Fernández Vega Ophthalmological Institute - Secondary glaucoma - Instituto Oftalmológico Fernández Vega

Secondary glaucoma 

Secondary glaucoma is the term given to the condition that is a result of the evolution of other complaints, which can be both ocular and systemic. Amongst the former, there is uveitis, alterations of the retina, alterations of the lens, intraocular tumours, detachment of tissue from the different structures of the interior of the eye, etc. It is also possible that it can be produced by some trauma as a result of surgical interventions such as corneal transplantation, or by the growth of new blood vessels (neovascularization) that are formed when the oxygen supply to the different tissues of the eye is very low. 



Congestive heart failure and some diseases that cause respiratory failure  may also be the cause of glaucoma, as well as prolonged corticosteroid treatments that are necessary for certain complaints. 

But this type of glaucoma that can also be caused by muscular neck movements made by musicians who play wind instruments like the trumpet, the saxophone or the trombone, as it increases the venous pressure in the jugular, which brings the blood to the sclera of the eye.  An excessively tight tie know can cause the same effects.


The symptoms of secondary glaucoma will depend on whether it is an open or closed angle glaucoma, since one is progressive and the other occurs suddenly.


In the former, there will be a gradual loss of peripheral vision. In the latter, the symptoms are those of acute glaucoma: ocular pain, which can extend to the nape of the neck and trigeminal, blurred vision, pupil dilation, change in iris colour, corneal hardening, nausea and vomiting, etc.



The most important thing to establish the most appropriate treatment for secondary glaucoma is to determine its cause, since in many cases, the treatment of the complaint that causes it suffices to prevent its progression.
However, when it is not possible to prevent its growth, in other cases it is necessary to treat it in the same way as the primary glaucoma. 

treatment and SURGERY 

In either case, the surgery will aim to restore the drainage of the aqueous humour, so that it can pass from the posterior chamber to the anterior, exit the eye and normalise intraocular pressure (IOP).
Filtration surgery techniques will be used if the glaucoma is open angle, or irridotomy if it is closed angle.

If the treatment is not successful, it is possible to implant a drainage valve, consisting of a small tube through which drainage of the aqueous humour will take place.

Results of the operation

The results of the treatment will depend on the cause of the secondary glaucoma, on the effectiveness of the treatment that has been followed to control the glaucoma, and on the type of glaucoma that has occurred. 

In the case of closed-angle glaucoma, the time from the time of surgery to its surgical treatment is key to assessing the results, since any damage that may have occurred will be irreversible. In open-angle glaucoma, it will depend on how advanced it is at the time of diagnosis.

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