Inflammatory Glaucoma Flashcards
Can inflammatory glaucoma be open or closed angle glaucoma?
Can be open or closed
In inflammatory glaucoma, name some of the inflammatory conditions from which it can arise
Uveitis, infection, trauma, iol surgery
Why is inflammatory glaucoma extra complicated?
Because your at risk of secondary glaucoma with just the inflammation but treatment for inflammation is steroids which increase iop even more which increases the risk of steroid glaucoma too
Describe the features of intraocular inflammation
Cells and flare in the aqueous
In inflammatory glaucoma, how and why does iop increase ?
Because there’s inflammatory debris which accumulates in the trab which prevents drainage of aqueous which causes an increase of iop.
Describe trabeculitis:
This is when the trabecular becomes inflamed leading to swelling of the trabecular tissue and reduced drainage of aqueous
What causes a closed angle in inflammatory glaucoma?
The development of posterior synchaie which is where the posterior iris comes into contact with the anterior lens
Why does posterior synchaie develop in uveitis especially?
Because the iris is more sticky which increases the chance of adhesion
Why is posterior synchaie such an issue with inflammatory glaucoma?
It causes pupil block which prevents aqueous draining from the posterior chamber via the pupil into the anterior chamber
How does closed angle/pupil block cause an increase of iop in inflammatory glaucoma?
The iris bows forward (iris bombe) which brings the anterior iris into contact with the posterior cornea (anterior synchaie) which causes the peripheral iris to block the iris and drainage is prevented causing an increase of iop
What is the difference between PACG and secondary closed glaucoma?
The difference is within the anterior chamber.
- for PACG: the ac is shallow and the angle is narrow and miotic drugs are used to pull the iris from the angle
- secondary glauc: synchaie. adhesion between the iris and lens but the angle is normal and a mydriatic drug is used to break the adhesions of the iris and lens
What does breaking the adhesion of the anterior synchaie do?
It allows resuming of the aqueous and iop becomes normal
Is the angle affected in secondary angle closure glaucoma?
No and the peripheral iris being pulled towards the angle doesn’t risk angle closure because the angle is normal
What is inflammatory glaucoma a complication of?
Uveitis
What is the referral for inflammatory glaucoma?
Urgent telephone call to hes
