eMedicine Specialties > Ophthalmology > Intraocular Pressure
Glaucoma, Unilateral: Differential Diagnoses & Workup
Updated: Mar 8, 2007
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Increased EVP
Orbital fracturesOther traumatic injuries
Underlying malignancy
Thyroid disease
Congestive heart failure
Other systemic diseases (eg, spontaneous carotid-cavernous fistulae have been reported in association with Ehlers-Danlos syndrome and pseudoexfoliation)ICE syndrome Corneal edema
Workup
Laboratory Studies
- Lab studies are indicated based on the suspected etiology (eg, thyroid function test, vasculitis workup) of unilateral glaucoma.
Imaging Studies
- B-scan echography to evaluate for orbital tumor, foreign body, and extraocular muscle enlargement (in thyroid ophthalmopathy and other conditions with EVP); also indicated if fundus cannot be visualized
- CT scan of orbits to evaluate orbital fracture, foreign body, dilation of superior ophthalmic vein, and enlargement of cavernous sinus (present with carotid-cavernous sinus fistulae)
- Angiography to evaluate for arteriovenous anomalies
- Orbital venography to evaluate for orbital varix
- Color Doppler to evaluate for orbital varix
Other Tests
- In patients with increased EVP, gonioscopic examination may reveal reflux of blood in the Schlemm canal.
- Ocular pulse amplitude, as measured by pneumotonometry, is a useful noninvasive tool to evaluate patients with carotid-cavernous fistulae.
- Malignancy workup for patients with superior vena cava syndrome, orbital tumors
- Cardiac workup for patients with congestive heart failure
More on Glaucoma, Unilateral |
| Overview: Glaucoma, Unilateral |
Differential Diagnoses & Workup: Glaucoma, Unilateral |
| Treatment & Medication: Glaucoma, Unilateral |
| Follow-up: Glaucoma, Unilateral |
| References |
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References
Albert DM, Jakobiec FA, Azar DT. Glaucoma associated with increased episcleral venous pressure. In: Principles and Practice of Ophthalmology. 2nd ed. WB Saunders Co;2000: 2781-2792.
Alvarado JA, Underwood JL, Green WR, et al. Detection of herpes simplex viral DNA in the iridocorneal endothelial syndrome. Arch Ophthalmol. Dec 1994;112(12):1601-9. [Medline].
Cibis GW, Tripathi RC, Tripathi BJ. Glaucoma in Sturge-Weber syndrome. Ophthalmology. Sep 1984;91(9):1061-71. [Medline].
Font RL, Ferry AP. The phakomatoses. Int Ophthalmol Clin. 1972;12(1):1-50. [Medline].
Gandolfi SA, Cimino L, Sangermani C, et al. Improvement of spatial contrast sensitivity threshold after surgical reduction of intraocular pressure in unilateral high-tension glaucoma. Invest Ophthalmol Vis Sci. Jan 2005;46(1):197-201. [Medline].
Jain SS, Rao P, Kothari K, et al. Posterior scleritis presenting as unilateral secondary angle-closure glaucoma. Indian J Ophthalmol. Sep 2004;52(3):241-4. [Medline].
Kirsch M, Henkes H, Liebig T, et al. Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients. Neuroradiology. Jul 2006;48(7):486-90. [Medline].
Manor RS, Kurz O, Lewitus Z. Intraocular pressure in endocrinological patients with exophthalmos. Ophthalmologica. 1974;168(4):241-52. [Medline].
Uram M, Zubillaga C. The cutaneous manifestations of Sturge-Weber syndrome. J Clin Neuroophthalmol. Dec 1982;2(4):245-8. [Medline].
Watson PG, Hayreh SS. Scleritis and episcleritis. Br J Ophthalmol. Mar 1976;60(3):163-91. [Medline].
Weiss DI. Dual origin of glaucoma in encephalotrigeminal haemangiomatosis. Trans Ophthalmol Soc U K. 1973;93(0):477-93. [Medline].
Further Reading
Keywords
open angle, closed angle, vision loss, visual deficit, open-angle glaucoma, episcleral venous pressure, EVP, glaucoma associated with iridocorneal endothelial syndrome, ICE syndrome
Differential Diagnoses & Workup: Glaucoma, Unilateral