# Glaucoma --- **Glaucoma** is an increased pressure of fluids inside the eye—usually the **aqueous humor** in the [[eyes|anterior segment]]—which causes damaging pressure on the [[optic nerve]]. It's difficult to detect (it's painless and shows no obvious symptoms), but quite dangerous—untreated it can lead to blindness. This is the condition they're checking for when the do the puff of air into your eyeball (but I don't think they do that much anymore) Although more prevalent in the older adult (it is one of the leading causes of blindness in the older adult), this is an abnormal finding. Can lead to blindness, which is irreversable. Sometimes associated with [[diabetes mellitus]]. **Infantal glaucoma** is a recessive autosomal disease that causes enlarged, cloudy eyes. might have photophobia, tearing, conjunctivitis, eyelid spasms, may have visual loss. There is a type of surgery called a **goniotomy**, which is the removal of the obstruction of the aqueous humor. Normally aqueous humor flows form the posterior segement and goes into the anterior segment, and then drains out of a special duct. This is constantly flowing. ![[healthy eye.png]] Can be open or closed/narrow angle. **OPEN** angle is when the fluid is generated in the back of the eye and goes into the front of the eye it gets blocked from the ducts. It's still draining a little bit. **CLOSED angle** the fluid is generated but it is stuck behind the pupil, and doesn't even get to teh front of the eye. This is much more dangerous. ## Signs & Symptoms There may be no signs or symptoms of glaucoma until there are late stages visual changes and loss. The hallmark sign of glaucoma is "halo" vision, or a loss of peripheral vision. Halo vision loss of peripheral vision blurry vision • Nausea • Red eyes, difficulty focusing, eyes don't adjust in low light • Possible headaches, ache around eyes ## Treatment meds: [[carbonic anhydrase inhibitors]] [[prostaglandins]] [[beta blockers|timolol maleate]] - a beta blocker eyedrop (that doesn't produce systemic effects) If meds are not working they can do surgery like: Trabeculectomy Surgery named after the thing the humor flows out of opens it up a little bit Laser trabeculoplasty Peripheral iridotomy for closed angle (i think) Post operative- monitor for intraocular infection-endophthalmitis ___