terminology and guidelines for glaucoma ii - Kwaliteitskoepel

4.5.3 - SECONDARY ANGLE-CLOSURE GLAUCOMAS WITH POSTERIOR “PUSHING” MECHANISM WITHOUT
PUPILLARY BLOCK
4.5.3.1 - Aqueous misdirection glaucoma
a) Long-term pupillary dilation and cycloplegia
b) Topical and systemic IOP lowering medication as needed
c) Laser or surgical dissection of the anterior hyaloid face or lens capsule and/or iridotomy
d) Vitrectomy with dissection of the anterior hyaloid face
Miotics are contraindicated
4.5.3.2 - Iris and ciliary body cysts, intraocular tumors
a) Topical and systemic IOP lowering medication as needed
b) Cyst destruction with laser or surgical excision
c) Tumor irradiation
d) Filtering surgery
e) Cyclodestruction
4.5.3.3 - Silicon oil or gas implanted in the vitreous cavity
a) Topical/systemic IOP lowering medications as needed
b) Silicon oil or gas aspiration
c) Filtering surgery
d) Drainage device
e) Cyclodestruction
4.5.3.4 - Uveal effusion due to
1. inflammation (scleritis, uveitis, HIV infection)
2. increased choroidal venous pressure (nanophthalmos, scleral buckling, panretinal photocoagulation, central
retinal vein occlusion, artero-venous communication)
3. tumor
a) Anti-inflammatory medication (for 1)
b) Topical and systemic IOP lowering medication as needed (for 1, 2 and 3)
c) Relaxation of scleral buckling; vitrectomy, sclerectomy in nanophthalmus (for 2)
d) Tumor excision or irradiation (for 3)
e) Cyclodestruction (for 1, 2 and 3)
4.5.3.5 - Retinopathy of prematurity (stage V)
a) Topical and systemic IOP lowering medications
b) Cyclodestruction
c) Filtering procedure with or without antimetabolite
d) Drainage devices
4.5.3.6 - Congenital anomalies that can be associated with secondary glaucoma
Treatment to be adapted to the primary anomaly, the mechanism of IOP elevation and the quality of life of the
patient
Ch. 4 - 14 EGS