Page 106 - NAME OF CONDITION: REFRACTIVE ERRORS

 Visual field
 Optic nerve head and retinal nerve fiber layer analysis
 Slit lamp indirect ophthalmoscopy using 90 D and 78 D lenses.
 Fundus diagrams.
 Stereoscopic disc photographs.
 Red free fundus photography.
 Confocal scanning laser ophthalmoscopy.(HRT)
 Scanning laser polarimetry (GDx)
 Optical coherence tomography.
 Additional Investigations to rule out secondary causes:
 B scan, UBM
 Fluorescein angiography

c) Treatment:

Standard Operating procedure
a. In Patient
Surgical treatment when
 target IOP not achieved with medical therapy

 Any contraindication to medical therapy exists.

 Has an edge over medical therapy in advanced glaucomas.

 Poor compliance

Surgical options:
Trabeculectomy, Combined cataract and glaucoma surgery, non penetrating glaucoma
surgeries and aqueous drainage devices.

b. Out Patient:

Medical and laser therapy :

Medical therapy.
 Effective for majority of patients.

 Most widely acceptable

 Widely available.

 Most appropriate medication with greatest chance of reaching target IOP, with good
safety profile, convenient dosing and affordable medication should be chosen

Drug Methods of action IOP Side- effects Contraindications

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