Cornelia de Lange Syndrome with Congenital Glaucoma

Cornelia De Lange syndrome (CDLS), also known as Brachmann de Lange syndrome is a rare syndrome. It is characterised by distinctive facial dysmorphism, growth retardation, developmental delay, upper limb reduction defects, gastroesophageal dysfunction, ophthalmologic and genitourinary anomalies, hirsutism, pyloric stenosis, congenital diaphragmatic hernias, cardiac septal defects, and hearing loss. The syndrome was first described by a Dutch paediatrician named Cornelia de Lange, in 1933.

Though the genetic basis of this syndrome is not clear, a majority of cases are due to spontaneous mutations. The defective gene can be inherited from either parent, making it autosomal dominant type of inheritance. Synophrys, long curled lashes, myopia, and hypertrichosis of the brows. These patients have also been found to have ptosis, epiphora, nasolacrimal duct obstruction, and microcornea, congenital glaucoma, corneal opacities, iris heterochromia and optic nerve head pallor/atrophy.

Hypotony as a Hazard of Trabeculectomy with Mitomycin C

An eighty two year old Caucasian lady with primary open angle glaucoma attended eye clinic. She was using guttate latanoprost 50 g/ml, Brimonidine 2 mg/ml and combined Dorzolamide 20 g/ml and Timolol 5 mg/ml.

This lady was myopic with right eye manifest refraction spherical equivalent of -2.00 and left eye manifest refraction spherical equivalent of -8.00 dioptres. The left eye was amblyopic as a result of this anisometropia. This lady had had bilateral uncomplicated cataract extractions by phacoemulsification with intraocular lens implantation and subsequently bilateral neodymium yttrium aluminium garnet or Nd: YAG laser posterior capsulotomies.

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Surgical Management of Glaucoma in Sturge-Weber Syndrome

Sturge-Weber syndrome (SWS) or encephalo-trigeminal hemangiomatosis is a sporadic, mesodermal phakomatosis characterised by hemangiomas involving many parts of the body, particularly ocular, intracranial and facial cutaneous structures.

Glaucoma is a common feature, with an incidence of 30%-71% in patients with Sturge-Weber syndrome. Many mechanisms of raised intraocular pressure have been described in the past, the most consistent being congenital trabeculodysgenesis, increased episcleral venous pressure and hypersecretion due to ciliary body angioma.

An increased risk of intra and post-operative complications has been noted with glaucoma filtering procedures in these patients, predominantly due to rupture of the fragile vasculature in the choroidal hemangiomas, leading to expulsive choroidal haemorrhage or exudative choroidal detachment (CD) caused by sudden decompression during or after filtering procedures. Prohylactic sclerotomies have been advocated, to be performed prior to ocular decompression, during filtering procedures in order to avoid these complications.

Ocular Biometry in Patients with Primary Open Angle Glaucoma (POAG)

Glaucoma is the leading cause of blindness all over the world after cataract blindness. In 2010, worldwide 60.5 million people were expected to have OAG (Open angle glaucoma) and ACG (Angle closure glaucoma), increasing to 79.6 million by 2020, and of these, 74% will have OAG1. Asians represent 47% of those with all glaucoma and 87% of those with ACG1. 4.5 million People with OAG and 3.9 million people with ACG were expected to have bilateral blindness in 2010, rising to 5.9 and 5.3 million people in 2020, respectively.

There are approximately 11.2 million persons aged 40 years and older with glaucoma in India. Primary open angle glaucoma is estimated to affect 6.48 million persons. The estimated number with primary angle-closure glaucoma is 2.54 million. Those with any form of primary angle-closure disease could comprise 27.6 million persons.

Novasorb Cationic Nanoemulsion and Latanoprost: the Ideal Combination for Glaucoma Management?

Novasorb is a patented eye drop formulation platform developed to optimise the interaction of the eye drop-the cationic nanoemulsion-with the different layers of the tear film, mainly with the tear film lipid layer (TFLL), and the ocular surface. 

The composition of the cationic nanoemulsion was designed to mimic the attributes and functions of the tear film and TFLL, and take advantage of the negatively-charged mucin layer covering the corneal and conjunctival epithelium, to increase its spreading and residence time on the ocular surface. Consequently, Novasorb®-based artificial tears (AT, e.g. Cationorm®) are functionally and mechanically very close to a healthy tear film; with an iso-osmolar to slightly hypo-osmolar aqueous phase, polar (cetalkonium chloride, CKC) and nonpolar (mineral oils or medium chain triglycerides, MCT) lipids, and surfactants (e.g. Tyloxapol and Poloxamer) that mimic the surface active proteins present at the interface with the TFLL.

Ologen versus Mitomycin-C for Trabeculectomy in a Predominantly African American PopulationOlogen versus Mitomycin-C for Trabeculectomy in a Predominantly African American Population

Glaucoma is the most common cause of irreversible blindness worldwide. Treatment of glaucoma begins with medical management but often requires surgical intervention. Since the late 1960s, the most common surgical treatment for glaucoma has been trabeculectomy. AGIS investigators and others have established that race plays a significant role in an individual’s response to trabeculectomy. Specifically, African American patients have been shown to have advanced glaucoma at time of diagnosis and respond less favorably than Caucasian patients to trabeculectomy. Our group wishes to investigate the role of ethnicity in specific surgical treatments for glaucoma.

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Primary Open Angle Glaucoma Poses Threats in the Form of Increased Axial Length

Primary Open Angle Glaucoma (POAG) is one of the most common forms of eye disease that occurs due to high Intraocular Pressure (IOP). If untreated, it would leads to periphery loss of vision that gradually leads to complete blindness.. When a comparative study was initiated to determine the axial length (AL) and K value between two groups of patients consisting patients with POAG and the age matched controls group, Patients with POAG are having longer AL and flatter corneas than the age-matched controls. This would clearly highlights the risks involved for the patients of POAG.

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General on Glaucoma and Oxidative Stress. Comments on Study Design: “Biomarkers of Lipid Peroxidation in the Aqueous Humor of Primary Open angle Glaucoma Patients”

Glaucoma is an optic neuropathy that causes progressive changes in the visual field and whose main known risk factor is the increased IOP. It is true that the latest acquisitions in image analysis technology (Optical Coherence Tomography -OCT-) have provided objective and quantifiable data of morphological damage, in any way eliminates the subjectivity and variability of the methods previously employed. If we speak from the functional point of view, computerized perimetry remains the method most commonly used scanning glaucomatous damage worldwide. While exploring the optic disc remains the way easier to assess the damage to the optic nerve, the great variability in the interpretation and errors derivatives thereof, the OCT has become critical in monitoring patients with glaucoma.

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