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Recent research highlights 2017

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Antihypertensive Medication Postpones the Onset of Glaucoma

Hypertension, March 2017, Volume 69, Issue 3

This large population based study identified that patients treated with antihypertensive medication had a lower risk of developing glaucoma compared with individuals not on this treatment. This effect was seen with all forms of antihypertensive medication. Hence, although hypertension itself is associated with glaucoma, the use of antihypertensive medication appears to be protective against developing glaucoma.

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Unilateral Glaucoma

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Introduction

Unilateral glaucoma is a common presentation that is often associated with very high IOP and rapidly progressive disease with a high risk of loss of vision in the affected eye. The majority of patients will have a secondary form of glaucoma and it is essential to identify the underlying diagnosis as management often involves both addressing this underlying cause as well dealing with the raised IOP.1

The differential diagnosis is broad with a list of common causes presented in Table 1.1 Although the emphasis here is on conditions that most typically cause unilateral glaucoma, bilateral glaucoma can sometimes present unilaterally hence needs to be considered in your differential. Continue reading

Uses and Abuses of Diamox

Figure 1: Patient with acute angle closure
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Introduction
Diamox (acetazolamide) is a systemically administered carbonic anhydrase inhibitor (CAI). Although there are several clinical indications for Diamox, its usage is limited due to many side effects, contraindications and drug interactions. Often the adverse effects are mild and self-limiting but sometimes they are severe and life-threatening. Caution is therefore needed when considering treating a patient with Diamox. Continue reading

Selective Laser Trabeculoplasty (SLT) for glaucoma

Figure 1: SLT
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SLT is a safe and effective laser technique to lower intraocular pressure (IOP) in the management of glaucoma. SLT can be used as a primary treatment as an alternative to eye drops for open angle glaucoma. SLT may also be considered as an adjunct to eye drops if they alone do not lower the IOP to a satisfactory level. Sometimes patient’s have issues with eye drops like side effects, poor compliance or cost issues, in which case SLT would be a good option. In many cases it can prevent the need for glaucoma surgery. Continue reading

New surgical devices for glaucoma : The Ex-PRESS device

Figure 4: Goniscopy view of the Ex-PRESS device
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The ExPRESS miniature glaucoma device is a new surgical technique that has been developed as an alternative filtration procedure to standard trabeculectomy.1 The device consists of a stainless-steel tube (3mm long) with an anchoring footplate that diverts aqueous from the anterior chamber through its lumen (50µm) to the sub-conjunctival space (Figure 1 and 2). Continue reading

An Overview of Macular Degeneration for General Practitioners

Macula Degeneration
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Introduction
Aged-related macular degeneration (AMD) is the leading cause of legal blindness in New Zealand. One in 7 people over the age of 60 years is affected by AMD. The incidence of AMD increases with age, and with aging of the population, it is expected that the prevalence of visual impairment from AMD will double in the next 20 years. It is therefore an important condition that will be seen more commonly in General Practice. Continue reading