By George A. Cioffi, MD
This part underwent significant revision for the 2008-2009 edition.Topics mentioned comprise the epidemiologic facets of glaucoma; hereditary and genetic components; intraocular strain and aqueous humor dynamics; medical review; scientific administration of and surgical remedy for glaucoma. This version includes up to date tables and revised pictures, in addition to various new photos illustrating either sickness entities and surgical recommendations.
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Additional info for 2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009)
The trabecular meshwork is composed of multiple layers, each of which consists of a collagenous connective tissue core covered by a continuous endothelial layer covering. It is the site of pressure-dependent outflow. The trabecular meshwork functions as a I-way valve that permits aqueous to leave the eye by bulk flow but limits flow in the other direction, independent of energy. Its cells are phagocytic, a function they may exhibit in the presence of inflammation and after laser treatment. In most older eyes, trabecular cells contain a large number of pigment granules within their cytoplasm that give the entire meshwork a brown or muddy appearance.
Although other risk factors affect an individual's susceptibility to glaucomatous damage, lOP is the only one that can be effectively altered at this time. CHAPTER 2: Intraocular Pressure and Aqueous Humor Dynamics. > 6 ~ cT. 5 4 3 2 o 9 10111213141516171819202122232425262728293031 IOP(mm Figure 2-3 Frequency distribution Study. (Reproduced from Colton Ophthalmol. 7980;25' 723-729) of intraocular T, Ederer F The distribution Hg) pressure: of intraocular pressures in the general population Surv Factors Influencing Intraocular Pressure lOP varies with a number of factors, including the following (Table 2-2): .
However, the impact of lOP fluctuations on the optic nerve remains unknown. The relationship between blood pressure and lOP may be important CHAPTER 2: Intraocular Pressure and Aqueous Humor Dynamics. 27 in optic nerve damage: systemic hypotension, especially during sleep, has been suggested as a possible cause of decreased optic nerve perfusion resulting in damage. Clinical Measurement of Intraocular Pressure Measurement of lOP in a clinical setting requires a force that indents or flattens the eye.
2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009) by George A. Cioffi, MD