Wednesday, September 26, 2018

Inverse glaucoma

In normal eye aqueous humour flow from ciliary body to anterior chamber. In Malignant glaucoma or Aqueous misdirection syndrome, aqueous humour escapes into posterior chamber. Now posterior chamber has two fluids - aqueous and vitreous. This mixture now push our lens forward. This leads to formation of shallow AC.

Now in this case if I give Pilocarpine then ciliary zonules will be slacked which will ultimately causes lens to move more anteriorly, leading to shallow AC.

Remember: Pilocarpine is DOC for acute congestive glaucoma and it is C/I in inverse glaucoma.

So I will need to give drugs which will cause tightening of ciliary zonules. This can happen when I will relax ciliary muscle. Now relaxation of ciliary muscles is done by cycloplegic drugs. Example - Atropine/ Homatropine.

Did you see the contrast?
Atropine is C/I in Acute ACG but it is DOC for inverse glaucoma!

Hope it helps!

That's all
-Demotional bloke

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