A clinical study of secondary glaucoma

Secondary Glaucoma is a group of disorders in which raised intraocular pressure is associated with some primary ocular or systemic cause. This prospective study aims to evaluate the various commonly seen causes of secondary glaucoma. A total of 50 patients with raised intraocular pressure coming to a teaching hospital during a period of three years were studied. Patients with primary glaucoma were excluded from this study. Clinical evaluation was done in all the cases and the visual acuity, intraocular pressure and the optic nerve head changes were recorded. The various age groups and the gender distribution were noted. Also history of diabetes, hypertension and trauma was specifically asked for. Out of 50 patients, a total of 29 (58%) patients were above 60 years of age. Predominantly 28 (56%) were male patients. Visual acuity was less than 3/60 in 34 (68%) of all patients. The mean intraocular pressure recording was 34 mm of Hg, within a range of 21 to 46 mm of Hg. Only 23 (46%) patients showed optic neuropathy. The most common causes were lens induced glaucoma seen in 24 (48%) cases and next 14% each seen in neovascular glaucoma and pseudoexfoliative glaucoma. Diabetes and/or Hypertension were present in 8 (16%) patients. This study identifies ocular factors like cataracts in lens induced glaucoma, age factor in pseudoexfoliative glaucoma and systemic factors like diabetes and/or hypertension in neovascular glaucoma, and also emphasizes that the prompt detection of these causes can prevent severe visual impairment.