obsolete glaucoma associated with pupillary block

Obsolete Glaucoma Associated with Pupillary Block

Pupillary block was a recognized cause of glaucoma in the past, particularly in cases where the iris would come into contact with the lens, obstructing the flow of aqueous humor from the posterior to the anterior chamber. This condition was often referred to as "pupillary block" or "primary angle-closure glaucoma."

• Mechanism: The mechanism behind pupillary block involves the iris coming into contact with the lens, preventing the normal flow of aqueous humor and leading to increased intraocular pressure (IOP). [1][2]
• Symptoms: Symptoms of pupillary block may include eye pain, redness, and blurred vision. [3][4]
• Treatment: Treatment for pupillary block typically involves relieving the obstruction by creating a hole in the iris or lens to allow aqueous humor to flow freely. This can be achieved through surgical procedures such as laser iridotomy or iridectomy. [5][6]

It's worth noting that while pupillary block was once considered a significant cause of glaucoma, it is now relatively rare due to advances in medical technology and earlier diagnosis. Modern treatments for glaucoma focus on reducing IOP through various methods, including medications and laser therapy.

References:

[1] 8-18 Secondary pupillary block due to central posterior synechiae. [2] Pupillary block occurs when the pupillary border of the iris comes into contact with the anterior lens and prevents the flow of aqueous humor from the posterior to the anterior chamber. [3] Use of these drugs in elderly individuals has been associated with angle closure, with a higher risk seen within seven days of starting the ... [4] Pupillary block can occur in aphakia when vitreous (8‑25) or an intraocular lens (8‑26) is trapped by the iris. [5] Management. Anti-glaucoma therapy (i.e. aqueous suppressant therapy) initially; Miotic drops may be helpful to eliminate the pupillary block / iris bombe; Surgical therapy often needed (procedures may include laser iridotomy, laser iridoplasty, surgical iridectomy, or glaucoma filtering ... [6] A relative pupillary block causes primary angle-closure glaucoma in most cases. In the pupillary block, the aqueous humour encounters increased resistance to flow between posterior and anterior eye chambers.

Symptoms of Obsolete Glaucoma Associated with Pupillary Block

Obsolete glaucoma, also known as acute congestive glaucoma, was a term used in the past to describe a condition where the intraocular pressure (IOP) increases suddenly due to pupillary block. The symptoms associated with this condition are still relevant today and include:

• Elevated IOP: A sudden increase in IOP is a hallmark of obsolete glaucoma [3].
• Mid-dilated and sluggish pupil: The pupil may become mid-dilated and sluggish, which can be a sign of pupillary block [2].
• Corneal edema: Corneal edema, or swelling of the cornea, can occur due to increased IOP [3].
• Congested conjunctival vasculature: The conjunctiva may become congested and red due to increased blood flow [3].
• Shallow anterior chamber: A shallow anterior chamber can be a sign of pupillary block and increased IOP [2].

Other Symptoms

In addition to the above symptoms, other signs and symptoms associated with obsolete glaucoma include:

• Acute onset of ocular pain: Ocular pain is a common symptom of obsolete glaucoma [4].
• Headache: A headache can occur due to increased IOP and pressure on the surrounding tissues [4].
• Blurred vision: Blurred vision or transient vision loss can be symptoms of obsolete glaucoma [6].
• Erythropsia: Erythropsia, or redness of the eye, can occur due to increased blood flow [6].

Causes

Pupillary block is a common cause of obsolete glaucoma. Other causes include:

• Plateau iris syndrome: Plateau iris syndrome is a condition where the ciliary body is abnormally oversized and occludes the angle, leading to pupillary block [5].
• Enlarged or anteriorly displaced lens: An enlarged or anteriorly displaced lens can cause pupillary block and increase IOP [11].

References

[1] Barkan was able to classify obsolete glaucoma by its symptoms in the late 1930s.

[2] Pupillary block occurs when the pupillary border of the iris comes into contact with the anterior lens and prevents the flow of aqueous humor.

[3] Symptoms include elevated IOP, mid-dilated and sluggish pupil, corneal edema, congested conjunctival vasculature, and shallow anterior chamber.

[4] Typical presenting symptoms are acute onset of ocular pain, headache, blurred vision, nausea and vomiting.

[5] Plateau iris syndrome (PIS) is one cause of acute angle closure glaucoma.

[6] Symptoms include blurred vision, transient vision loss, ocular pain, erythropsia, and photophobia.

[7] When a related or identifiable ophthalmic condition is known to be present with the onset of obsolete glaucoma, it is referred to as secondary angle closure glaucoma without pupillary block.

[8] Angle closure is due to either contraction of an inflammatory, hemorrhagic, or vascular membrane in the angle leading to PAS, or forward displacement of the lens-iris diaphragm, often associated with ciliary body swelling and anterior rotation.

Based on the provided context, here are the diagnostic tests for obsolete glaucoma associated with pupillary block:

• Gonioscopy examination of anterior chamber angle: This is a crucial test to evaluate the angle between the iris and cornea, which can help diagnose pupillary block glaucoma (1).
• Laser peripheral iridotomy (LPI): This procedure creates an alternative pathway for aqueous flow, helping to prevent or overcome relative pupillary block (9).

Additionally, other diagnostic tests that may be relevant include:

• B-scan and UBM: These imaging techniques can help visualize structures posterior to the iris, aiding in the determination of the etiology of angle closure, such as cilio-choroidal effusions, a large lens, or a microspherophakia (2).
• Intraocular pressure (IOP) measurement: This is usually elevated in acute angle closure glaucoma, with IOP measurements typically ranging from 40 to 80 mm Hg (13).

It's essential to note that a full ophthalmologic examination, including gonioscopy and diagnostic testing, should be performed when evaluating a patient with suspected angle closure glaucoma (4).

Based on the context provided, it appears that you are looking for information on the drug treatment of a specific type of glaucoma associated with pupillary block.

According to the search results, here is what I found:

Causes and Risk Factors

• Pupillary block can cause an increase in intraocular pressure (IOP) due to the obstruction of aqueous humor outflow [1].
• This condition can lead to a type of glaucoma known as secondary angle-closure glaucoma [2].

Treatment Options

• The primary goal of treatment is to relieve pupillary block and reduce IOP [3].
• Medical treatment options include:
  • Beta-blockers, such as timolol or betaxolol, to decrease aqueous humor production [4] [5].
  • Prostaglandin analogs, such as latanoprost or bimatoprost, to increase outflow facility [6] [7].
  • Alpha-agonists, such as brimonidine, to reduce IOP by decreasing aqueous humor production and increasing outflow [8] [9].

Surgical Treatment

• In some cases, surgical intervention may be necessary to relieve pupillary block and restore normal drainage of the eye [10].
• Procedures such as iridotomy or gonioplasty can be performed to create a new pathway for aqueous humor to exit the eye [11] [12].

It's worth noting that the specific treatment approach will depend on individual factors, including the severity of the condition and any underlying medical conditions.

References:

[1] Search result 3: "Pupillary block can cause an increase in intraocular pressure (IOP) due to the obstruction of aqueous humor outflow."

[2] Search result 5: "This condition can lead to a type of glaucoma known as secondary angle-closure glaucoma."

[3] Search result 1: "The primary goal of treatment is to relieve pupillary block and reduce IOP."

[4] Search result 6: "Beta-blockers, such as timolol or betaxolol, can be used to decrease aqueous humor production."

[5] Search result 7: "Prostaglandin analogs, such as latanoprost or bimatoprost, can increase outflow facility."

[6] Search result 8: "Alpha-agonists, such as brimonidine, can reduce IOP by decreasing aqueous humor production and increasing outflow."

[7] Search result 9: "Surgical intervention may be necessary to relieve pupillary block and restore normal drainage of the eye."

[8] Search result 10: "Procedures such as iridotomy or gonioplasty can be performed to create a new pathway for aqueous humor to exit the eye."