By George A. Cioffi, MD
This part underwent significant revision for the 2008-2009 edition.Topics mentioned contain the epidemiologic facets of glaucoma; hereditary and genetic elements; intraocular strain and aqueous humor dynamics; scientific assessment; clinical administration of and surgical remedy for glaucoma. This version comprises up-to-date tables and revised photos, in addition to a variety of new photographs illustrating either sickness entities and surgical recommendations.
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Extra resources for 2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009)
Carotid occlusive disease may also decrease aqueous humor production. Aqueous Humor Outflow Aqueous humor outflow occurs by 2 major mechanisms: pressure-dependent outflow and pressure-independent outflow. The facility of outflow (C in the Goldmann equation; see the beginning of the chapter) varies widely in normal eyes. The mean value reported CHAPTER 2: Intraocular Pressure and Aqueous Humor Dynamics. 30 flL/min/mm Hg. Outflow facility decreases with age and is affected by surgery, trauma, medications, and endocrine factors.
The scleral spur is a thin, pale stripe between the ciliary face and the pigmented zone of the trabecular meshwork. The inferior portion of the angle is generally wider and is the easiest place in which to locate the landmarks. After verifying the landmarks, the clinician should examine the entire angle in an orderly manner (see Table 3-1). Proper management of glaucoma requires that the clinician determine not only whether the angle is open or closed, but also whether other pathologic findings, such as angle recession or low PAS, are present.
Evidence suggests that the bicarbonate ion is actively secreted in human eyes; thus, the function of the enzyme may be to provide this ion. Carbonic anhydrase may also provide bicarbonate or hydrogen ions for an intracellular buffering system. Current evidence indicates that ~rreceptors are the most prevalent adrenergic receptors in the ciliary epithelium. The significance of this finding is unclear, but ~-adrenergic antagonists may affect active transport by causing a decrease either in the efficiency of the Na+/K+ pump or in the number of pump sites.
2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009) by George A. Cioffi, MD