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Questions for class No. 8 "Pathology of Intraocular Pressure" 1. Anterior and posterior chambers of the eye. Production of aqueous humor, its circulation, and outflow pathways. 2. Congenital glaucoma: classification, clinical presentation, treatment. 3. Primary glaucoma: classification, diagnosis, clinical features of the two forms of primary glaucoma. 4. Current principles and methods of conservative (medical) treatment of primary glaucoma. 5. Current principles and main methods of laser and microsurgical treatment of primary glaucoma. 6. Acute angle-closure glaucoma attack: etiopathogenesis, clinical presentation, diagnosis, emergency treatment measures. 7. Differential diagnosis of acute angle-closure glaucoma attack and acute iridocyclitis; differences in the treatment of these conditions. 8. Secondary glaucoma: classification, clinical presentation, principles of treatment.

Reading File
This class covers the physiology of aqueous humor and the full clinical spectrum of glaucoma, from congenital disease to primary and secondary forms, including acute emergencies.
  1. Anterior and posterior chambers; aqueous humor
    • Anatomy of the chambers and anterior chamber angle
    • Aqueous production by ciliary processes
    • Flow through pupil and drainage via trabecular and uveoscleral pathways
  2. Congenital glaucoma
    • Primary congenital versus secondary developmental glaucomas
    • Typical infant presentation, examination, and surgical-first management
  3. Primary glaucoma
    • Classification, especially primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG)
    • Diagnosis through IOP measurement, gonioscopy, optic-disc assessment, visual fields, and OCT
    • Differences in clinical features between the two forms
  4. Medical treatment of primary glaucoma
    • IOP-lowering drug classes and their mechanisms
    • Long-term target IOP, adherence, monitoring, and stepwise escalation
  5. Laser and microsurgical treatment
    • Laser trabeculoplasty, laser peripheral iridotomy, and selected laser cyclodestructive procedures
    • Trabeculectomy, drainage devices, minimally invasive glaucoma surgery, and their general indications
  6. Acute angle-closure glaucoma
    • Pupillary-block mechanism and other causes of sudden angle closure
    • Symptoms, examination findings, confirmation, and emergency IOP lowering followed by definitive iridotomy
  7. Acute angle closure versus acute iridocyclitis
    • Key bedside differences in pain pattern, pupil, cornea, IOP, anterior chamber, and treatment
    • Why confusing the two can lead to harmful treatment
  8. Secondary glaucoma
    • Classification by cause: inflammatory, lens-related, neovascular, traumatic, drug-induced, pigmentary/pseudoexfoliative, and postoperative
    • Treating both the raised IOP and its underlying cause
At a high level, glaucoma is an optic neuropathy in which raised IOP is an important, modifiable risk factor. The core learning sequence is: understand aqueous dynamics, determine whether the drainage angle is open or closed, identify primary versus secondary cause, assess optic-nerve damage, then choose medicines, laser, or surgery appropriate to the mechanism.
Acute angle closure is the priority emergency topic because delay can cause permanent visual loss. Congenital glaucoma is generally treated surgically, while chronic primary glaucoma is usually managed with individualized pressure-lowering therapy and ongoing structural and functional monitoring.
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