Patients with neovascular glaucoma secondary to ocular ischaemia syndrome need pan-retinal photocoagulation and urgent referral to a physician

Tip of the month

Patients with neovascular glaucoma secondary to ocular ischaemia syndrome need pan-retinal photocoagulation and urgent referral to a physician

The science behind the tip The cause of neovascular glaucoma in two thirds of patients is either proliferative diabetic retinopathy or an ischaemic...

December 31, 2015

Avoid the upper nasal quadrant when inserting an aqueous drainage implant, as it can result in acquired Brown syndrome

Tip of the month

Avoid the upper nasal quadrant when inserting an aqueous drainage implant, as it can result in acquired Brown syndrome

The science behind the tip Aqueous drainage tubes are commonly used in the surgical treatment of refractory glaucoma. New onset persistent diplopia...

November 30, 2015

Artifacts in the SD-OCT images in a patient with glaucoma or suspected glaucoma may lead to an erroneous conclusion

Tip of the month

Artifacts in the SD-OCT images in a patient with glaucoma or suspected glaucoma may lead to an erroneous conclusion

The science behind the tip Structural measurements of the optic disc and retinal nerve fibre layer (RNFL) have become an indispensable tool in the...

October 31, 2015

The ISNT rule is of limited benefit in differentiating early glaucoma from normal

Tip of the month

The ISNT rule is of limited benefit in differentiating early glaucoma from normal

The science behind the tip The ISNT rule states that a healthy optic disc has a characteristic configuration of the neuro-retinal rim; which is...

September 30, 2015

Patients with advanced glaucoma who are to undergo trabeculectomy should be warned that there is a small risk of permanent visual loss as a consequence of the surgery

Tip of the month

Patients with advanced glaucoma who are to undergo trabeculectomy should be warned that there is a small risk of permanent visual loss as a consequence of the surgery

The science behind the tip Transient visual disturbance after trabeculectomy is common and it can take several months for the vision to recover....

July 31, 2015

In clinical practice, anterior segment OCT cannot replace gonioscopy as a method of examining the filtration angle

Tip of the month

In clinical practice, anterior segment OCT cannot replace gonioscopy as a method of examining the filtration angle

The science behind the tip The diagnosis and management of all types of glaucoma is dependent on the accurate evaluation of the angle and its...

June 30, 2015

In every patient with ocular hypertension, search for signs of pseudoexfoliation syndrome as these patients are at significant risk of converting to glaucoma

Tip of the month

In every patient with ocular hypertension, search for signs of pseudoexfoliation syndrome as these patients are at significant risk of converting to glaucoma

The science behind the tip Patients with ocular hypertension and pseudoexfoliaton syndrome are twice as likely to convert to glaucoma as those...

June 30, 2015

Patients with progressive normal tension glaucoma may benefit from elevation of the head of the bed when they sleep

Tip of the month

Patients with progressive normal tension glaucoma may benefit from elevation of the head of the bed when they sleep

The science behind the tip Intraocular pressure (IOP) is significantly higher in the supine position than in the sitting position. Progressive...

April 30, 2015

RNFL measurement with SD OCT can contribute to glaucoma diagnosis, but only if prior clinical examination has yielded a relevant level of glaucoma suspicion

Tip of the month

RNFL measurement with SD OCT can contribute to glaucoma diagnosis, but only if prior clinical examination has yielded a relevant level of glaucoma suspicion

The science behind the tip It is well known that SD OCT can discriminate with reasonable accuracy between healthy volunteers and glaucoma patients...

March 31, 2015

In patients with narrow filtration angles or primary angle-closure glaucoma who have a patent laser iridotomy, it is safe to prescribe any systemic drugs which have an anti-cholinergic effect on the pupil

Tip of the month

In patients with narrow filtration angles or primary angle-closure glaucoma who have a patent laser iridotomy, it is safe to prescribe any systemic drugs which have an anti-cholinergic effect on the pupil

The science behind the tip Many commonly used systemic medications have been reported to cause acute congestive angle closure in individuals with...

February 28, 2015

Systemic beta-blocker and nitrates result in a lowering of IOP which has implications for the management of ocular hypertension and glaucoma

Tip of the month

Systemic beta-blocker and nitrates result in a lowering of IOP which has implications for the management of ocular hypertension and glaucoma

The science behind the tip Systemic beta-blockers and nitrates are frequently used in the elderly. It has been known for many years that systemic...

January 31, 2015

Corneal refractive surgery (LASIK) poses a risk to the glaucoma patient

Tip of the month

Corneal refractive surgery (LASIK) poses a risk to the glaucoma patient

The Science behind the Tip The transient, yet significant, IOP elevation caused by the suction ring may further damage an already compromised optic...

December 31, 2014

If glaucoma progresses despite seemingly controlled IOP, then it may be worthwhile investigating and treating obstructive sleep apnoea syndrome (OSAS)

Tip of the month

If glaucoma progresses despite seemingly controlled IOP, then it may be worthwhile investigating and treating obstructive sleep apnoea syndrome (OSAS)

The Science behind the Tip The exact physiopathology of glaucoma is still poorly understood, but the role of vascular dysregulation has become...

November 30, 2014

Per-operative use of anti-VEGF agents improves the chance of success of trabeculectomy

Tip of the month

Per-operative use of anti-VEGF agents improves the chance of success of trabeculectomy

The Science behind the Tip Anti-VEGF agents have been widely used in a variety of ocular diseases for their activity in decreasing blood vessel...

October 31, 2014

After the insertion of a drainage tube, the risk of a delayed supra-choroidal haemorrhage can be reduced by avoiding post-operative hypotony

Tip of the month

After the insertion of a drainage tube, the risk of a delayed supra-choroidal haemorrhage can be reduced by avoiding post-operative hypotony

The Science behind the Tip One of the most serious post-operative complications of tube-shunt surgery is a delayed supra-choroidal haemorrhage,...

September 30, 2014

Temporal placement of a laser peripheral iridotomy is safe and is less likely to result in linear dysphotopsia than if the PI is placed superiorly

Tip of the month

Temporal placement of a laser peripheral iridotomy is safe and is less likely to result in linear dysphotopsia than if the PI is placed superiorly

The Science behind the Tip To prevent pupil block, a laser peripheral iridotomy (PI) is the initial treatment for patients with primary...

July 31, 2014

Patients with pseudoexfoliation syndrome often have loss of hearing and should be referred for audiometry

Tip of the month

Patients with pseudoexfoliation syndrome often have loss of hearing and should be referred for audiometry

The Science behind the Tip Pseudoexfoliation syndrome is an important cause of glaucoma. It has been known for many years that pseudoexfoliation...

June 30, 2014

Dietary supplementation and glaucoma

Tip of the month

Dietary supplementation and glaucoma

The Science behind the Tip Dietary supplements belong to the broad group of complementary and alternative medicine (CAM). A recent survey in Canada...

May 31, 2014

Patients with pigmentary glaucoma respond well to laser trabeculoplasty, but steps must be taken to reduce the risk of the IOP spike that may occur immediately after the laser treatment

Tip of the month

Patients with pigmentary glaucoma respond well to laser trabeculoplasty, but steps must be taken to reduce the risk of the IOP spike that may occur immediately after the laser treatment

The Science behind the Tip Argon or selective laser trabeculoplasty (LT) is an established therapeutic option in the treatment of patients with...

April 30, 2014

It is important that glaucoma patients at risk of end-of-life visual impairment should be identified and treated accordingly

Tip of the month

It is important that glaucoma patients at risk of end-of-life visual impairment should be identified and treated accordingly

The Science behind the Tip The ultimate outcome measure of glaucoma treatment is visual impairment and blindness at the time of death. Based on a...

March 31, 2014

Perimetry should be undertaken soon after phacoemulsification and multifocal IOL implantation in patients with glaucoma, in order to establish new baseline parameters

Tip of the month

Perimetry should be undertaken soon after phacoemulsification and multifocal IOL implantation in patients with glaucoma, in order to establish new baseline parameters

The Science behind the Tip To determine change in visual function in patients with glaucoma, regular visual field testing is undertaken using...

February 28, 2014

The early diagnosis of glaucoma and early detection of glaucoma progression should be enhanced by the use of spectral domain OCT measurement of the neuro retinal rim

Tip of the month

The early diagnosis of glaucoma and early detection of glaucoma progression should be enhanced by the use of spectral domain OCT measurement of the neuro retinal rim

The Science behind the Tip Recent studies using spectral domain ocular coherence tomography (SD OCT) measurement of the optic disc margin show that...

January 31, 2014

Consider using preservative-free topical medication in patients with ocular surface disease

Tip of the month

Consider using preservative-free topical medication in patients with ocular surface disease

The Science behind the Tip Many glaucoma drops contain a preservative agent to minimise the risk of microbial contamination. Benzalconium chloride,...

November 30, 2013

Cataract surgery after trabeculectomy increases the risk of bleb failure and this risk is increased if the time between trabeculectomy and cataract surgery is short

Tip of the month

Cataract surgery after trabeculectomy increases the risk of bleb failure and this risk is increased if the time between trabeculectomy and cataract surgery is short

The Science behind the Tip Trabeculectomy surgery is a recognised risk factor for the subsequent development of cataract. Phacoemulsification with...

November 30, 2013

Generic drops can differ from brand drops and it may be necessary to monitor patients more closely after switching

Tip of the month

Generic drops can differ from brand drops and it may be necessary to monitor patients more closely after switching

The Science behind the Tip In order to be approved for general use, a generic drug has to show the criterion of essential similarity when compared...

October 31, 2013