Ophthalmology Glaucoma for UPSC CMS: Types, IOP, Visual Fields and Treatment Algorithms

Types of Glaucoma#

Primary open-angle: Most common. Insidious. Cupped optic disc, field defects (arcuate, nasal step). IOP elevated. Treatment: eye drops -> laser -> surgery.

Primary angle-closure: Acute (halos, severe pain, fixed mid-dilated pupil, nausea). Treatment: pilocarpine, acetazolamide, peripheral iridotomy.

Secondary: Due to other conditions (uveitis, steroid use, trauma, neovascular).

Visual Field Defects#

• Arcuate scotoma: Arc-shaped defect from disc to macula
• Nasal step: Step defect respecting horizontal midline
• Paracentral scotoma: Small defect near fixation
• Tubular vision: End-stage glaucoma

Treatment Algorithm#

First line: Prostaglandin analogs (latanoprost). Second: Beta-blockers (timolol). Third: CA inhibitors (dorzolamide). Add pilocarpine for angle-closure.