Glaucoma

Definition of acute glaucoma attack (APACA/acute primary angle closure attack), triad (eye pain, headache, vomiting), diagnosis, and emergency treatment. Covers evidence from the 5th edition of the Glaucoma Clinical Practice Guidelines and APGS 2025 guidelines: mannitol infusion, pilocarpine eye drops, laser iridotomy, ALPI, anterior chamber paracentesis, lens reconstruction, and contralateral eye management.

Ahmed ClearPath is a non-valved glaucoma drainage device approved by the FDA in 2019. It features a low-profile design and includes a ripcord, used for intraocular pressure management in refractory glaucoma.

Overview of alternative and complementary therapies for glaucoma. Explains the current evidence and limitations of supplements such as marijuana (cannabinoids), ginkgo biloba, vitamins, omega-3 fatty acids, melatonin, and lifestyle adjustments.

Anterior segment optical coherence tomography (AS-OCT) is a non-contact, non-invasive imaging device that obtains cross-sectional images of the anterior segment of the eye. It is widely used for angle assessment in glaucoma and for pre- and post-operative evaluation.

An autosomal dominant disorder characterized by anterior segment dysgenesis and systemic abnormalities. Glaucoma occurs in approximately 50-60% of cases, primarily caused by mutations in PITX2 or FOXC1.

Blue-on-yellow perimetry (SWAP) is a non-standard perimetry that selectively evaluates the blue cone system using a blue stimulus on a yellow background to detect visual field abnormalities in early glaucoma.

Canaloplasty is a non-penetrating glaucoma surgery that dilates Schlemm's canal to restore physiological aqueous outflow. In addition to the conventional ab externo approach, modified techniques such as ab interno canaloplasty (ABiC) and the OMNI system have been developed.

This article explains the intraocular pressure-lowering effects of cannabinoids and their potential application in glaucoma treatment, covering the endocannabinoid system, receptors, effects by route of administration, neuroprotective effects, side effect profile, and the opinions of major ophthalmology societies.

A comprehensive explanation of glaucoma eye drops by drug class. Covers prostaglandin analogs (PGAs), EP2 receptor agonists (Eybelis), beta-blockers, CAIs, alpha-2 agonists, ROCK inhibitors, and fixed combinations, including their mechanisms of action, side effects, contraindications, list of approved drugs in Japan, and treatment steps. Also provides a comprehensive description of target intraocular pressure setting and adherence improvement strategies.

This article explains the indications, surgical techniques, complications, and mechanisms of action of transscleral cyclophotocoagulation (TS-CPC), micropulse transscleral cyclophotocoagulation (MP-CPC), slow coagulation continuous-wave TSCPC (SC-TSCPC), endoscopic cyclophotocoagulation (ECP), and high-intensity focused ultrasound circular cyclocoagulation (HIFU-UCCC), including the latest case reports and histological findings.

This article explains the definition of developmental glaucoma (congenital glaucoma), Japanese classification (early-onset and late-onset), CGRN international classification, epidemiology, symptoms (buphthalmos, Haab striae), diagnostic criteria, goniotomy, trabeculotomy, tube shunt surgery, genes (CYP1B1), MIGS, and amblyopia management.

Explains the indications, contraindications, clinical pharmacology, insertion technique, clinical trial results (post-cataract surgery, allergic conjunctivitis, post-corneal transplant), and adverse reactions of Dextenza. Also details the efficacy and patient satisfaction of dropless therapy.

Explains causative drugs (mydriatics, anticholinergics, SSRIs, topiramate), mechanisms of pupillary block/non-pupillary block, symptoms and clinical findings, diagnosis (gonioscopy, UBM, AS-OCT), and treatment (acetazolamide, LPI, lens extraction) for drug-induced acute angle-closure glaucoma.

Explanation of the principles, indications, techniques (limbal/pars plana approach), combined cataract surgery (phaco-ECP), complications, and outcomes of endoscopic cyclophotocoagulation (ECP). Includes comparison with transscleral methods and results of the latest meta-analysis.

Explains the pathology, diagnosis, and treatment of exfoliation glaucoma (pseudoexfoliative glaucoma, PXG). Covers association with LOXL1 gene, clinical findings of Sampaolesi line and exfoliation material, differentiation from POAG, diurnal intraocular pressure variation, role of SLT, trabeculectomy, zonular weakness during cataract surgery, OCTA vessel density studies, and wipe-out syndrome.

FDT (Frequency Doubling Technology) is a visual field test that utilizes the frequency doubling illusion. It is used for early glaucoma screening by detecting selective damage to the M-cell system.

Ghost cell glaucoma is a secondary open-angle glaucoma caused by obstruction of the trabecular meshwork by degenerated red blood cells (ghost cells) after vitreous hemorrhage, and most cases resolve with appropriate treatment.

This article explains the definition, incidence by surgical type, difficulties in intraocular pressure measurement, precautions for drug therapy, and stepwise treatment strategies including tube shunt surgery for secondary glaucoma occurring after corneal transplantation (PKP, DSAEK, DMEK).

A glaucoma drainage device (GDD) is an implant consisting of a tube and a plate, and is a surgical option for refractory glaucoma when trabeculectomy is difficult. This article explains the domestically approved devices (Baerveldt® and Ahmed®), surgical techniques, evidence from TVT/PTVT studies, and pediatric indications.

This article explains the etiology, diagnosis, and treatment of pseudophakic glaucoma and aphakic glaucoma that occur after cataract surgery. It covers various mechanisms of intraocular pressure elevation, including retained ophthalmic viscosurgical devices (OVD), steroid-induced glaucoma, UGH syndrome, iris chafing, lens particles, pupillary block, and pigment dispersion. It details pharmacotherapy, including contraindications for Eybelis, and surgical indications.

Glaucoma screening is a testing program to detect glaucoma early at an asymptomatic stage and prevent irreversible vision loss. Although mass screening of the general population is not recommended, targeted screening for high-risk groups is useful.

This article explains the pathology, diagnosis, and treatment of secondary glaucoma associated with uveitis. Intraocular pressure rises due to combined mechanisms of open-angle and angle-closure, leading to glaucomatous optic neuropathy.

Indications, technique, and complications of Nd:YAG laser goniopuncture. Detailed description of the perforation procedure of the trabecular meshwork and Descemet's membrane as an additional treatment for intraocular pressure elevation after non-penetrating glaucoma surgery (NPGS), and its management.

Explanation of indications, techniques, classification methods, and abnormal findings in gonioscopy. Details on direct and indirect methods, compression gonioscopy, comparison of Shaffer, Scheie, and Spaeth classifications, differentiation from AS-OCT and UBM, and the latest imaging devices.

This article explains the background, principles, devices, and clinical significance of home intraocular pressure measurement (home tonometry). It details the features and limitations of the iCare HOME rebound tonometer, Triggerfish contact lens sensor, and EyeMate implantable sensor, as well as the importance of out-of-office intraocular pressure monitoring.

Explanation of imaging techniques for the optic nerve and retinal nerve fiber layer (RNFL) in glaucoma. Covers OCT (SD-OCT, SS-OCT), HRT, GDx, fundus photography, RNFL thickness, BMO-MRW, GCC analysis, limitations of normative databases, progression detection, and latest technologies (PS-OCT, AI).

This article explains the physiological significance of intraocular pressure (IOP) and various methods of IOP measurement. It details the principles and measurement techniques of the Goldmann applanation tonometer (GAT), as well as the characteristics of non-contact tonometers, rebound tonometers, and dynamic contour tonometers. The effects of central corneal thickness and corneal biomechanics on measurement values, target IOP setting, and continuous IOP monitoring are also discussed.

This article explains the indications, technique, treatment outcomes, and complications of argon laser peripheral iridoplasty (ALPI). It details the actual laser treatment for acute primary angle closure and plateau iris syndrome.

Explanation of indications, procedure, laser settings, complications, and treatment outcomes of laser peripheral iridotomy (LPI). Includes evidence from ZAP trial and EAGLE trial, differentiation between Nd:YAG laser and argon laser, and rare complications (decompression retinopathy, ciliochoroidal detachment).

Explanation of the principles, indications, irradiation conditions, procedures, complications, and treatment outcomes of laser trabeculoplasty (ALT/SLT). Includes details of the 6-year results of the LiGHT trial, positioning in the 5th edition of the Japanese Glaucoma Guideline and the 6th edition of the EGS, and usage in exfoliation glaucoma.

This article explains the principles, techniques, efficacy, and safety of excimer laser trabeculotomy (ELT) and femtosecond laser image-guided high-precision trabeculotomy (FLIGHT). It also includes their positioning in MIGS and future prospects.

Classification (phacomorphic, phacolytic, lens-particle, phacoantigenic), pathophysiology, diagnosis, and treatment of lens-induced glaucoma. Includes positioning of secondary glaucoma based on the 5th edition of the Glaucoma Clinical Practice Guidelines, differentiation and management of intumescent cataract, phacolysis, lens cortex, and phacoanaphylactic glaucoma, dosage of hyperosmotic agents, and mechanism of contraindication for miotics.

Explains the principles, measurement parameters (GCC, GCIPL), diagnostic ability, progression detection, floor effect limitations, and OCTA prospects of macular OCT (optical coherence tomography) in glaucoma diagnosis. Includes the importance of comprehensive evaluation by combining with RNFL analysis.

A rare secondary angle-closure glaucoma in which aqueous humor is misdirected posteriorly, causing forward displacement of the iris-lens diaphragm, angle closure, and elevated intraocular pressure. It often occurs after filtration surgery.

This article explains the etiology (diabetic retinopathy, retinal vein occlusion, ocular ischemic syndrome), staging, diagnosis of iris rubeosis, anti-VEGF therapy, panretinal photocoagulation, trabeculectomy (with MMC), and tube shunt surgery for neovascular glaucoma (NVG).

Explains neuroprotective strategies in glaucoma. Covers clinical evidence for brimonidine, citicoline, nicotinamide, and neurotrophic factors, mechanisms of RGC death, and latest research trends in combination therapy, gene therapy, and NAD+ therapy.

Explains the mechanism of action, clinical trial results, and side effects of nitric oxide (NO)-donating prostaglandin analogs (latanoprostene bunod, NCX 470). Covers differences from conventional PGAs and evidence from VOYAGER, APOLLO, and LUNAR trials.

Explanation of indications, contraindications, surgical technique (superficial flap, deep flap, Schlemm's canal opening, TDM dissection), implants, goniopuncture, treatment outcomes, and complications of non-penetrating deep sclerectomy (NPDS). Also details the latest techniques such as XEN-DS.

Definition of normal-tension glaucoma (NTG), epidemiology based on the Tajimi Study, ocular perfusion pressure and vascular factors, diagnosis and differential diagnosis, evidence from CNTGS/LoGTS, first-line medication, and target intraocular pressure setting.

This article explains the principles and algorithms of optical coherence tomography angiography (OCTA), and its clinical significance in glaucoma diagnosis including vessel density assessment, microvascular dropout, longitudinal progression assessment, and postoperative evaluation.

Definition of ocular hypertension, risk stratification based on OHTS/EGPS, predictors of progression to POAG, central corneal thickness and corneal hysteresis, thresholds for follow-up and treatment initiation, SLT, preservative-free formulations, and management of secondary ocular hypertension.

Explains the mechanism of action, clinical trials (AYAME, PEONY, RENGE, FUJI), side effects, and differences from conventional PGAs of omidenepag isopropyl (Eybelis®). Covers the dual intraocular pressure-lowering mechanism via EP2 receptors and the advantage of no prostaglandin-associated periorbitopathy (PAP).

A review of glaucoma eye drops by drug class, covering mechanisms of action, intraocular pressure-lowering effects, and side effects. Includes prostaglandin analogs, beta-blockers, alpha agonists, carbonic anhydrase inhibitors, ROCK inhibitors, miotics, and combination drugs.

Explains the structure, features, surgical technique, and clinical outcomes of the Paul Glaucoma Implant. Covers comparisons with Ahmed and Baerveldt, outcomes in adult and pediatric glaucoma, and complications.

This article explains the definition, pathophysiology, triad, risk factors, diagnosis, and treatment of pigmentary glaucoma (PG) and pigment dispersion syndrome (PDS). It covers the mechanism of pigment dispersion due to reverse pupillary block, Krukenberg spindle, trabecular meshwork pigmentation, precautions for laser treatment, and the latest cases of iatrogenic pigmentary glaucoma.

Pathophysiology, diagnosis, and treatment of plateau iris syndrome (PIS) are explained based on the Japan Glaucoma Treatment Guidelines 5th edition and the International PPP 2026. It covers UBM findings of anterior rotation of the ciliary body, double hump sign, and stepwise treatment including ALPI after LPI, pilocarpine, and lens extraction.

This article explains the definition, epidemiology, symptoms, diagnosis, differential diagnosis, treatment, CMV association, and pathophysiology of Posner-Schlossman syndrome (PSS). It covers acute management with steroids and intraocular pressure-lowering drugs based on the Uveitis Clinical Practice Guidelines, the 5th Edition of the Glaucoma Clinical Practice Guidelines, and TITAN Report 2, as well as ganciclovir and valganciclovir treatment for CMV-positive cases, and surgical indications.

Explains the structure, material, surgical technique, and clinical outcomes of the PreserFlo MicroShunt (Ab-Externo MicroShunt). Covers the characteristics of the SIBS material, comparison with XEN and trabeculectomy, and complication management.

Explains the staging, diagnosis, and treatment of primary angle closure glaucoma (PACG), primary angle closure (PAC), and primary angle closure suspect (PACS). Covers the 5th edition of the Glaucoma Clinical Practice Guidelines, the EAGLE study, laser iridotomy, lens extraction, and management of plateau iris.

This article explains the definition, risk factors, diagnosis, treatment, and pathophysiology of primary open-angle glaucoma (POAG). It covers evidence based on the 5th edition of the Japanese Glaucoma Guideline, the Tajimi Study, AAO PPP, and the 6th edition of EGS, including 6-year results of the LiGHT Trial, surgical strategies for MIGS and refractory POAG, and the latest research on optic disc hemorrhage.

Explains the differentiation, pathophysiology, and treatment of primary angle-closure glaucoma (PACG) and secondary angle-closure glaucoma. Covers mechanisms of pupillary block and plateau iris, topiramate-induced ACG, cases with retinitis pigmentosa, and acetazolamide idiosyncratic reactions.

Explains the principles, measurement algorithms, result interpretation, and progression assessment of standard automated perimetry (SAP). Covers the SITA algorithm, Anderson-Patella criteria, GHT, MD, VFI, PSD indices, event analysis, trend analysis, and comparisons with SWAP and FDT.

This article explains the pathology, diagnosis, and treatment of glaucoma associated with Sturge-Weber syndrome (SWS). It covers GNAQ somatic mosaic mutations, differences between early-onset and late-onset types, mechanisms of angle dysgenesis and elevated episcleral venous pressure, selection of trabeculotomy and tube shunt surgery, and complications related to choroidal hemangioma.

Explains the types, clinical outcomes, and safety of sustained release glaucoma drug delivery systems. Covers devices such as Durysta, iDose TR, bimatoprost ocular insert, punctal plugs, and drug-eluting contact lenses.

Explanation of the mechanism of action, intraocular pressure-lowering effect, side effects, combination drugs, and off-label use of topical carbonic anhydrase inhibitors (dorzolamide, brinzolamide). Comprehensive clinical information based on EGS, AAO PPP, and the Japanese Glaucoma Treatment Guidelines.

Indications, surgical technique, complications, and clinical outcomes of trabecular bypass surgery (MIGS) using iStent and Hydrus microstents. Covers intraocular pressure lowering effect and safety profile when combined with cataract surgery.

Comprehensive explanation of trabeculectomy indications, surgical technique (MMC 0.04% for 4 minutes), antimetabolites (MMC, 5-FU), postoperative management (laser suture lysis, needling), complications (hypotony maculopathy, bleb infection), bleb evaluation using Moorfields classification, and long-term outcomes.

Explanation of trabeculotomy and minimally invasive glaucoma surgery (MIGS) including surgical classification, techniques, indications, outcomes, complications, and pathophysiology. Covers clinical evidence for ab externo trabeculotomy, microhook, KDB, GATT, iStent inject W, Hydrus, and usage requirements in Japan.

Comprehensive explanation of traumatic glaucoma. Covers mechanisms of blunt and penetrating trauma, acute management of hyphema, pathophysiology of angle recession, cyclodialysis, and ghost cell glaucoma, diagnosis using gonioscopy, UBM, and anterior segment OCT, and standard treatment from atropine eye drops, intraocular pressure-lowering medications, anterior chamber washout, to glaucoma implants.

Explains the principles, equipment, surgical technique, mechanism of action, and clinical outcomes of ultrasound cycloplasty (UCP). Covers indications, complications, and comparison with conventional cyclodestructive procedures using high-intensity focused ultrasound (HIFU) for ciliary body coagulation.

The Xen gel stent (XEN45) is a minimally invasive glaucoma surgery (MIGS) device that drains aqueous humor from the anterior chamber to the subconjunctival space. It is a 6 mm tube made of porcine gelatin and received FDA approval in 2016.