Surgery

1
GLAUCOMA
VISUAL OR BLIND ?
BLIND Determine primary cause Relieve pain
Enucleation Evisceration /
prosthesis Cyclocryosurgery
Cyclophotocoagulation Evaluate fellow eye
VISUAL
PRIMARY OR SECONDARY ?
PRIMARY (CLOSED) Medical Therapy
0.005 Latanoprost or Mannitol
2 Pilocarpine Methazolamide
Recheck IOP in 3-4 hrs Evaluate Fellow Eye
SECONDARY Treat 1o Cause Uveitis
Lens Luxation Hyphema
Neoplasia Evaluate Fellow Eye
Prophylactic Therapy Demecarium or
Betaxolol ?IOP q1 mo for 3 mo
then q 3 mo
IOP gt 20 Perform Sx
Surgery Combined Procedures
Cyclocryosurgery Cyclophotocoagulation
Gonioimplantation
IOP lt 20 Continue Medical Rx Either Sx now or
if IOP gt 20 mm Hg