Current profile of secondary glaucomas

Abstract

Purpose: To study the current profile of secondary glaucomas for their incidence and to identify risk factors. Materials and Methods: In this retrospective chart review, 2997 patients newly diagnosed and referred with glaucoma to our tertiary glaucoma center in the year 2005 were included. Evaluation of all cases was done on the basis of a detailed history and recorded examination including vision, intraocular pressure (IOP), anterior segment examination, gonioscopy and fundus evaluation by glaucoma specialists. Demographic data, etiology of secondary glaucoma, and any other significant findings were noted. Results: Of 2997 referred patients, 2650 had glaucoma or were glaucoma suspects. Of all glaucoma patients or glaucoma suspects, 579 patients (21.84%) had secondary glaucoma. Age distribution was as follows: 25% were between 0-20 years; 27% were between 21-40 years; 30% were between 41-60 years and 18% were> 60 years. The male female ratio was 2.2. Frequent causes of secondary glaucoma were post - vitrectomy 14%, trauma 13%, corneo-iridic scar 12%, aphakia 11%, neovascular glaucoma 9%. Post-vitrectomy glaucoma eyes had vitreous substitutes in 83% cases of which 66% eyes had retained silicone oil for more than three months. Vision ≤20/200 was present in 63% eyes, 57% eyes had baseline IOP > 30 mm Hg. Of all traumatic glaucoma patients, 71% cases were < 30 years of age. Fifty per cent had baseline IOP of> 30 mm Hg and vision ≤20/200. Conclusions: Most patients with secondary glaucoma have poor vision (≤20/200) with high IOP and advanced fundus changes at presentation.

Keywords

• Aphakic glaucoma
• corneo-iridic scar
• late presentation
• post-vitrectomy glaucoma
• secondary glaucoma
• traumatic glaucoma