- •Contents
- •General Introduction
- •Objectives
- •1 Introduction to Glaucoma: Terminology, Epidemiology, and Heredity
- •Definitions
- •Classification
- •Open-Angle, Angle-Closure, Primary, and Secondary Glaucomas
- •Combined-Mechanism Glaucoma
- •Epidemiologic Aspects of Glaucoma
- •Primary Open-Angle Glaucoma
- •Primary Angle-Closure Glaucoma
- •Genetics, Environmental Factors, and Glaucoma
- •Environmental Factors
- •Genetic Testing
- •Aqueous Humor Formation
- •Suppression of Aqueous Formation
- •Rate of Aqueous Formation
- •Aqueous Humor Outflow
- •Trabecular Outflow
- •Uveoscleral Outflow
- •Tonography
- •Episcleral Venous Pressure
- •Intraocular Pressure
- •Distribution in the Population and Relation to Glaucoma
- •Factors Influencing Intraocular Pressure
- •Diurnal Variation
- •Clinical Measurement of Intraocular Pressure
- •Infection Control in Clinical Tonometry
- •3 Clinical Evaluation
- •History and General Examination
- •Refraction
- •External Adnexae
- •Pupils
- •Biomicroscopy
- •Gonioscopy
- •Direct and Indirect Gonioscopy
- •Gonioscopic Assessment and Documentation
- •The Optic Nerve
- •Anatomy and Pathology
- •Glaucomatous Optic Neuropathy
- •Examination of the Optic Nerve Head
- •The Visual Field
- •Clinical Perimetry
- •Variables in Perimetry
- •Automated Static Perimetry
- •Interpretation of a Single Visual Field
- •Interpretation of a Series of Visual Fields
- •Patterns of Glaucomatous Nerve Loss
- •Manual Perimetry
- •Other Tests
- •4 Open-Angle Glaucoma
- •Primary Open-Angle Glaucoma
- •Clinical Features
- •Risk Factors for POAG Other Than IOP
- •Associated Disorders
- •Prognosis
- •Clinical Features
- •Differential Diagnosis
- •Diagnostic Evaluation
- •Prognosis and Therapy
- •The Glaucoma Suspect
- •Ocular Hypertension
- •Secondary Open-Angle Glaucoma
- •Exfoliation Syndrome
- •Pigmentary Glaucoma
- •Lens-Induced Glaucoma
- •Intraocular Tumors
- •Ocular Inflammation and Secondary Glaucoma
- •Elevated Episcleral Venous Pressure
- •Accidental and Surgical Trauma
- •Schwartz Syndrome (Schwartz-Matsuo Syndrome)
- •Drugs and Glaucoma
- •5 Angle-Closure Glaucoma
- •Introduction
- •Pathogenesis and Pathophysiology of Angle Closure
- •Pupillary Block
- •Angle Closure Without Pupillary Block
- •Lens-Induced Angle-Closure Glaucoma
- •Iris-Induced Angle Closure
- •Primary Angle Closure
- •Risk Factors for Developing Primary Angle Closure
- •Acute Primary Angle Closure
- •Subacute or Intermittent Angle Closure
- •Chronic Angle Closure
- •The Occludable, or Narrow, Anterior Chamber Angle
- •Plateau Iris
- •Secondary Angle Closure With Pupillary Block
- •Lens-Induced Angle Closure
- •Secondary Angle Closure Without Pupillary Block
- •Neovascular Glaucoma
- •Iridocorneal Endothelial Syndrome
- •Tumors
- •Inflammation
- •Aqueous Misdirection
- •Nonrhegmatogenous Retinal Detachment and Uveal Effusions
- •Epithelial and Fibrous Ingrowth
- •Trauma
- •Retinal Surgery and Retinal Vascular Disease
- •Nanophthalmos
- •Persistent Fetal Vasculature
- •Flat Anterior Chamber
- •Drug-Induced Secondary Angle-Closure Glaucoma
- •6 Childhood Glaucoma
- •Classification
- •Genetics
- •Primary Congenital Glaucoma
- •Juvenile Open-Angle Glaucoma
- •Developmental Glaucomas of Childhood With Associated Ocular or Systemic Anomalies
- •Axenfeld-Rieger Syndrome
- •Peters Anomaly
- •Aniridia
- •Sturge-Weber Syndrome
- •Neurofibromatosis
- •Secondary Glaucomas
- •Aphakic Glaucoma
- •Evaluating the Pediatric Glaucoma Patient
- •History
- •Visual Acuity
- •External Examination
- •Anterior Segment Examination
- •Tonometry
- •Central Corneal Thickness
- •Gonioscopy
- •Optic Nerve and Fundus Evaluation
- •Axial Length
- •Other Testing
- •Treatment Overview
- •Surgical Management
- •Medical Management
- •Prognosis and Follow-Up
- •7 Medical Management of Glaucoma
- •Medical Agents
- •Prostaglandin Analogues
- •β-Adrenergic Antagonists
- •Adrenergic Agonists
- •Carbonic Anhydrase Inhibitors
- •Parasympathomimetic Agents
- •Combined Medications
- •Hyperosmotic Agents
- •General Approach to Medical Treatment
- •Open-Angle Glaucoma
- •Angle-Closure Glaucoma
- •Administration of Ocular Medications
- •Use of Glaucoma Medications During Pregnancy or by Nursing Mothers
- •Use of Glaucoma Medications in Elderly Patients
- •Generic Medications
- •Compliance
- •8 Surgical Therapy for Glaucoma
- •Surgery for Open-Angle Glaucoma
- •Laser Trabeculoplasty
- •Incisional Surgery for Open-Angle Glaucomas
- •Combined Cataract and Filtering Surgery
- •Surgery for Angle-Closure Glaucoma
- •Laser Iridotomy
- •Laser Gonioplasty, or Peripheral Iridoplasty
- •Incisional Surgery for Angle Closure
- •Other Procedures to Lower IOP
- •Glaucoma Drainage Device Implantation
- •Ciliary Body Ablation Procedures
- •Nonpenetrating Glaucoma Surgery
- •Special Considerations in the Surgical Management of Elderly Patients
- •Basic Texts
- •Related Academy Materials
- •Requesting Continuing Medical Education Credit
Basic Texts
Glaucoma
Allingham RR, Damji KF, Freedman S, Maroi SE, Rhee DJ. Shields’ Textbook of Glaucoma. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2010.
Anderson DR, Patella VM. Automated Static Perimetry. 2nd ed. St Louis: Mosby; 1998.
Drance SM, Anderson DR, eds. Automatic Perimetry in Glaucoma: A Practical Guide. Orlando, FL: Grune & Stratton; 1985.
Epstein DL, Allingham RR, Schuman JS, eds. Chandler and Grant’s Glaucoma. 4th ed. Baltimore: Lippincott Williams & Wilkins; 1997.
Harrington DO, Drake MV. The Visual Fields: Text and Atlas of Clinical Perimetry. 6th ed. St Louis: Mosby; 1990.
Levin LA, Nilsson SFE, Ver Hoeve J, Wu SM, Kaufman PL, Alm A. Adler’s Physiology of the Eye: Clinical Application. 11th ed. Elsevier/Saunders; 2011.
Minckler DS, Van Buskirk EM, eds. Color Atlas of Ophthalmic Surgery: Glaucoma. Philadelphia: Lippincott Williams & Wilkins; 1992.
Ritch R, Shields MB, Krupin T, eds. The Glaucomas. 2nd ed. St Louis: Mosby; 1996.
Stamper RL, Lieberman MF, Drake MV, eds. Becker-Shaffer’s Diagnosis and Therapy of the Glaucomas. 8th ed. St Louis: Mosby; 2009.
Tasman W, Jaeger EA, eds. Duane’s Ophthalmology on DVD-ROM. Philadelphia: Lippincott Williams & Wilkins; 2012.
Thomas JV, Belcher CD III, Simmons RJ, eds. Glaucoma Surgery. St Louis: Mosby; 1992. Zimmerman TJ, Kooner KS, Fechtner RD, Sharir M. Textbook of Ocular Pharmacology. 3rd ed.
Philadelphia: Lippincott Williams & Wilkins; 1997.
Related Academy Materials
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Print Publications and Electronic Products
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Access free, trusted articles and content with the Academy’s collaborative online encyclopedia, EyeWiki, at http://eyewiki.org/Main_Page.
Requesting Continuing Medical Education Credit
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The American Academy of Ophthalmology designates this enduring material for a maximum of 10 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Medical Association requires that all learners participating in activities involving enduring materials complete a formal assessment before claiming continuing medical education (CME) credit. To assess your achievement in this activity and ensure that a specified level of knowledge has been reached, a posttest for this Section of the Basic and Clinical Science Course is provided. A minimum score of 80% must be obtained to pass the test and claim CME credit.
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4.Once you have passed the test with a score of 80% or higher, you will be directed to your transcript. If you are not an Academy member, you will be able to print out a certificate of participation once you have passed the test.
Originally released June 2012; reviewed for currency September 2, 2014; CME expiration date: June 1, 2016. AMA PRA Category 1 Credits™ may be claimed only once during this period.
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How to Use the Self Testing Function
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