, 26–34

P

pachymetry, 397

pain relief, retrobulbar alcohol injection, 540 paraminohippurate (PAH), formation rate of aqueous

humor, 17–18

parasympathomimetic drugs see cholinergic drugs; pilocarpine

pars plana, pars plicata, 9 pars planitis, 283

patient education, 343–4, 354–5 eyedrop solutions, 354–5 pre-surgical treatment, 462–3

valves, 33

Schwalbe’s line, 26, 71–2

Schwalbe’s ring, centrally displaced, 298 Schwartz syndrome, 281

scleral flap, 495–6

scleral spur, anatomy, 26–7, 70–1 sclerectomy

anterior/posterior, 481

deep sclerectomy with collagen implant (DSCI), 544–6 scotoma

defining, 93

differential diagnosis, 247 screening, 551

second messengers, 376 secondary glaucoma

beta-adrenergic antagonists, 397–8 in children/infants, 320–4 open-angle glaucoma, 266–93 treatment

carbonic anhydrase inhibitors, 415 hyperosmotic agents, 434

self-mutilation, ocular, 61

Shaffer assessment, 20° irido-trabecular angle, 189 Shaffer classification, angle of anterior chamber, 78–9 Shaffer-Weiss classification, 294

Shocket procedure, 483

short posterior ciliary arteries (SPCAs), 143, 145

short wavelength, automated perimetry (SWAP), 92, 96, 131–4, 551

shunts

ExPress shunt, 484

into Schlemm’s canal, 546–8 into suprachoroidal space, 547 red-eyed shunt syndrome, 286

sickling of RBCs, 280, 413 siderosis, 277 signal-to-noise ratios, 138

silicone, cause of pupillary block, 281 Simmons shell, 511

sinusotomy, 542 slit-lamp funduscopy, 154

small bistratified ganglion (konio) cells, 132

sodium hyaluronate and sodium chondroitin sulfate, 275 Spaeth grading system, 80

sphaerophakia, 322–3 sphincterotomies, 501

standard automated white-onwhite threshold perimetry (SAP), 131

staphyloma, posterior pole or peripheral fundus, 164 static perimetry, 93–4

steroid glaucoma, 270–1 children/infants, 324 Stickler syndrome, 316

Sturge-Weber syndrome, 78, 286, 313–14

suction cup method, formation rate of aqueous humor, 17–18, 40

sulfonamide-derived topical agents, 409 superior vena cava obstructions, 285 suprachoroidal hemorrhage, 514–15 surgical treatment, 346–7, 462–5

anesthesia, 464 equipment, 464

indications for filtering surgery, 462 operative care, 463–4

outpatient vs inpatient surgery, 463 patient eduation, 462–3 perioperative medications, 465 postoperative care, 464 preoperative care, 462

preoperative medications, 463

See also specific treatments suture lysis contact lenses, 477

sutures, lysis with lasers, 458, 479, 519

Swedish Interactive Testing Algorithm (SITA) program, 94, 95, 551

symblepharon ring, 511

sympathetic nervous system, anatomy and physiology, 376 sympathetic ophthalmia, 283, 517

symptoms of glaucoma, 339 synechiae

laser synechialysis, 459–60 vs iris processes, 70

syphilis, 283

T

tangent screen, 103

target pressure concept, 345–6, 351 tear film, turnover rate, 348 temporal summation, 101

temporal-superior-nasal-inferior-temporal (TSNIT), 184 Tenon’s capsule, 9

excision, 470 therapeutic index, 347

therapeutic trial in one eye, 352–3 thermal sclerostomy, 480–1 threshold testing, 94 thymoxamine, 401–2

thyroid eye disease, 285 and POAG, 243

thyrotropic exophthalmos, 285

TIGR (trabecular meshwork-inducible glucocorticoid response) gene, 332, 550

timolol, 393–406

in combination, 364, 369, 386 side effects, 365 structure/dose, 393

tissue inhibitor of metalloproteinases (TIMPs), 270 Tono-Pen tonometer, 50

tonography, 16–17, 39

aqueous outflow pathway, facility of outflow, 39 tonometry, 47–57

applanation, 47–53

continuous monitoring of IOP, 57 dynamic contour, 56–7 indentation, 53–6

infants, 299

results in glaucomatous vs normal eyes, 40 thick/thin corneas, 58

topographic change analysis (TCA), 182 trabecular lamellae, endothelial cell processes, 28 trabecular meshwork

ablation instrument (Trabectome), 547 anatomy, 26–30

boundary with cornea, parallelepiped method, 72 collapse, 33

deep pigment, 85 dexamethasone, 271 glycosaminoglycans, 271 gonioscopic appearance, 73–4 inflammatory precipitates, 283 pigment dispersion syndrome, 72

regulation of IOP by extrinsic mechanisms, 38, 243–4 and Schlemm’s canal, 33

trabecular meshwork—Schlemm’s canal—venous system, 2, 5, 9

trabecular pigment band, 78–9 trabeculectomy, 470–9

with cataract surgery, 498

Indiana Bleb Grading System, 478 indications, 471

initial procedure, 471–2

Moorfields Bleb Grading System, 477 Moorfields Safer Surgery System, 473–6 options and modifications, 477–9

postoperative lasering, adjustment, or release of sutures, 477–8

with/without antimetabolite, 202, 476, 480, 495, 496–7 with/without mitomycin-C combined with trabec-

ulotomy, children/infants, 538–40 see also laser trabeculectomy

trabeculodialysis, 324 children/infants, 539

trabeculodysgenesis, 295–7 specimen, 306

tracer methods, formation rate of aqueous humor, 17–18 tranexamic acid, 279

transpalpebral tonometry, 56 Traube-Hering waves, 61 trauma, glass in inferior angle, 89

trauma, causing glaucoma, 276–80 chemical burns, 276 children/infants, 324

electric injury, 277 non-penetrating trauma, 277 penetrating trauma, 277 radiation, 277

travoprost, 363 preservatives, 365 side effects, 369–70

travoprost/timolol combination, 364 treatment, 345–58

adequacy, 341–2 adjust to patient, 352

advantages/disadvantages of medical and surgical therapy, 347

advantages/disadvantages of non-penetrating glaucoma surgery, 543

follow-up, 342

medical treatment, 346–58 new, 551

new procedures, 542–9 surgical treatment, 346–7 target pressure, 345–6, 351

see also medical treatment; specific treatments triamcinolone acetonide, 270

trisomies, 319

tube-shunt devices, 282, 283 tumors, 283–4

children/infants, 323–4 tunica vasculosa lentis, 297–8 TYRP1, 334

U

ultrafiltration, 12

formation of aqueous humor, 12 ultrasonic biomicroscopy (UBM), 191, 543 ultrasound, 540

unilateral—acquired vs bilateral—genetic, 1 unoprostone, 363–4

side effects, 369–70 urea, 432, 433

urolithiasis, CAIs, 411, 413

UV excimer laser photoablation, 452–3 uveal meshwork

anatomy, 27 ultrastructure, 27

uveitis

complications of laser treatment, 452 Fuchs’ heterochromic iridocyclitis, 282 and prostaglandins, 370

uveitis with glaucoma, 281–2 uveitis-glaucoma-hyphema syndrome, 275

uveoscleral (unconventional, extracanalicular, uveovortex) flow, 38

V

van Herick, estimate of angle width from anterior chamber depth, 80

vanadate, 21

variable corneal compensator, corneal birefringence, 183–4

vascular autoregulation, 150 vascular insufficiency, ONH, 145

vascular ischemia, and glaucoma, 324

venous system, trabecular meshwork—Schlemm’s canal—venous system, 2, 5, 9

viscocanalostomy, 542–4

viscoelastic material, retention, 518–19 viscoelastic substances, causing glaucoma, 274–5 visual field, 91–7

absolute/relative defects, 92 differential light sensitivity, 91, 95 normal, 91, 92

ocular variables, 99–100 patient variables, 98–9

and refractive correction, 100

short wavelength, automated perimetry (SWAP), 92, 96 short/long-term fluctuation, 91–2

terminology, 91–2 visual field defects

frequency distribution of location, 106 screening tests, 94–5

visual field testing, 92–108 artifacts that affect results, 98

visual field testing (continued) background illumination, 100

combined static and kinetic perimetry, 96 computerized bowl perimetry, 106–8 equipment/techiques, 102–8 Goldmann/bowl perimetry, 103–4 kinetic perimetry, 93, 102

noisefield perimetry, 95 optokinetic perimetry, 95 static perimetry, 93–4 stimulus exposure time, 101 stimulus size and intensity, 101 tangent screen, 103

testing variables, 100–2 threshold testing, 94

ture, 95–6 zone testing, 94

vitrectomy, glaucoma after, 281–2

vitreous in the anterior chamber, glaucoma from, 276 von Recklinghausen’s disease, 314–15

W

Wallerian degeneration, 144 WDR36, 334

Weill-Marchesani syndrome, 322

Welch Allyn direct ophthalmoscope, 157 wind instruments, and IOP, 61

X

X-linked familial exudative retinopathy (Norries disease), 324

xanthogranuloma, 323

Z

Zeiss four-mirror lens, 75

Zeiss lens (indirect gonioscopic method), 73–4 Zentmayer’s ring or Scheie’s line, 267

zone testing, 94