MANUAL DE GONIOSCOPIA. La exploracion clinica del angulo irido- corneal ( Manual of Gonioscopy. Clini cal examination of the irido-corneal angle). By Angel . A gonioscopia direta é usualmente realizada com a lente de Koeppe e pratica- Figura 5 - A gonioscopia de indentação permite o exame do recesso do seio. PDF | Purpose: To assess Automatic Gonio-Photography (AGP)-true color images of the anterior gonioscopia circa l'identificazione di reperti.
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Angulo cerrado en gonioscopia sin estructuras visibles. Angulo abierto en gonioscopia raudone.info An evaluation of the anterior chamber angle's configura- tion is an essential part of the anterior segment ex- amination, especially in patients with glaucoma. In addition to this downloadable pdf of the book, the links to each individual chapter and the videos that were previously available on DVD and.
Todos los derechos reservados. Introduction year of clinical internship in a tertiary eye care centre.
After completion of graduation most of the optometry students Glaucoma is the second leading cause of blindness after prefer to undergo a clinical fellowship at the L V Prasad Eye cataracts and is the leading cause of irreversible blindness, Institute for an year, where the fellows are trained in each with an estimated burden of 8. India currently has approxi- blind from glaucoma worldwide in A further million people, including 11 mil- case detection and treatment of primary angle closure dis- lion children, are blind or visually impaired simply from lack ease PACD.
In this sce- India, respectively. Kumar et al.
This approach fits into the eye care delivery model Patients and methods advocated by of the L V Prasad Eye Institute whereby a focussed examination conducted close to the home location The study was conducted in the outpatient department of of the individual results in the identification of suspected the L V Prasad Eye Institute, Hyderabad, India itself.
The specific pathologies. This can then initiate an efficient study was approved by the ethics committee of the L V referral process to confirm the diagnosis and adminis- Prasad Eye Institute and was conducted according to the ter the appropriate treatment within a reasonable time tenets of the Declaration of Helsinki.
Informed consent was frame. It also helps developing the communication with obtained from all the participants. During this time between and glaucoma shared care of glaucoma patients. Both the optometrists performed gonioscopy and optic enables a coordinated training and development model disc assessment on over patients while gaining expe- for all professionals involved in glaucoma detection and rience in the assessment and management of patients with management.
It has been shown in various the standard proforma of patient examination. The L V Prasad Eye Institute, being a centre of excellence The primary goal of this study is to establish the in the eye care delivery pyramidal model,15 most of the sensitivity and specificity with which the two experi- patients come with complex eye problems. Patients initially enced optometrists can detect glaucomatous changes using report to the front office personnel and are directed to the gonioscopy and optic disc assessment relative to the gold comprehensive outpatient department where the complete standard ophthalmologists diagnosis.
Referral to the subspecialty clinic is then made is advocated by the World Health Organization WHO , at depending on the necessity. The examination procedures the lowest level of the pyramid is a vision center managed were based on the standard proforma.
For each patient, by a vision technician. Primarysecondary interface exists post dilation evaluation of the optic disc and fundus was between the primary care services at the vision center and done with a Each vision Disc cupping and appearance were documented by drawing center caters to a population of 50, Agreement of glaucoma specialists and experienced optometrists in gonioscopy and optic disc evaluation rim, asymmetry, peripapillary atrophy, disc haemorrhages were estimated, assigning linear weights to disagreements and collateral vessels.
Gonioscopy was carried out for every among the above categories. Details of the kappa statis- patient before dilation, with a Sussman 4 mirror gonio tic have been explained elsewhere. For the current study all examiners retained their likelihood ratios. For this analysis, the suspect categories own gonioscopic and optic disc assessment information so in both gonioscopy and optic disc interpretation were com- that the entire procedure remained masked among the bined with the disease category for both optometrists and observers.
No other clinical data were available to ophthalmologists. Likelihood ratio LR is the probability the observers. The LR for a given test result indicates Categorization of gonioscopy and optic disc findings how much that result will raise or lower the probabil- ity of disease. A LR of 1, or close to 1, would mean For the purpose of the current study gonioscopic findings that the test provides no additional information about the were categorized as 0, 1 and 2 for open angle, primary post-test probability of the disease.
A classification was used. After Separate cohorts of subjects were evaluated for agree- the initial work-up by the general optometrists, each of the ment in gonioscopy and optic disc interpretation by both two experienced optometrists and the glaucoma specialist optometrists.
Optometrist 1 performed gonioscopy in 72 ophthalmologist carried out gonioscopy. Mean age of these subjects was angles without any other abnormality. Statistical analysis Tables 3 and 4 show the diagnostic accuracies of each optometrist separately for gonioscopy and optic disc The primary outcome was the agreement between glau- evaluation. Three possible diagnostic categorizations were open from occludable angles. An evidence-based update. Laser peripheral iridoplasty for angle-closure.
Cochrane Database Syst Rev.
Shaffer RN. A suggested anatomic classification to define papillary block glaucoma. Invest Ophthalmol. Argon laser peripheral iridoplasty for plateau iris syndrome. Surgical rounds from the Hamilton Glaucoma Center. Glaucoma Today. Current approaches to the management of acute primary angle closure.
Curr Opin Ophthalmol. World Medical Organization. Declaration of Helsinki. Argon laser iridoplasty: a primary mode of therapy in primary angle closure glaucoma.
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Indian J Ophthalmol. Lam DS. Argon laser peripheral iridoplasty versus conventional systemic medical therapy in treatment of acute primary angle closure glaucoma: a prospective, randomized, controlled trial. Arch Soc Esp Oftalmol. Zhang HC.
Peripheral iridoplasty with double frequency Nd YAG laser as treatment for angle closure glaucoma. A clinical study on laser peripheral iridoplasty for primary angle-closure glaucoma with positive provocative tests after iridectomy. Intraocular pressure increased to 48 mmHg in both eyes.
The patient received topical steroids, maximum hypotensive treatment and oral valacyclovir.
Intraocular pressure gradually decreased throughout the second and third months, and medications were gradually tapered. The time to complete resolution of pigment dispersion was 18 weeks. Visual acuity and visual fields remained normal, but the photophobia was permanent. Relatamos o caso de um paciente de 61 anos, com dor ocular bilateral aguda, hiperemia e intensa fotofobia.
A acuidade e os campos visuais permaneceram normais, mas o paciente manteve a fotofobia. Clogging of the trabecular meshwork with pigment may cause an acute rise of intraocular pressure IOP.
Patients typically present with acute and usually severe photophobia, red eye, and ocular discomfort or pain, which sometimes simulates acute bilateral iridocyclitis. Cases often occur after a flulike illness or upper respiratory tract infection, some of them after the use of oral moxifloxacin Middle-aged women are most commonly affected.
Two clinical sub-types have been described.
In the first 1,5 , pigment discharge originates in the iris stroma.This hypothesis is supported by the fact that in eyes with PIC and cataract, from which the cataract has been removed, the abnormal positioning of the ciliary body persists, but an increase of the anterior chamber depth takes place, as well as the widening of the angle, which prevents the installation of an acute crisis of glaucoma The intraocular pressure aplannation tonometry was 14 mmHg in the right eye and 15 mmHg in the left eye.
In some cases, the iris root is short and thick and inserted in a more anterior position in the ciliary body, anteriorization of the ciliary processes also occurring.
A acuidade e os campos visuais permaneceram normais, mas o paciente manteve a fotofobia. Br J Ophthalmol. Ocular developmental abnormalities and glaucoma associated with intersticial 6p25 duplications and deletions.
Ritch R. Angle-closure glaucoma is rare in children and young adults; only scattered cases associated with specific clinical entities have been reported