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Page iii

HANDBOOK OF GLAUCOMA

Augusto Azuara-Blanco MD, PhD

Consultant Ophthalmic Surgeon

Aberdeen Royal Infirmary

Clinical Senior Lecturer

University of Aberdeen

Aberdeen

UK

Vital P Costa MD

Director, Glaucoma Service

University of Campinas, Brazil

Associate Professor of Ophthalmology (Post-Graduation),

University of Campinas

Associate Professor of Ophthalmology (Post-Graduation)

University of San Paolo, Brazil

Richard P Wilson MD

Attending Surgeon, Glaucoma Service

Wills Eye Hospital

Professor of Ophthalmology

Jefferson Medical College

Thomas Jefferson University

Philadelphia PA

USA

MARTIN DUNITZ

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Page iv

© 2002 Martin Dunitz Ltd, a member of the Taylor & Francis Group

First published in the United Kingdom in 2002

by Martin Dunitz Ltd, The Livery House, 79 Pratt Street, 0AE

Tel.: +44 (0) 20 74822202

Fax.: +44 (0) 20 72670159 E-mail: info@dunitz.co.uk Website: http://www.dunitz.co.uk

This edition published in the Taylor & Francis e-Library, 2003.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP.

A CIP record for this book is available from the British Library.

ISBN 0-203-21561-3 Master e-book ISBN

ISBN 0-203-29287-1 (OEB Format)

ISBN 1-841840-43-2 (Print Edition)

Distributed in the USA by Fulfilment Center Taylor & Francis 7625 Empire Drive Florence, KY 41042

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Toll free tel: 1-800-634-7064

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Composition by Scribe Design, Gillingham, Kent

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Page v

 

CONTENTS

 

 

Contributors

vii

 

Preface

xi

 

Acknowledgements

xii

I

 

 

Background to anatomy and pathophysiology, classification and examination

 

1

Anatomy, physiology and pathophysiology

 

 

Jeanette G Maresco and Sai B Gandham

3

2

The concept of glaucoma, classification

 

 

Augusto Azuara-Blanco, Richard P Wilson and Vital P Costa

17

3

The intraocular pressure in glaucoma

 

 

Mark R Lesk

21

4

Anterior chamber angle examination: gonioscopy and ultrasound biomicroscopy

 

 

Celso Tello, Jeffrey M Liebmann and Robert Ritch

31

5

Optic nerve and retinal nerve fiber layer

 

 

Vital P Costa, Richard P Wilson and Augusto Azuara-Blanco

49

6

Visual field and other functional tests in glaucoma

 

 

Vital P Costa, Richard P Wilson and Augusto Azuara-Blanco

67

II

 

 

Clinical entities

 

7

Chronic or primary open angle glaucoma

 

 

Augusto Azuara-Blanco, Richard P Wilson and Vital P Costa

101

8

Primary angle closure glaucoma

 

 

Augusto Azuara-Blanco, Richard P Wilson and Vital P Costa

111

9

Secondary glaucomas

 

 

Vital P Costa, Richard P Wilson and Augusto Azuara-Blanco

119

10

Pediatric glaucoma and glaucoma associated with developmental disorders

 

 

Augusto Azuara-Blanco, Richard P Wilson and Vital P Costa

147

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Page vi

III

 

 

Treatment

 

11

Medical therapy

 

 

Vital P Costa, Richard P Wilson and Augusto Azuara-Blanco

161

12

Glaucoma laser procedures

 

 

Martha Motuz Leen

181

13

Glaucoma surgical procedures

 

 

Augusto Azuara-Blanco, Richard P Wilson and Vital P Costa

201

14

Non-penetrating glaucoma surgery

 

 

Tarek Shaarawy and André Mermoud

245

15

Treatment overview

 

 

Augusto Azuara-Blanco, Richard P Wilson and Vital P Costa

253

 

Index

259

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Page vii

CONTRIBUTORS

Augusto Azuara-Blanco MD, PhD

Consultant Ophthalmic Surgeon

Aberdeen Royal Infirmary

Clinical Senior Lecturer

University of Aberdeen

Aberdeen AB25 2ZN

UK

Vital P Costa MD

Director, Glaucoma Service

University of Campinas, Brazil

Associate Professor of Ophthalmology (Post-Graduation),

University of Campinas

Associate Professor of Ophthalmology (Post-Graduation)

University of San Paolo

Sao Paolo 01234-000

Brazil

Sai B Gandham MD

Assistant Professor and Director, Glaucoma Unit

The Albany Medical College

Lions Eye Institute

Albany NY 12208

USA

Martha Motuz Leen MD

Clinical Assistant Professor

Department of Ophthalmology

University of Washington;

Pacific EyeCare

Bremerton

Poulsbo WA 98370

USA

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Page viii

Mark R Lesk MD

Clinical Assistant Professor

Department of Ophthalmology

School of Medicine

University of Montreal

Montreal

Quebec

Canada

Jeffrey M Liebmann MD

Professor of Clinical Ophthalmology

New York Medical College

Associate Director, Glaucoma Service

The New York Eye and Ear Infirmary

New York NY 10003

USA

Jeannette G Maresco MD

Lions Eye Institute

Albany NY 12208

USA

André Mermoud MD, PD

Head, Glaucoma Unit

Hôpital Ophtalmique Jules Gonin

University of Lausanne

Lausanne

Switzerland

Robert Ritch MD

Professor Clinical Ophthalmology

New York Medical College

Chief, Glaucoma Service

The New York Eye and Ear Infirmary

New York NY 10003

USA

Tarek Shaarawy MD

Head, Glaucoma Unit

Memorial Research Institute of Ophthalmology

Giza

Egypt

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Page ix

Celso Tello MD

Clinical Assistant Professor of Ophthalmology

New York Medical College

Glaucoma Service

The New York Eye and Ear Infirmary

New York NY 10003

USA

Richard P Wilson MD

Attending Eye Surgeon, Glaucoma Service

Wills Eye Hospital

Professor of Ophthalmology

Jefferson Medical College

Thomas Jefferson University

Philadelphia PA 19107

USA

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Page xi

PREFACE

The goal of Handbook of Glaucoma is to provide practical clinical information about the management of glaucoma in a concise text. The book is written for both practising ophthalmologists and ophthalmologists in training. We have tried to integrate the essential clinical manifestations, diagnostic technologies and therapeutic modalities of this group of diseases. We have also included the important recent developments in the pathogenesis and management of the different types of glaucoma; for example, practical guidelines for the interpretation of standard and new visual field tests (SITA algorithm) are provided. A large number of drugs have been recently introduced for the treatment of glaucoma and the clinical use of drugs for glaucoma therapy has greatly evolved, adapting with the advent of each new drug. The surgical outcome of guarded filtration surgery continues to improve with the use of antifibrotic agents, but an impeccable surgical technique is needed to avoid shortand long-term complications. A separate chapter has been dedicated to non-penetrating glaucoma surgery. We have used more than 200 illustrations and numerous tables to provide a natural and easily understandable flow of information.

Augusto Azuara-Blanco Vital P Costa Richard P Wilson

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Page xii

ACKNOWLEDGEMENTS

We are indebted to the contributors to this book for giving so generously their time and work. They are all recognized for their clinical and research expertise in their subject, and have authored excellent chapters: Drs Celso Tello, Jeffrey M Liebmann, and Robert Ritch (Examination of the anterior chamber angle); Dr Martha M Leen (Glaucoma laser procedures); Drs Tarek Shaarawy and André Mermoud (Non-penetrating glaucoma surgery); Drs Sai B Gandham and Jeannette G Maresco (Anatomy, physiology, and pathophysiology), and Dr Mark Lesk (The intraocular pressure in glaucoma). We are also extremely grateful to Alan Burgess, our commissioning editor at Martin Dunitz Ltd, for his help, patience, and advice, and to Charlotte Mossop for her expert editorial assistance.

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