ISSN 2398-2969      

Glaucoma: secondary to anterior uveitis

icanis

Introduction

  • Cause: obstruction of aqueous outflow resulting from presence of inflammatory products within anterior and posterior chambers.
  • Signs: discomfort, episcleral congestion, conjunctival hyperemia, corneal edema, inflammatory products within anterior chamber, elevated intraocular pressure, visual deficits.
  • Diagnosis: ophthalmic examination, tonometry, serological testing, aqueocentesis.
  • Treatment: antiinflammatory and antiglaucoma medications.
  • Prognosis: fair.

Pathogenesis

Etiology

Predisposing factors

General
  • Breed (Golden retriever, Japanese Akita, Samoyed, Siberian Husky).
  • Living in endemic areas of infectious causes.
  • Presence of cataract.
  • Previous cataract surgery.

Pathophysiology

  • Acute anterior uveitis:
    • Obstruction of iridocorneal angle with inflammatory cells, fibrin and cellular debris impedes aqueous outflow.
  • Chronic uveitis:
    • Anterior synechiae - adhesions between anterior iris and posterior cornea leading to occlusion of the iridocorneal angle and ciliary cleft.
    • Posterior synechiae - adhesions between posterior iris and anterior lens capsule. This is termed iris bombe if it completely encircles the pupil and prevents transpupillary aqueous flow Eye: chronic uveitis - Pug. There is build-up of aqueous humor behind the iris which causes elevation in intraocular pressure and pushes the iris-lens diaphragm anteriorly predisposing to anterior synechiae.

Timecourse

  • Vary variable.
  • Can be acute in presentation or develop chronically over months to years.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Gelatt K N, Mackay E O (2004) Secondary glaucomas in the dog in North America. Vet Ophthalmol 7, 245-259 PubMed.

Other sources of information

  • BSAVA Manual of Ophthalmology(2014) Gould D & McLellan G (eds). 3rd edn, pp 247-272.
  • Veterinary Ophthamology(2013) Gelatt K, Gilger B, Kern T (eds). 5th edn, pp 1099-1100.

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