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Abstract #11960 Published in IGR 7-1
Management of elevated intraocular pressure in the presence of uveitis
Samples JRClinical and Surgical Ophthalmology 2004; 22: 324-332
A number of difficult dilemmas can arise in the management of glaucoma associated with acute and chronic uveitis. Fortunately, most patients with a first or second episode of acute uveitis have a normal optic nerve. Real dilemmas occur when chronically elevated intraocular pressure develops. Problems in the management of such patients include determining whether or not they have corticosteroid-induced pressure rises, ascertaining to what degree inflammation has impaired outflow in the eye, and ultimately determining what measures are required to lower the pressure to prevent the development of glaucomatous optic neuropathy. Because it may be difficult to establish filtration in inflamed eyes and because they are often best treated with either cyclophotocoagulation or a tube implant, timing of surgical intervention may be critical in these cases. Trabeculectomy in quiet eyes that have had uveitis may be surprisingly effective in some cases but not in other cases. The best surgical outcome is achieved in a quiet and uninflamed eye, and failure to intervene can lead to irreversible loss of visual function.
Dr. J.R. Samples, Casey Eye Institute, Glaucoma Service, 3375 SW Terwilliger Blvd., Portland, OR 97201, USA
Classification:
9.4.6 Glaucomas associated with inflammation, uveitis (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)