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Summary Glaucoma Referrals

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Glaucoma complete notes

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  • March 2, 2023
  • 32
  • 2022/2023
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Glaucoma Referrals

Components of a glaucoma referral

 Hx (Age, ethnicity etc)
 IOP (>25mmhg)
 CCT (<555)
 ACA (Van herricks grade 1 or 2)
 VF (Nasal step, develops)
 Disc assessment (thinning of NRR, Atrophy, DDLS)
 Imaging




Hx
 Age and ethnic origin – As people get older greater
risk/Px of African descent are more prone to POAG/Px
of south east Asian are more prone to PACG

 Previous hx of OHT or glaucoma


 OH = Uveitis (very carefully
monitored)/Pseudoexfoliation/pigment
dispersion/myopia (greater than 6D=more risk)

 GH= Diabetes/HBP/Perip VD/Migraines


 Meds = steroid use

,  FGH- Glaucoma

POAG risk factors:

,Risk factors of ACG:




Hyperopic = more risk of ACG (smaller eyes)
South east Asian due to anteriorly positioned lens and shallower
anterior chamber angle




IOP

 Measured using applanation tonometry
 Protocol in place to ensure regular calibration
 Establish a baseline
 Minimum of 2 readings on a single occasion
 Record: TIME, INSTRUMENT USE AND READINGS

When to refer or consider referral :

 IOP>25mmHg irrespective of CCT
 IOP 21-25mmHG and CCT <555nm aged < or = 65

, **Monitor in community if IOP <26 and CCT > or = 555nm
with no signs of progression or change **




Central Corneal Thickness

 Increased risk of glaucoma if CCT is less than 555nm
 Measured using pachymeter
 Record CCT mean and SD









Anterior Chamber Assessment
Van Herricks technique shows a peripheral anterior
chamber angle which is less than quarter of corneal
width

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