By Choplin N.T., Lundy D.S.
Glaucoma impacts 1% of the inhabitants over the age of forty. it will be significant that the practising clinician and general practitioner realize either fundamental and secondary glaucoma and instances linked to different problems. This lavishly illustrated textual content is authoritative and offers the reader with the full spectrum of the affliction. The ebook is split into 3 major sections: the fundamentals of Glaucoma, scientific Entities, and therapy of Glaucoma.
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Additional resources for Atlas of Glaucoma
By correlating ‘finger tension’ with applanation readings obtained just prior to palpation, the examiner can learn how much force correlates with varying levels of intraocular pressure, and may be able to estimate intraocular pressure to within 2–3 mmHg. 3 Estimation of intraocular pressure by palpation. SCHIOTZ TONOMETRY The Schiotz tonometer is an indentation instrument which measures intraocular pressure by registering the depth of indentation of the cornea produced when the instrument, carrying a known weight, is applied to the anesthetized eye.
Uveoscleral outflow reportedly accounts for anywhere from 4 to 45% of total aqueous drainage in humans. 9). In general, topical prostaglandin (PG)-F2␣ analogs reduce IOP predominantly by increasing uveoscleral outflow. The mechanism of the flow reduction appears to be a relaxation of the ciliary muscle causing the acute effect and the biochemical modification of its intercellular matrix, causing a more chronic effect. The mechanism for the pressure reduction in clinically 18 Atlas of glaucoma Cornea Cornea Sclera Trabecular outflow Sclera Uveoscleral outflow (a) Ciliary muscle Trabecular outflow Uveoscleral outflow (b) Ciliary muscle Ciliary muscle effects on uveoscleral outflow.
10) or by corneal iontophoresis. 11). When an equilibrium has been established, the concentrations of fluorescein in the cornea (Cc) and the anterior chamber (Ca) decrease over time. 12) is used to monitor these changes. The instrument can focus separately on the cornea and then on the anterior chamber, thus allowing a discrete measurement of each region. The rate of aqueous flow determines the cornea and anterior chamber fluorescein decay curves. 13. The magnitude of the anterior chamber aqueous humor flow (Fa) is a function of the anterior chamber volume (Va), the absolute value of the slope of the decay curve (A) and the ratio of the mass of fluorescein in the cornea to that in the anterior chamber (Mc /Ma) (Equation 2): Fa ϭ Va A[1 ϩ Mc/Ma] (2) Mc can be rewritten as Vc /Cc where Vc is the corneal stroma volume and Cc is the corneal stroma fluorescein concentration.