Glaucoma

Glaucoma is a condition characterized by an increased intraocular pressure with optic disc cupping and associated visual field defects. It is a disease of the aged but it may be a congenital condition too. The various types are:
• Congenital glaucoma.
• Primary open angle glaucoma.
• Primary angle closure glaucoma.
• Secondary glaucoma.

The increased intraocular pressure is due to the blockage in the aqueous outflow mechanism. This is more common among cigarette smokers where there is narrowing of the canals. Those with hypertension and thyrotoxicosis are also at an increased risk.
Symptoms:
1. Headache and eye ache.
2. Excessive lacrimation
3. Colored halos, delayed dark adaptation.
4. Nausea, vomiting.

Signs:
1. Shallow anterior chamber of eye.
2. Oval and large optic cup.
3. Splinter hemorrhages and pallor areas on disc.
4. Nasal shifting of the retinal vessels which is called Bayonetting sign.
5. Pulsation of the retinal arterioles at the disc margin is pathognomic of glaucoma.
6. Excavation of optic disc in later stages.
7. Visual field defects progressing from peripheral field changes and ending up with only a small island of tubular central vision.