Becker-Shaffer's Diagnosis and Therapy of the Glaucomas, 8th Edition (Becker-Shaffers)

Authored by three prominent specialists in the field, this text provides comprehensive coverage of diagnostic and treatment modalities for optimal glaucoma management. Revised throughout, this new edition presents the latest guidance in clinical examination, randomized trials, medical treatment, laser therapy, and surgical procedures. Hundreds of illustrations-with many classic black and white figures from the previous editions supplemented with new color images-depict the features of glaucomas and step-by-step procedures for their management, while expanded use of highlighted boxes, lists, and summary tables make the material easy to access. Evidence-based and updated information on all aspects of the glaucomas-including physiology, genetics, interventional trials, and new surgical techniques-offer a well-rounded foundation of knowledge for making the most informed diagnoses and choosing the most effective course of treatment.Combines the cumulative experience of three prominent glaucoma specialists-addressing a full range of clinical needs for practitioners of all levels-for a uniquely written coherent perspective.Includes extensive references to current and historically important sources to provide comprehensive interpretation of the latest medical literature.Synthesizes a classical approach to the glaucomas-based on seven earlier editions spanning over 40 years-with the most up-to-date evidence-based and epidemiologically-derived classifications and outcomes.Coherently correlates with authoritative consensus documents on key areas of glaucoma, drawn up by the world-wide specialists of the World Glaucoma Association, and reprinted in the text.Revamps traditional teachings on the angle closure glaucomas, in concert with the newest international literature and technologies, to keep you up to date on the latest advances.Illustrates detailed surgical interventions applicable to the complete spectrum of clinical settings-from the developing world through contemporary operating rooms.Examines the newest and most promising developments in pharmacology, laser and surgical advances for glaucoma management, to enable you to choose the most effective patient approach.Illustrates invaluable but little-known instruments for clinical and research diagnoses, including optic nerve cupping scales, bleb assessment instruments, and more. Copyright Page......Page 2 Foreword......Page 3 Preface......Page 4 List of Contributors......Page 5 Acknowledgments......Page 6 Dedication......Page 7 In Memorium......Page 8 EPIDEMIOLOGIC AND SOCIOECONOMIC ASPECTS OF THE GLAUCOMAS......Page 9 RISK FACTORS......Page 11 CLASSIFICATION OF THE GLAUCOMAS......Page 12 REFERENCES......Page 14 FUNCTION OF AQUEOUS HUMOR......Page 16 ULTRASTRUCTURE OF THE CILIARY PROCESSES......Page 17 VASCULAR SUPPLY......Page 19 ACTIVE TRANSPORT......Page 20 CHEMICAL COMPOSITION OF THE AQUEOUS HUMOR......Page 22 THE BLOOD–AQUEOUS BARRIER......Page 23 Tonography......Page 24 Paraminohippurate......Page 25 BLOOD FLOW TO THE CILIARY BODY......Page 26 HORMONAL EFFECTS......Page 27 PHARMACOLOGIC AGENTS......Page 28 REFERENCES......Page 29 FUNCTIONS OF THE CONVENTIONAL AQUEOUS OUTFLOW SYSTEM......Page 33 TRABECULAR MESHWORK TISSUES......Page 34 Uveal and corneoscleral meshwork ultrastructure......Page 35 Overview......Page 37 Distending cells that form invaginations or pseudovacuoles, ‘giant vacuoles’......Page 38 Schlemm’s canal endothelium pores......Page 39 Septa......Page 40 Herniations or protrusions of Schlemm’s canal inner wall......Page 41 JUXTACANALICULAR SPACE RESISTANCE......Page 42 TISSUE LOADING STUDIES......Page 43 BOUNDARY CONDITIONS......Page 44 THE AQUEOUS OUTFLOW SYSTEM AS A PASSIVE FILTER......Page 45 UVEOSCLERAL FLOW......Page 46 Perfusion......Page 47 FACTORS AFFECTING THE FACILITY OF OUTFLOW......Page 48 EPISCLERAL VENOUS PRESSURE......Page 49 REFERENCES......Page 50 Goldmann tonometer......Page 55 Pneumatic tonometer......Page 58 The OcutonTM tonometer......Page 60 Schiøtz tonometer......Page 61 Impact–rebound tonometer......Page 63 DYNAMIC CONTOUR TONOMETRY......Page 64 SUMMARY OF TONOMETRY......Page 65 DISTRIBUTION OF INTRAOCULAR PRESSURE IN THE GENERAL POPULATION......Page 66 AGE......Page 67 CARDIOVASCULAR FACTORS......Page 68 PSYCHIATRIC DISORDERS......Page 69 SURGERY......Page 70 REFERENCES......Page 71 ANATOMIC FEATURES OF NORMAL EYES......Page 76 PUPIL AND IRIS......Page 77 SCLERAL SPUR......Page 78 SCHWALBE’S LINE......Page 79 REFERENCES......Page 80 Indirect gonioscopic lenses......Page 81 Indentation (compression) gonioscopy......Page 83 REFERENCES......Page 85 TRABECULAR PIGMENT BAND......Page 86 SPAETH CLASSIFICATION......Page 88 EXAMPLES......Page 89 DIFFICULTIES AND ARTIFACTS IN GONIOSCOPY......Page 90 USE OF DRUGS......Page 91 SUMMARY OF IMPORTANT GONIOSCOPIC TECHNIQUES......Page 92 APPENDIX......Page 93 TERMINOLOGY AND DEFINITIONS......Page 99 THEORY OF VISUAL FIELD TESTING......Page 100 STATIC PERIMETRY......Page 101 SCREENING TESTS......Page 102 THE FUTURE OF VISUAL FIELD TESTING......Page 103 COMBINED STATIC AND KINETIC PERIMETRY......Page 104 REFERENCES......Page 105 RELIABILITY......Page 106 MEDIA CLARITY......Page 107 BACKGROUND ILLUMINATION......Page 108 STIMULUS EXPOSURE TIME......Page 109 GENERAL PRINCIPLES......Page 110 Preparing the patient......Page 111 Technique of manual bowl (Goldmann) perimetry......Page 112 Technique of computerized bowl perimetry......Page 114 REFERENCES......Page 116 Generalized depression......Page 117 Nasal step or depression......Page 118 Isolated paracentral scotomata......Page 119 CHRONIC OPEN-ANGLE GLAUCOMA......Page 120 OTHER CAUSES......Page 123 Short-term fluctuation......Page 124 DETERMINATION OF NORMAL VISUAL FIELD......Page 127 Global indexes......Page 128 Localized variation within the visual field......Page 129 RECOGNITION OF CHANGE......Page 130 QUANTIFYING VISUAL FIELD CHANGE......Page 133 REFERENCES......Page 137 COLOR VISION AND SHORT-WAVELENGTH AUTOMATED PERIMETRY......Page 139 FREQUENCY-DOUBLING PERIMETRY......Page 142 HIGH-PASS RESOLUTION PERIMETRY......Page 144 The pattern electroretinogram (PERG)......Page 145 The multifocal visual-evoked potential (mfVEP)......Page 146 REFERENCES......Page 148 MECHANISMS OF GLAUCOMATOUSOPTIC NEUROPATHY......Page 151 WHERE ARE THE GANGLION CELLS INJURED?......Page 152 WHAT INJURES GANGLION CELLS?......Page 153 Connective tissue structures within the optic nerve head......Page 154 Vascular nutrition of the optic disc......Page 156 REFERENCES......Page 158 CLINICAL TECHNIQUES OF EVALUATION......Page 162 Optic disc size......Page 164 Neuroretinal rim shape......Page 165 Optic cup configuration and depth......Page 166 Position of central retinal vessels and branches......Page 167 Optic disc hemorrhages......Page 168 Nerve fiber layer defects......Page 169 Peripapillary choroidal atrophy......Page 170 HIGH MYOPIA DISC PATTERN......Page 171 FOCAL NORMAL-PRESSURE PATTERN (FOCAL ISCHEMIC)......Page 174 PRIMARY OPEN-ANGLE GLAUCOMA PATTERN (GENERALIZED ENLARGEMENT)......Page 175 REFERENCES......Page 176 HEIDELBERG RETINA TOMOGRAPHY (HRT)......Page 179 Components of the HRT report......Page 181 OPTICAL COHERENCE TOMOGRAPHY (OCT)......Page 183 Macular scan......Page 185 RNFL thickness average analysis......Page 186 Macular analysis......Page 187 QUALITY ASSESSMENT......Page 188 TESTING FROM THE PATIENT’S PERSPECTIVE......Page 189 LONGITUDINAL EVALUATIONS......Page 190 GDX......Page 191 Strengths and limitations......Page 192 CONCLUSIONS......Page 193 REFERENCES......Page 195 CLASSIFICATIONS OF ANGLE-CLOSURE DISEASE......Page 196 CLARIFICATIONS AND COMMENTARY......Page 197 NEW IMAGING TECHNOLOGIES......Page 199 PUPILLARY BLOCK GLAUCOMA......Page 200 Age......Page 201 Iris bowing and lens–iris channel......Page 202 Provocative tests......Page 204 Clinical examination......Page 205 Medical management of acute PACG......Page 207 Slit-lamp maneuvers in management of acute PACG......Page 208 Laser interventions for acute PACG......Page 209 Management of the fellow eye......Page 210 Correlating older and newer terminologies for angle closure......Page 211 Plateau iris configuration......Page 212 Plateau iris syndrome......Page 213 Intumescent and swollen lens......Page 214 REFERENCES......Page 215 NEOVASCULAR GLAUCOMA......Page 220 Pathogenesis......Page 221 Diabetes mellitus......Page 222 Ocular ischemic syndrome......Page 223 Clinical presentation......Page 224 Treatment......Page 225 Clinical presentation......Page 226 Cogan-Reese syndrome......Page 227 Pathophysiology......Page 228 Treatment......Page 229 INFLAMMATION......Page 230 PENETRATING KERATOPLASTY......Page 231 CILIARY BLOCK GLAUCOMA (AQUEOUS MISDIRECTION OR MALIGNANT GLAUCOMA)......Page 232 INTRAOCULAR TUMORS......Page 233 NANOPHTHALMOS......Page 234 Treatment......Page 235 SCLERAL BUCKLING PROCEDURE......Page 236 Secondary pupillary block glaucoma: iris–lens adhesions......Page 237 Microspherophakia......Page 239 REFERENCES......Page 240 PREVALENCE......Page 247 DIMINISHED AQUEOUS HUMOR OUTFLOW FACILITY......Page 251 Altered corticosteroid metabolism......Page 252 OPTIC NERVE CUPPING AND ATROPHY......Page 253 FINDINGS......Page 254 GOALS......Page 255 TYPES OF TREATMENT......Page 256 PROGNOSIS......Page 257 THE GLAUCOMA SUSPECT AND OCULAR HYPERTENSION......Page 258 EPIDEMIOLOGY OF OCULAR HYPERTENSION......Page 259 RISK FACTORS FOR DEVELOPMENT OF OPEN-ANGLE GLAUCOMA......Page 260 TREATMENT......Page 262 PATHOGENESIS......Page 263 DIFFERENTIAL DIAGNOSIS......Page 264 TREATMENT......Page 265 REFERENCES......Page 266 PIGMENTARY GLAUCOMA......Page 274 EXFOLIATION SYNDROME (PSEUDOEXFOLIATION SYNDROME)......Page 277 CORTICOSTEROID GLAUCOMA......Page 278 LENS-INDUCED GLAUCOMA......Page 279 PHACOLYTIC GLAUCOMA......Page 280 GLAUCOMA AFTER CATARACT SURGERY......Page 281 GLAUCOMA FROM VISCOELASTIC SUBSTANCES......Page 282 GLAUCOMA AFTER NEODYMIUM:YTTRIUM-ALUMINUM-GARNET LASER POSTERIOR CAPSULOTOMY......Page 283 CHEMICAL BURNS......Page 284 CONTUSION INJURIES......Page 285 GHOST-CELL GLAUCOMA......Page 286 HYPHEMA......Page 287 RETINAL DETACHMENT AND GLAUCOMA......Page 288 GLAUCOMA WITH UVEITIS......Page 289 GLAUCOMATOCYCLITIC CRISIS......Page 290 INTRAOCULAR TUMORS AND GLAUCOMA......Page 291 ELEVATED EPISCLERAL VENOUS PRESSURE......Page 292 ARTERIOVENOUS FISTULAS......Page 293 IDIOPATHIC ELEVATIONS......Page 294 REFERENCES......Page 295 SYNDROME CLASSIFICATION......Page 302 Isolated trabeculodysgenesis......Page 303 Anterior stromal defects......Page 305 Corneodysgenesis......Page 306 Office examination......Page 307 Intraocular pressure measurement......Page 308 Corneal measurements: diameter and central thickness......Page 309 Axial length measurement......Page 310 Ophthalmoscopy......Page 311 GENETICS AND HEREDITY......Page 312 PATHOPHYSIOLOGY......Page 313 Other causes of corneal enlargement or clouding......Page 314 Other causes of epiphora or photophobia......Page 315 MANAGEMENT......Page 316 Initial surgery......Page 317 Long-term follow-up, management, and prognosis......Page 318 DEVELOPMENTAL GLAUCOMA WITH ANOMALOUS SUPERFICIAL IRIS VESSELS......Page 319 ANIRIDIA......Page 320 STURGE-WEBER SYNDROME (ENCEPHALOFACIAL ANGIOMATOSIS, ENCEPHALOTRIGEMINAL ANGIOMATOSIS)......Page 321 NEUROFIBROMATOSIS (VON RECKLINGHAUSEN’S DISEASE)......Page 322 Rieger’s anomaly and syndrome......Page 324 PETER’S ANOMALY......Page 326 CHROMOSOME ABNORMALITIES......Page 327 PERSISTENT FETAL VASCULATURE (PERSISTENT HYPERPLASITIC PRIMARY VITREOUS)......Page 328 Aphakic pediatric glaucoma......Page 329 Weill-Marchesani and GEMSS syndromes......Page 330 INFLAMMATION......Page 331 REFERENCES......Page 332 NTRODUCTION......Page 338 PRIMARY OPEN-ANGLE, NORMAL-TENSION, AND JUVENILE-ONSET OPEN-ANGLE GLAUCOMA......Page 339 TIGR/MYOCILIN......Page 340 OPTINEURIN......Page 341 EXFOLIATION SYNDROME AND GLAUCOMA......Page 342 AXENFELD-RIEGER ANOMALY......Page 343 REFERENCES......Page 344 SYMPTOMS AND HISTORICAL INFORMATION RELATED TO THE GLACOMAS......Page 347 IDENTIFYING GLAUCOMA SUSPECTS......Page 348 DETERMINING ADEQUACY OF TREATMENT......Page 349 TREATMENT FOLLOW-UP......Page 350 PATIENT EDUCATION......Page 351 REFERENCES......Page 352 TARGET PRESSURE......Page 353 ADVANTAGES......Page 354 BASIC PHARMACOLOGY......Page 355 CORNEAL BARRIERS......Page 356 DRUG FORMULATION......Page 357 COMPLIANCE......Page 358 ADJUST THE TREATMENT PROGRAM TO THE PATIENT AND HIS OR HER LIFESTYLE......Page 359 INITIATE OR CHANGE THERAPY THROUGHA THERAPEUTIC TRIAL IN ONE EYE......Page 360 WHEN THERAPY IS INEFFECTIVE, SUBSTITUTE RATHER THAN ADD DRUGS......Page 361 TEACH PATIENTS THE PROPER TECHNIQUE FOR INSTILLING EYEDROPS......Page 362 RECOMMEND COMPARISON SHOPPING FOR MEDICATIONS......Page 363 REFERENCES......Page 364 MECHANISM OF ACTION......Page 367 LATANOPROST (XALATAN, PHXA41)......Page 369 ISOPROPYL UNOPROSTONE (UF-021,RESCULATM)......Page 371 SIDE EFFECTS......Page 372 SUGGESTIONS FOR USE......Page 376 REFERENCES......Page 379 The adrenergic system and adrenergic agonists......Page 384 EPINEPHRINE......Page 385 Clonidine......Page 386 MONOAMINE OXIDASE AND CATECHOL O-METHYLTRANSFERASE INHIBITORS......Page 388 Epinephrine (Eppy, Epinal, Epifrin, and generics)......Page 389 Suggestions for use......Page 390 Side effects......Page 391 Laser iridotomy......Page 393 Side effects......Page 394 REFERENCES......Page 395 MECHANISM OF ACTION......Page 400 TIMOLOL MALEATE......Page 401 LEVOBUNOLOL......Page 403 NADOLOL......Page 404 SECONDARY GLAUCOMA......Page 405 BLOOD FLOW AND NEUROPROTECTION......Page 406 OCULAR......Page 407 SYSTEMIC......Page 408 Thymoxamine......Page 409 REFERENCES......Page 410 DIRECT EFFECT ON AQUEOUS HUMOR FORMATION......Page 415 TOPICAL CARBONIC ANHYDRASE INHIBITORS......Page 416 Brinzolamide......Page 417 Methazolamide......Page 418 TOPICAL CARBONIC ANHYDRASE INHIBITORS......Page 419 CONTRAINDICATIONS......Page 420 Other severe symptoms......Page 421 SUGGESTIONS FOR USE......Page 422 OTHER USES......Page 423 REFERENCES......Page 424 ANGLE-CLOSURE GLAUCOMA......Page 428 DRUGS IN CLINICAL USE......Page 429 Pilocarpine......Page 430 Methacholine (Mecholyl)......Page 431 Neostigmine (prostigmine)......Page 432 OCULAR......Page 433 EXAMINATION......Page 435 REFERENCES......Page 436 DRUGS IN CLINICAL USE......Page 439 INTRAVENOUS AGENTS......Page 440 SUGGESTIONS FOR CLINICAL USE......Page 441 REFERENCES......Page 442 PHOTODISRUPTION......Page 444 BASIC LASER SAFETY......Page 445 REFERENCES......Page 446 TYPES OF LASER......Page 447 ND:YAG LASER IRIDOTOMY......Page 448 LIGHT BROWN IRIS......Page 449 Pressure elevation......Page 450 Endothelial damage......Page 451 PLATEAU IRIS......Page 452 REFERENCES......Page 453 RESULTS......Page 455 Mechanism......Page 456 Procedure......Page 457 POSTOPERATIVE TREATMENT......Page 458 Intraocular pressure elevation......Page 459 Technique......Page 460 OTHER LASER SCLEROSTOMY TECHNIQUES......Page 461 REFERENCES......Page 462 CYCLOPHOTOCOAGULATION......Page 464 OTHER LASER PROCEDURES......Page 465 REOPENING FAILED FILTRATION SITES......Page 466 LASER SYNECHIALYSIS......Page 467 REFERENCES......Page 468 INSTRUCTIONS TO THE PATIENT......Page 470 THE OPERATING ROOM......Page 471 ACTIVITY......Page 472 REFERENCES......Page 473 EXTERNAL FILTRATION SURGERY......Page 474 LIMBUS-BASED FLAP......Page 475 FORNIX-BASED FLAP......Page 476 TRABECULECTOMY......Page 478 Standard technique......Page 479 Moorfields Safer Surgery System technique......Page 481 Results......Page 483 Postoperative lasering, adjustment, or release of sutures......Page 485 THERMAL SCLEROSTOMY (SCHEIE PROCEDURE)......Page 488 THE MOLTENO IMPLANT......Page 489 Techniques......Page 490 KRUPIN VALVE AND EX-PRESS IMPLANT......Page 491 AHMED VALVE......Page 492 RESULTS AND COMPLICATIONS OF DRAINAGE DEVICES......Page 493 REFERENCES......Page 495 TYPES OF GLAUCOMA AND THEIR INFLUENCE ON CATARACT MANAGEMENT......Page 499 SELECTING THE APPROPRIATE SURGICAL APPROACH......Page 500 SELECTING THE APPROPRIATE PROCEDURE: HISTORICAL CONSIDERATIONS......Page 501 Incision sites......Page 502 Scleral flap......Page 503 Antimetabolite use......Page 504 Postoperative medical management......Page 506 Miotic pupil......Page 507 Incision construction......Page 509 CATARACT SURGERY WITH PRE-EXISTING FILTRATION BLEB......Page 511 REFERENCES......Page 512 FLAT ANTERIOR CHAMBER WITH HYPOTONY......Page 516 CILIARY BLOCK (MALIGNANT GLAUCOMA)......Page 521 SUPRACHOROIDAL HEMORRHAGE (SCH)......Page 522 INTRAOPERATIVE FLAT ANTERIOR CHAMBER......Page 523 INTRAOCULAR INFECTION......Page 524 DIGITAL PRESSURE......Page 525 RETAINED VISCOELASTIC MATERIAL......Page 526 ENCAPSULATED BLEB......Page 527 Slit-lamp or minor surgery setting......Page 528 BLEB COMPLICATIONS AND MANAGEMENT......Page 529 THIN-WALLED BLEBS......Page 530 OVERFUNCTIONING BLEBS......Page 533 LATE HYPOTONY AFTER FILTERING SURGERY......Page 535 HYPOTONY FROM IRITIS OR ISCHEMIA......Page 536 REFERENCES......Page 537 Intraoperative procedures......Page 540 TRABECULOTOMY AB EXTERNO......Page 543 COMBINED TRABECULOTOMY AND TRABECULECTOMY......Page 546 Cyclocryotherapy......Page 547 REFERENCES......Page 548 VISCOCANALOSTOMY......Page 550 BYPASS INTRASCLERAL CHANNELS (NON-PENETRATING DEEP SCLERECTOMY)......Page 552 SHUNTS INTO SCHLEMM’S CANAL......Page 554 SHUNTS INTO THE SUPRACHOROIDAL SPACE......Page 555 REFERENCES......Page 556 PATHOPHYSIOLOGY......Page 558 TREATMENT......Page 559 REFERENCES......Page 560 Structure......Page 561 Argon laser trabeculoplasty......Page 562 Combined cataract/trabeculectomy......Page 563 Comparison of cyclophotocoagulation and glaucoma drainage device implantation......Page 564 Laser and medical treatment of primary angle-closure glaucoma......Page 565 Measurement of intraocular pressure......Page 566 Epidemiology of intraocular pressure......Page 567 Target intraocular pressure in clinical practice......Page 568 A......Page 569 C ......Page 570 G ......Page 571 L ......Page 572 P ......Page 573 S ......Page 574 V ......Page 575 Z ......Page 576 Foreword Preface List of Contributors Dedication Acknowledgements Part i: Introduction Chapter 1 Introduction and Classification of the Glaucomas Part ii Aqueous dynamics Chapter 2 Aqueus Humor Formation Chapter 3 Aqueous Humor Outflow System With the assistance of Murra y A Johnstone Chapter 4 Intraocular Pressure Part iii Clincial examination Section 1 Chapter 5 Methods of Gonioscopy Chapter 6 Gonioscopic anatomy Chapter 7 Clinical Interpretation of Gonioscopic Findings Section 2 Chapter 8 Visual Field Theory and Methods Chapter 9 Techniques and Variables in Visual Field Testing Chapter 10 Visual Field Interpretation Chapter 11 Other psychophysical tests Section 3 Chapter 12 Optic Nerve Anatomy and Pathophysiology Chapter 13 Clinical Evaluation of the Optic Nerve Head Chapter 14 Optic Nerve Imaging With the assistance of Robert J Noecker and Larissa Camejo Part iv Clinical entities ^ Chapter 15 Primary angle closure glaucoma Chapter 16 Secondary angle closure glaucoma Chapter 17 Primary Open-Angle Glaucoma Chapter 18 Secondary Open-Angle Glaucoma Chapter 19 Combined Mechanism glaucoma Chapter 20 Developmental and childhood glaucoma Chapter 21 Genetics of Glaucoma Part v Management Chapter 22 Introduction to Patient Management Chapter 23 Medical Treatment of Glaucoma: General Principles Part vi Medical Treatment Chapter 24 The Adrenergic System and Adrenergic Agonists Chapter 25 Adrenergic Antagonists Chapter 26 Cholinergic Drugs Chapter 27 Carbonic Anhydrase Inhibitors Chapter 28 Prostaglandins Chapter 29 Hyperosmotic agents Part vii Laser therapy Chapter 30 General aspects of laser therapy With the assistance of Michael Berlin Chapter 31 Laser Treatment for Internal Flow Block With the assistance of Michael Berlin Chapter 32 Laser Treatment For Outflow Obstruction ^ ^^ With the assistance of Michael Berlin Chapter 33 Miscellaneous Laser Procedures Including Laser Ciliary Body Therapy With the assistance of Michael Berlin Part viii Surgical Principles and Procedures Chapter 34 General Surgical Care Chapter 35 Glaucoma Outflow Procedures Chapter 36 Surgical Management of Cataract and Glaucoma Chapter 37 Complications and failure of filtering surgery Chapter 38 Childhood Glaucomas Chapter 39 New ideas in glaucoma surgery Part ix Conclusion Chapter 40 Challenges for the New Millennium Appendix With the assistance of Robert N. Weinreb Index. ^^ Introduction and classification of the glaucomas Aqueous humor formation Aqueous humor outflow system overview Intraocular pressure Gonioscopic anatomy Methods of gonioscopy Clinical interpretation of gonioscopic findings Visual field thoery and methods Techniques and variables in visual field testing Visual field interpretation Other psychophysical tests Optic nerve anatomy and pathophysiology Clinical evaluation of the optic nerve head Optic nerve imaging Primary angle closure glaucoma Secondary angle closure glaucoma Primary open angle glaucoma Secondary open angle glaucoma Developmental and childhood glaucoma Genetics of glaucoma Introduction to patient management Medical treatment of glaucoma: general principles Prostaglandins The adrenergic system and adrenergic agonists Adrenergic antagonists Carbonic anhydrase inhibitors Cholinergic drugs Hyperosmotic agents General aspects of laser therapy Laser treatment for internal flow block Laser treatment for outflow obstruction Miscellaneous laser procedures including laser ciliary body therapy General surgical care Glaucoma outflow procedures Surgical management of cataract and glaucoma Complications and failure of filtering surgery Pediatric and miscellaneous procedures New ideas in glaucoma surgery Challenges for the new century. Authored By Three Prominent Specialists In The Field, This Text Provides Comprehensive Coverage Of Diagnostic And Treatment Modalities For Optimal Glaucoma Management. Revised Throughout, This New Edition Presents The Latest Guidance In Clinical Examination, Randomized Trials, Medical Treatment, Laser Therapy, And Surgical Procedures. Hundreds Of Illustrations, With Many Classic Black And White Figures From The Previous Editions Supplemented With New Color Images, Depict The Features Of Glaucomas And Step-by-step Procedures For Their Management, While Expanded Use Of Highlighted Boxes, Lists, And Summary Tables Make The Material Easy To Access. Evidence-based And Updated Information On All Aspects Of The Glaucomas, Including Physiology, Genetics, Interventional Trials, And New Surgical Techniques, Offer A Well-rounded Foundation Of Knowledge For Making The Most Informed Diagnoses And Choosing The Most Effective Course Of Treatment. Combines The Cumulative Experience Of Three Prominent Glaucoma Specialists, Addressing A Full Range Of Clinical Needs For Practitioners Of All Levels, For A Uniquely Written Coherent Perspective. Includes Extensive References To Current And Historically Important Sources To Provide Comprehensive Interpretation Of The Latest Medical Literature. Introduction And Classification Of The Glaucomas -- Aqueous Humor Formation -- Aqueous Humor Outflow System Overview -- Intraocular Pressure -- Gonioscopic Anatomy -- Methods Of Gonioscopy -- Clinical Interpretation Of Gonioscopic Findings -- Visual Field Theory And Methods -- Techniques And Variables In Visual Field Testing -- Visual Field Interpretation -- Other Psychophysical Tests -- Optic Nerve Anatomy And Pathophysiology -- Clinical Evaluation Of The Optic Nerve Head -- Optic Nerve Imaging -- Primary Angle Closure Glaucoma -- Secondary Angle Closure Glaucoma -- Primary Open Angle Glaucoma -- Secondary Open Angle Glaucoma -- Developmental And Childhood Glaucoma -- Genetics Of Glaucoma -- Introduction To Patient Management -- Medical Treatment Of Glaucoma: General Principles -- Prostaglandins -- The Adrenergic System And Adrenergic Agonists -- Adrenergic Antagonists -- Carbonic Anhydrase Inhibitors -- Cholinergic Drugs -- Hyperosmotic Agents -- General Aspects Of Laser Therapy -- Laser Treatment For Internal Flow Block -- Laser Treatment For Outflow Obstruction -- Miscellaneous Laser Procedures Including Laser Ciliary Body Therapy -- General Surgical Care -- Glaucoma Outflow Procedures -- Surgical Management Of Cataract And Glaucoma -- Complications And Failure Of Filtering Surgery -- Pediatric And Miscellaneous Procedures -- New Ideas In Glaucoma Surgery -- Challenges For The New Century. Includes Bibliographical References And Index.