Abstract
Glaucoma is a potentially devastating complication that can occur in the setting of ocular trauma and can lead to permanent irreversible vision loss from elevated intraocular pressure (IOP) causing glaucomatous optic neuropathy. Ocular trauma can cause elevated IOP via many different mechanisms including both open- and closed-angle forms. Such causes include direct obstruction of the trabecular meshwork by blood, blood breakdown products, or inflammatory debris and resulting anterior synechiae. Pupillary block and secondary angle closure can be caused by lens subluxation, hyphema, or inflammatory synechiae. IOP can also become elevated due to changes in ocular tissues from chemical injury, corticosteroids used to treat inflammation, toxicity from retained intraocular foreign bodies, elevated episcleral venous pressure, and chronic damage to the trabecular meshwork. Vigilance is required and sometimes a lifetime of follow-up care must be administered, as some forms of traumatic glaucoma can occur many years after the initial injury. At-risk populations must be recognized such as those with sickle cell anemia in hyphema cases as they are at much greater risk for complications. There are many options for surgical glaucoma management, should it become necessary, and it is essential for the surgeon to know the strengths and weaknesses of each procedure.
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Kim, W.I. (2019). Traumatic Glaucoma. In: Calvano, C., Enzenauer, R., Johnson, A. (eds) Ophthalmology in Military and Civilian Casualty Care. Springer, Cham. https://doi.org/10.1007/978-3-030-14437-1_8
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