Glaucoma Review: Angle Closure & Pediatric Glaucoma

Vocabulary flashcards covering key glaucoma concepts, signs, etiologies, and treatments from the lecture notes.

Angle Closure

Blockage of aqueous outflow at the iridotrabecular angle leading to elevated intraocular pressure (IOP).

Aqueous Humor

Clear fluid produced by the ciliary body that flows from the posterior to the anterior chamber and drains through the trabecular meshwork.

Pupillary Block

Occlusion of outflow caused by the peripheral iris blocking the trabecular meshwork, raising posterior chamber pressure.

Iris Bombe

Forward bowing of the iris due to posterior aqueous buildup during pupillary block, contributing to angle closure.

Anterior Chamber (AC)

Space between the cornea and the iris; shallow AC is a sign of angle closure.

Hyperopia

Farsightedness; anatomical predisposition to primary angle closure glaucoma (PACG).

Primary Angle Closure Glaucoma (PACG)

Glaucoma due to anatomical predisposition with angle closure and impaired aqueous outflow, without another primary pathology.

Acute Angle Closure Glaucoma

Sudden, rapid rise in IOP with pain, redness, blurred vision, halos; forward iris pushing (iris bombe) and a shallow anterior chamber; often triggered by pupillary dilation.

Gonioscopy

Diagnostic exam to visualize the angle and confirm angle closure.

Laser Iridotomy

Laser procedure creating a hole in the iris to relieve pupillary block and reopen the angle.

Peripheral Iris Adhesion

Adhesions of the peripheral iris (synechiae) that impede aqueous access to the trabecular meshwork.

Anterior Synechia

Adhesion of the iris to the cornea or angle, contributing to angle closure.

Shallow Anterior Chamber

Reduced depth of the AC, a hallmark sign of angle closure risk.

Ciliary Injection

Redness of the eye due to ciliary body inflammation or congestion.

Steamy Cornea

Corneal edema seen in acute angle closure due to very high IOP.

Fixed Mid-Dilated Pupil

Pupil that remains mid-dilated and unreactive during an acute attack.

Intraocular Pressure (IOP)

Pressure inside the eye; elevated in glaucoma.

Haab Striae

Breaks in Descemet’s membrane from corneal stretching in congenital glaucoma.

Buphthalmos

Enlarged eyeball typical of congenital glaucoma.

Congenital Glaucoma

Glaucoma presenting at birth or in infancy due to developmental angle anomalies; often bilateral and inherited.

Classic Triad (Congenital Glaucoma)

Epiphora, photophobia, and blepharospasm.

Juvenile Open-Angle Glaucoma

Glaucoma occurring from about ages 5–35; angles appear normal; inherited in an autosomal dominant pattern.

Goniotomy

Pediatric glaucoma surgery cannulating Schlemm’s canal from the external approach to disrupt trabecular outflow resistance.

Trabeculotomy

Pediatric glaucoma surgery involving cannulation of Schlemm’s canal to improve outflow.

Trabeculectomy

Filtering surgery creating an ostium under a scleral flap to allow aqueous to drain, forming a bleb.

Bleb

Subconjunctival collection where aqueous drains after trabeculectomy.

Phacolytic Glaucoma

Inflammatory secondary glaucoma from leakage of liquified lens proteins from a mature cataract obstructing the trabecular meshwork.

Phacomorphic Glaucoma

Lens-induced secondary angle closure due to intumescent lens causing pupillary block.

Lens-Induced Glaucoma

Glaucoma caused by lens-related abnormalities (phacolytic, phacomorphic, etc.).

Ectopia Lentis

Displaced lens (often with microspherophakia) that can cause pupillary block and secondary glaucoma.

Microspherophakia

Small, spherically shaped lens that predisposes to pupillary block and glaucoma.

Neovascular Glaucoma (NVG)

Secondary glaucoma from retinal ischemia with neovascularization of the iris and angle (rubeosis iridis).

Rubeosis Iridis

Neovascularization of the iris, contributing to angle closure and glaucoma.

Panretinal Photocoagulation (PRP)

Laser treatment for retinal ischemia to reduce VEGF-driven neovascularization in NVG.

Anti-VEGF Intravitreal Injection

Intravitreal medication to inhibit neovascularization in NVG and ischemic retinopathies.

Glaucoma Drainage Device

Implantable device used to drain aqueous in refractory glaucoma (often NVG).

Steroid-Induced Glaucoma

Glaucoma resulting from prolonged corticosteroid use causing elevated IOP.

Prostaglandin Analogues (PGAs)

Eye drops (e.g., latanoprost, travoprost, bimatoprost, tafluprost) that increase uveoscleral and trabecular outflow; once daily.

Beta Blockers

IOP-lowering drops (e.g., timolol) that reduce aqueous production; 20–30% IOP decrease; often twice daily.

Alpha-2 Agonists

Drops (e.g., apraclonidine, brimonidine) that decrease aqueous production and may increase outflow; used 2–3x daily.

Carbonic Anhydrase Inhibitors (CAIs)

Drugs (systemic acetazolamide; topical dorzolamide, brinzolamide) that decrease aqueous production by inhibiting carbonic anhydrase; 15–20% IOP decrease.

Miotics (Pilocarpine)

Direct/indirect cholinergic agents that increase trabecular outflow by constricting the pupil; 15–25% IOP decrease.

Hyperosmotic Agents

Osmotic agents (glycerol, mannitol) used to rapidly reduce IOP by drawing fluid from the vitreous; 20–50% decrease.

Target Pressure

Individualized IOP goal based on damage, severity, life expectancy, and risk factors.

Pediatric Glaucoma Triad (Classic)

Epiphora, photophobia, and blepharospasm seen in congenital glaucoma.

Pupillary Dilation

Pupil enlargement which can precipitate acute angle-closure attacks in predisposed eyes.

Hypopyon?

(Not used in notes) — ignore; placeholder removed.