glaucoma

Glaucoma is a group of diseases of the optic nerve involving loss of retinal ganglion cells in a characteristic pattern of optic neuropathy.

Although raised intraocular pressure is a significant risk factor for developing glaucoma, there is no set threshold for intraocular pressure that causes glaucoma. One person may develop nerve damage at a relatively low pressure, while another person may have high eye pressure for years and yet never develop damage.

Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.

Types

 Primary glaucoma

• Primary open-angle glaucoma, also known as chronic open-angle glaucoma, chronic simple glaucoma, glaucoma simplex
• Low-tension glaucoma
• Primary angle-closure glaucoma, also known as primary closed-angle glaucoma, narrow-angle glaucoma, iris-block glaucoma, acute congestive glaucoma
  • Acute angle-closure glaucoma
  • Chronic angle-closure glaucoma
  • Intermittent angle-closure glaucoma
  • Superimposed on chronic open-angle closure glaucoma (combined mechanism)

• Variants of primary glaucoma
  • Pigmentary glaucoma
  • Exfoliation glaucoma, also known as pseudoexfoliative glaucoma or glaucoma capsulare

 Developmental glaucoma

• Primary congenital glaucoma
• Infantile glaucoma
• Glaucoma associated with hereditary of familial diseases

 Secondary glaucoma (H40.3-H40.6)

• Inflammatory glaucoma
  • Uveitis of all types
  • Fuchs heterochromic iridocyclitis

• Phacogenic glaucoma
  • Angle-closure glaucoma with mature cataract
  • Phacoanaphylactic glaucoma secondary to rupture of lens capsule
  • Phacolytic glaucoma due to phacotoxic meshwork blockage
  • Subluxation of lens

• Glaucoma secondary to intraocular hemorrhage
  • Hyphema
  • Hemolytic glaucoma, also known as erythroclastic glaucoma

• Traumatic glaucoma
  • Angle recession glaucoma: Traumatic recession on anterior chamber angle

• Postsurgical glaucoma
  • Aphakic pupillary block
  • Ciliary block glaucoma

• Neovascular glaucoma
• Drug-induced glaucoma
  • Corticosteroid induced glaucoma
  • Alpha-chymotrypsin glaucoma. Postoperative ocular hypertension from use of alpha chymotrypsin.

• Glaucoma of miscellaneous origin
  • Associated with intraocular tumors
  • Associated with retinal deatchments
  • Secondary to severe chemical burns of the eye
  • Associated with essential iris atrophy
  • Toxic Glaucoma [15]

 Absolute glaucoma

Etiology (exemples)

 genetic

• myocilin mutations
• PAX6 mutations
• FOXC1 mutations

References

 Gong G, Kosoko-Lasaki O, Haynatzki GR, Wilson MR. Genetic dissection of myocilin glaucoma. Hum Mol Genet. 2004 Apr 1;13 Spec No 1:R91-102. PMID: 14764620

 Gould DB, John SW. Anterior segment dysgenesis and the developmental glaucomas are complex traits. Hum Mol Genet. 2002 May 15;11(10):1185-93. PMID: 12015278

 Lines MA, Kozlowski K, Walter MA. Molecular genetics of Axenfeld-Rieger malformations. Hum Mol Genet. 2002 May 15;11(10):1177-84. PMID: 12015277

 Sarfarazi M. Recent advances in molecular genetics of glaucomas.
Hum Mol Genet. 1997;6(10):1667-77. PMID: 9300658