JONATHAN S. MYERS, MD
Chief, Glaucoma Service
Neovascular Glaucoma. Any eye condition that leads to problems with circulation can cause abnormal vessels to develop throughout the eye. When these develop in the drainage system of the eye, high eye pressures can result. Care for this condition is performed in close conjunction with a retina specialist, and it is possible you will need an eye injection or laser in addition to your glaucoma care.
Iridocorneal Endothelial Syndrome. This group of disorders affect one eye, and are due to abnormal cells that spread throughout the front part of the eye. When these cells spread into the drainage system of the eye, high eye pressures result. Glaucoma results in 50% of patients.
Traumatic Glaucoma. Injuries to the eye can affect the drainage system of the eye by direct impact, or by the presence of blood or inflammation. At times, the angle is excessively wide due to damage to the eye’s drainage system, or may be scarred down due to this injury.
Lens-Related Glaucoma. The development of a large cataract or an injury of the outer coating of the lens can lead to elevated eye pressures and the development of glaucoma. The lens can also move from its normal position and can close the drain of the eye. This prevents fluid from leaving the eye, resulting in eye pressures that are too high for the health of the optic nerve.
Pseudoexfoliation Syndrome. This syndrome is characterized by the deposition of fibrillar material in the front of the eye, which can lead to an increase in eye pressure. Glaucoma associated with pseudoexfoliation syndrome can often lead to very high eye pressures. The lens may have poor support in patients with pseudoexfoliation, and cataract surgery can be more complex.
Pigmentary Glaucoma. Approximately 25 to 50% of those with pigment dispersion syndrome develop glaucoma. Risk factors include younger age, male sex, and myopia. Clinical findings include transillumination defects of the iris (the colored part of the eye), and pigment throughout the front part of the eye. Wide fluctuations in eye pressure are often seen; these are said to occur during period of pigment release during pupillary dilation or physical activity.
Drug-induced Glaucoma. In approximately one-third of patients, steroid use (in eye drops, eye injections, inhalers, creams, or pills) can lead to some elevation of eye pressure, especially if used for more than 3 weeks. This is more likely to happen in patients with glaucoma. Steroid related rise in eye pressure can occur at any point during treatment with the medication, so patients requiring chronic therapy with steroids need to be carefully monitored. Upon stopping steroids, steroid induced rise in eye pressure usually resolves within 2-4 weeks.
Inflammatory Glaucoma. Inflammation in the eye, or uveitis, can cause the eye pressure to become elevated. The elevated eye pressure may be related to clogging of the drainage system with inflammatory debris or closure of the drainage system due to scarring.
Posner-Schlossman Syndrome, or glaucomatocyclitic crisis, is a specific condition associated with recurrent inflammation in one eye that leads to very high eye pressure spikes. The eye pressure is normal between these pressure spikes. The cause of the condition is not known, but there may be some association with herpes simplex virus. Fuchs heterochromic iridocyclitis is another condition in which a low amount of inflammation can lead to glaucoma in 25% of individuals. Signs of this condition include a lighter colored iris on the affected side, formation of cataract, and minimal inflammation in the eye.
JONATHAN S. MYERS, MD
L. JAY KATZ, MD
ELIZABETH DALE, MD
SCOTT FUDEMBERG, MD
NATASHA KOLOMEYER, MD
DANIEL LEE, MD
LINDSAY MACHEN, MD
MARLENE R. MOSTER, MD
MICHAEL PRO, MD
REZA RAZEGHINEJAD, MD
AAKRITI GARG SHUKLA, MD
MARY JUDE COX, MD
RACHEL NIKNAM, MD
JODY PILTZ-SEYMOUR, MD
JESSE RICHMAN, MD
GEOFFREY SCHWARTZ, MD
COURTLAND SCHMIDT JR., MD
MONISHA VORA, MD
ALICE WILLIAMS, MD
Fuchs heterochromic iridocyclitis is a condition in which a low amount of inflammation can lead to glaucoma in 25% of individuals. Signs of this condition include a lighter colored iris on the affected side, formation of cataract, and minimal inflammation in the eye.
Intraocular Tumors. Intraocular tumors can lead to glaucoma in the affected eye. These can invade the drainage system of the eye, cause bleeding and inflammation, and/or move the iris and lens forward leading to angle closure. Treatment should be coordinated with the patient’s ocular oncologist.
Glaucoma Related to Nanophthalmos. Eyes that are very small (nanophthalmic) can have an abnormal drainage system and have a higher risk of developing angle closure glaucoma. Surgery can be more complicated in these patients, as the fluid in the eye often does not behave normally.
Other forms of glaucoma do exist.
Ask your doctor for further information.