Secondary glaucoma

Some secondary glaucoma eye disease> diseases and certain systemic diseases in the eye complications, This type of glaucoma wide range of clinical manifestations and each has its own characteristics, treatment principle does not do the same, are quite different prognosis.
First, with iridocyclitis the secondary glaucoma
(1) from chronic iridocyclitis cause can be found in the following three conditions: ① iris pupillary membrane lead to adhesions after closure, atresia pupil, iris, the former angle closure, treatment is resection of the iris to prevent a wide range of angle trabecular adhesion and former permanent injury. ② various inflammatory cells, exudation, such as certificates pigment expected to stay at the former angle, the angle surrounding the former can produce adhesion and impede the outflow of aqueous humor. ③ inflammation can lead to change rubeosis ridls red iris, adhesion and the entire surrounding neovascular glaucoma neovascular glaucoma.
(B) from acute iridocyclitis caused by secondary open angle glaucoma, under normal circumstances, acute inflammation iris, aqueous humor formation decreased, but outflow has not changed and therefore intraocular pressure drop, but sometimes in the opposite situation, as inflammation of obstruction trabecular meshwork, or increasing the viscosity of water, resulting in the reduction of water outflow, increased intraocular pressure, herpes zoster and herpes simplex iridocyclitis can produce high intraocular pressure, this reason, the former angle can check it with the primary angle-closure glaucoma distinction, slit lamp, a corneal KP, said iridocyclitis high intraocular pressure is caused reasons.
(C) Glaucomatocyclitic crisis (glaucomatocy clitic crisis syndrome), will occur in young adults, mostly unilateral, cause unknown, and may increase the secretion of the prostate in the acute attack, the increase in water prostaglandin E, prostate can blood-aqueous barrier damage to the vascular permeability changes in the water increased.
Clinical manifestations: very acute onset, as a typical fog, the rainbow as, headache, nausea or vomiting symptoms of glaucoma, the symptoms disappeared after, vision, vision mostly without damage. Inspections, mixing mild congestive visible, corneal edema, a little coarse big gray cornea after deposition, not shallow anterior chamber, open angle, the muddy water had mild, slightly larger than pupil, light reaction exist, IOP Up to 5.32-7.98 kpa (40 ~ 60 mm Hg), no significant change in the fundus, the optic disc normal, when there are high intraocular pressure artery pulsatility.
The disease characterized by recurrent, and attack lasted more than 3 to 7 days, and more able to ease, attack clearance from a few months to 1 to 2 years.
Differential diagnosis: the disease often associated with acute angle-closure glaucoma mixed, under the younger, shallow anterior chamber does not have the typical gray KP, open angle, ease of visual function after no damage, and other general characteristics of identification.
Treatment: The main use acetazolamide have inhibited the water, the first of 500 mg, 6 hours once, and use of glucocorticoids points eyes, miotic drugs ineffective, does not need to mydriasis, and after treatment can be more in a week eased, no sequelae good prognosis.
Second, Crystal anomaly caused by glaucoma
(1) crystal deformation caused by glaucoma: When Crystal swelling, obstruction pupil, leading to elevation of intraocular pressure, treatment is timely removal crystal.
(2) crystal soluble glaucoma (phacolytic glaucoma): Crystal denatured protein leakage from the lens capsule, the former angle macrophage response, these macrophages can be blocked trabecular meshwork, leading to ocular hypertension , at the onset showed symptoms of acute glaucoma, cataract removal is the treatment.
(C) lens dislocation
3. Traumatic secondary glaucoma
4. Neovascular glaucoma (neovasular glaucoma)
The change is a red iris complications, red iris lead to any change can be found in the iris and retinal ischemia in patients> diseases, but the most common is diabetic retinopathy and central retinal vein occlusion, or anterior segment due to retinal hypoxia, iris and the former caused angle formed neovascular membranes, membrane contraction angle can be closed, resulting in peripheral iris adhesion and impede the flow of water, using an ordinary drug treatment and anti - glaucoma filtration surgery are invalid, the former has not fully closed before angle may trial of the former angle photocoagulation, diabetic retinopathy can be tested extensively retinal photocoagulation can be changed to prevent red iris, or even make abnormal vascular degradation, if the angle before had completely occluded using valve control device implantation Freezing of ciliary body and sometimes effective.