Uveitic Glaucoma

Nagpal, Agnieszka G.; Acharya, Nisha R.

doi:10.1007/978-3-540-69475-5_6

Cited by 2 publications

(2 citation statements)

References 50 publications

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“…98 There is no universally accepted approach to treat these challenging cases, 95 but goniotomy has high success rates and is frequently chosen as the first-line surgical treatment. 95,100,101 It also has several advantages including shorter operating time, preservation of conjunctiva for subsequent surgeries, and evidence suggesting good rates of success. 95 Disadvantages include a need for a clear cornea and a predominantly open angle, which may be difficult with peripheral anterior synechiae formation.…”

Section: Glaucoma Associated With Nonacquired Systemic Disease/ Syndromementioning

confidence: 99%

“…The pathophysiology, however, is complex and is not completely established 98. There is no universally accepted approach to treat these challenging cases,95 but goniotomy has high success rates and is frequently chosen as the first-line surgical treatment 95,100,101. It also has several advantages including shorter operating time, preservation of conjunctiva for subsequent surgeries, and evidence suggesting good rates of success 95.…”

Section: Surgical Management For Secondary Pediatric Glaucomamentioning

confidence: 99%

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Surgical Management of Secondary Pediatric Glaucoma

Carrabba¹,

Zhaver²,

Blieden³

2021

International Ophthalmology Clinics

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with acquired conditions. 8,9 Disorders such as Peters anomaly, Axenfeld-Reiger syndrome, and aniridia are associated with secondary pediatric glaucoma due to anterior segment dysgenesis. Other common causes of secondary pediatric glaucoma include trauma, ocular inflammation, and steroid-induced glaucoma (SIG). Clinical ManifestationsIntraocular pressure (IOP) control through various medical and surgical interventions is critical to avoid visual decline. 2 Surgical management is more complex in children with higher rates of failure than adults due to the anatomic differences, aggressive healing response, congenital and development anomalies, difficulty with examination, and a less predictable postoperative course. 10 A variety of surgical options are available for treatment of secondary pediatric glaucoma, and certain subtypes respond better to surgical treatment than others. Surgical options can be categorized based on the following: (1) augmentation of the innate aqueous outflow pathway (angle-based surgery), (2) creation of an external aqueous outflow [filtering surgery such as trabeculectomy and glaucoma drainage devices (GDD)], and (3) decreasing aqueous production (cyclodestructive procedures). 4 Internationally, there is a diverse approach to the management of glaucoma as evidenced by the international childhood glaucoma survey at the World Glaucoma Association consensus meeting on childhood glaucoma. 7 This highlights the rarity of the disease, differences in training, experience, availability of equipment and facilities as well as individual population difficulties such as: affordability, access to care, cultural variation in disease beliefs, and compliance. 7 There is evidence that the first surgical intervention often has the best chance of controlling IOP and preserving vision in childhood glaucoma or, perhaps, failure after the first intervention indicates a more aggressive disease process with guarded prognosis. [11][12][13] Treatment is chosen based on type of glaucoma, age of the patient, surgeon preference, and prognosis of the disease. 10 Angle surgery is often first-line if the angle is visible. 14 Surgical OptionsA variety of surgical options exist for secondary pediatric glaucoma. Goniotomy was first characterized in the 1940-1950s by Otto Barkan and is quick and atraumatic in trained hands. This technique has the advantage of saving the conjunctiva to preserve the option for future filtration surgeries. 10 Visualization of the angle is important in traditional goniotomy, which can preclude its use in patients with opaque corneas. In these cases, the view of the angle structures could potentially be improved with carbonic anhydrase inhibitors, endoscope use, or removal of the corneal 112 ' Carrabba et al

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Section: Glaucoma Associated With Nonacquired Systemic Disease/ Syndromementioning

confidence: 99%

Section: Surgical Management For Secondary Pediatric Glaucomamentioning

confidence: 99%

Surgical Management of Secondary Pediatric Glaucoma

Carrabba¹,

Zhaver²,

Blieden³

2021

International Ophthalmology Clinics

View full text Add to dashboard Cite

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Acute hypertensive uveitis as the first presentation of multiple sclerosis

Shields

Simon

Chan

et al. 2019

Indian J Ophthalmol

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Ophthalmic manifestations of multiple sclerosis are frequent including acute optic neuritis, ocular motor disturbances and intermediate uveitis. We report an unusual case of multiple sclerosis presenting as acute hypertensive uveitis. A 56-year-old man was referred by his family doctor with a 2-week history of right eye pain and decreased vision. Best-corrected visual acuity was Count Fingers on the right and 6/9-2 on the left. Intraocular pressure was 55mmHg and 14 mmHg on the right and left respectively. He had a right relative pupillary defect and a left internuclear ophthalmoplegia. Vitreous cells were present in the right eye and there was peripheral sclerosis and periphlebitis superior temporally. MRI Brain and Spine revealed multiple T2 hyperintense lesions consistent with multiple sclerosis. Multiple sclerosis may present initially with an acute elevation of intraocular pressure and intermediate uveitis.

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Uveitic Glaucoma

Cited by 2 publications

References 50 publications

Surgical Management of Secondary Pediatric Glaucoma

Surgical Management of Secondary Pediatric Glaucoma

Acute hypertensive uveitis as the first presentation of multiple sclerosis

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