Which field of vision is last to go in chronic simple glaucoma?
High-Yield Explanation
Ans. d (Temporal). (Ref. Parson, Diseases of Eye, 18th/pg.216)# In POAG (chronic simple glaucoma) glaucomatous disc changes are characteristic with cupping starting in inferior temporal quadrant, followed by bayoneting sign, baring of circumlinear vessels, splinter haemorrhages, temporal neural rim, polar notching, laminar dot sign and optic pallor and atrophy.# Field defects include isopter contraction, baring of blind spot, arcuate (Bjerrum) scotoma, superior paracentral scotoma, Seidel's scotoma, ring scotoma, Roenne's nasal step, tubular field and lastly only temporal island of vision.Colored halos is a vital symptom of PACG# Treatment of POAG (primary open angle glaucoma):- Medical treatment is always first in place, operative treatment is last resort.- Pilocarpine, beta-blockers, epinephrine, dipivefrin, dorazolamide, and latanoprost are used.- Latanoprost is a Pg analogue, which acts by increasing the uveoscleral outflow.- LASER (ALT)- Newer trabeculotomy with anti-metabolites and valve implantation.- Filtering surgeries.# Treatment of PACG (primary angle closure glauicoma)- Pilocarpine 2-4%, but definitive is surgery, PBI, but now replaced in most cases by LASER iridotomy.