What is Glaucoma?

Glaucoma is when the intraocular pressure is elevated, compromising vision either partially or completely.

What causes Glaucoma to develop?

In a patient with healthy eyes the aqueous humor produced within the Ciliary body located behind the Iris flows through the Pupil and drains through a sieve structure found in the corner of the eye known as the Iridocorneal Cleft. The fluid is produced and then drained at a steady rate resulting a stable intraocular pressure (IOP) of 15-20mmHg.

In the unhealthy eye, there is inadequate outflow of aqueous humor through the Iridocorneal Cleft resulting in the build up of fluid within the eye. This causes the IOP to increase, the more this increases the more damage is done to the Optic nerve which blocks nerve impulses causes blindness.

Does it cause permanent blindness?

The longer the IOP is increased the more damage is done to the Optic nerve, once this is permanently damaged vision can not be restored. Therefore, early surgical intervention is strongly recommended. 

Is there only one type of Glaucoma?

No, there are two types of Glaucoma. These are:

Primary Glaucoma - This is thought to be the inherited type and is seen mainly in purebred dogs. It is caused by either:

  1. Open Angle Glaucoma - Where the point where the Iris meets the Corneal is open at the correct angle but the Iridocorneal Cleft becomes clogged over time resulting in a slow loss of peripheral vision until the whole eye is effected. This type of Glaucoma has little warning signs and is seen most commonly in Beagles and Norwegian Elkhounds.  
  2. Narrow Angle Glaucoma - This type of Glaucoma occurs suddenly when the Iris is pushed or pulled forward blocking the drainage angle. Commonly seen in Cocker Spaniels and is a medical emergency causing pain, redness of the eye, dilated pupils, nausea and vomiting.
  3. Gondiodysgenesis - This is a developmental abnormality of the actual drainage angle causing decrease fluid outflow when the eye becomes inflamed. It is commonly seen in Basset Hounds.

Secondary Glaucoma - This is often the result of pre-existing ocular conditions such as Uveitis, Lens dislocation, Intraocular tumours and trauma to eye interfering the natural flow of ocular fluid. 

The clinical signs of Glaucoma include:

  • Excessive tear production
  • Yellow/Green Ocular discharge
  • Reddened Eye
  • Behavioural changes due to pain and loss of vision
  • Enlarged Pupil that doesn’t respond to light
  • Enlarged Eye

How is Glaucoma diagnosed?

Diagnosis is made by evaluation of clinical signs and taking a detailed history from the client. In addition to this two diagnostic techniques are used, these are:

  1. Tonometry - The measurement of IOP with a Tonopen.
  2. Gonioscopy - Evaluation of the drainage angle, done by placing anaesthetic drops into the eye and then installing a dome shaped lens onto the corneal surface. The front of the eye can then be examined with a slit lamp.  

What treatment is available?

Glaucoma in animals is much more difficult to treat than when it is present in human eyes. Mannitol is the intravenous drug of choice used to decrease the IOP, while eye drops such as Pilocarpine are used to increase the outflow of Aqueous humor. Once the IOP is stable, surgical options become available. 

If vision is present:

Laser Cyclophotocoagulation - A laser is used to burn through the white outer layer of the eye and selectively destroy small areas of the ciliary body to reduce the production of eye fluid. Occasionally more than one surgery is needed to achieve a positive outcome from this treatment.     

Cyclocryothermy - A small probe is placed on the outside of the eye and small areas of ciliary body are frozen to decrease the amount of intraocular fluid being produced. 

Anterior Chamber Shunts - A small valve is implanted under the white of the eye through a small incision acting as a new drainage pathway for the fluid to leave the eye.

If vision isn’t present: 

Evisceration and Implantation of Intrascleral Silicon Prosthesis – A silicone implant is implanted within the eye. This procedure involves shelling out the eye leaving the fibrous sclera and cornea, the shape of the eye is maintained with a sterile silicone sphere and the eye is pain free for the patient. Complications include corneal ulceration.

Ciliary Ablation by Intravitreal Injection of Gentamycin – Gentamycin (a antibiotic) is injected into the eye in high concentrations, the ciliary body is killed resulting in the cessation or reduction of aqueous humor production. A GA is needed and complications can include: shrinking of the eye, return of glaucoma and chronic pain.

Enucleation – Removal of the eye.

anonymous asked:

Can you do a fic rec for hartwin? I cant find amy good fics to read for this otp :(

Ok, Anon, here we go! Sorry for the wait. Also everytime someone asks for a rec list I realise I read mostly, if not only fluff. Or at least angst with a Happy Ending. Sorry.

I’ll start by suggesting you go through @notbrogues AO3 and @missbeckywrites AO3 profiles (check their tumblrs too, for ficlets!): you can’t go wrong with them, -I’m also incapable of choosing between their works, so you know. 

Some of my favourites on Tumblr mostly writers are @speaking-of-tailors @nerdyydragon @agent-eggy @phaeleah

And now some of my Bookmarks/To Read:
  The Gentleman is Not for Sale (But He is for Rent) by mizore, mongoose_bite: Michelle wins the Lottery and despite the fact that now their life is a bit better, their new social circle doesn’t really accepts them. So Eggsy hires Harry, a gentleman for rent.
2.  You Are The Melody by @scandalmuss: AU where Eggsy post his videos on Youtube and Producer!Harry. Still one of my absolute favourite.
3.An Ocular Condition by ProdigalQueer: “Harry sees his adjustment as easy, but that’s only because he’s not really looking.” Post V-Day fix-it fic.
4. The Courtship of Harry Hart by potentiality_26:  “Eggsy decides to woo Harry- which turns out to be more complicated than it seems.” I’m weak for Eggsy wooing Harry, ok.
5. Eggs & Icing Sugar by faedreamer: Baker!Eggsy and Harry that is forced to find a new hobby, so he joins his class. This is one of the cutest thing I’ve ever read and also features chubby!Eggsy which is always a plus.
6. Joys of Baking by Sheepie: Post V-Day chubby!Harry for the sake of equality and some body positivity!
7. Heart and Understanding Series by potentiality_26: Kingsman Agents are Cupids and Eggsy is Harry’s latest assignment. Absolutely lovely, the entire series.
8. Surface Tension by Saucery: “Eggsy is a pool boy. Harry lusts after him.” Because we need some pwp.
9. Unwrapped by AnnaofAza: “Eggsy’s wrapped in a ribbon, gold shimmering in the moonlight, and a neatly-tied bow is perched on his heart.” Same reason as the previous one.
10. Unapologetic by moonflowers: another pwp (but not quite) for good measure :D
11. Married to the Job by trilliath: Married!Harry. Oooh, the misunderstandings and the pining in this one!
12. Penzance to Paddington by leggsyunwin: this one. This one is so real; who hasn’t bad days?
13. Season and Circumstance by mongoose_bite: Regency!AU because which fandom doesn’t have one?
14. Surreal But Nice by moonflowers: Notting Hill!AU, do I have to say more?
15. My Liege, My Love by @moopyloopy: Prince!Harry modern Royalty AU. I do a happy dance everytime the author updates it.

There is anterior dislocation of the lens. Rupture of the zonular fibers may result from ocular trauma or other conditions. The patient underwent surgical extraction of the dislocated lens, anterior vitrectomy, and implantation of an iris-fixated intraocular lens.