Organization of the Course
The Basic and Clinical Science Course comprises 13 volumes, incorporating fundamental ophthalmic knowledge, subspecialty areas, and special topics:
1 Update on General Medicine
2 Fundamentals and Principles of Ophthalmology
3 Clinical Optics
4 Ophthalmic Pathology and Intraocular Tumors
5 Neuro-Ophthalmology
6 Pediatric Ophthalmology and Strabismus
7 Oculofacial Plastic and Orbital Surgery
8 External Disease and Cornea
9 Uveitis and Ocular Inflammation
10 Glaucoma
11 Lens and Cataract
12 Retina and Vitreous
13 Refractive Surgery
References
Readers who wish to explore specific topics in greater detail may consult the references cited within each chapter and listed in the Additional Materials and Resources section at the back of the book. These references are intended to be selective rather than exhaustive, chosen by the BCSC faculty as being important, current, and readily available to residents and practitioners.
• Introduction to the BCSC
Multimedia
This edition of Section 10, Glaucoma, includes videos related to topics covered in the book. The videos were selected by members of the BCSC faculty and are available to readers of the print and electronic versions of Section 10 (www.aao.org/bcscvideo_section10). Mobile- device users can scan the QR code below (you may need to install a QR-code reader on the device) to access the video content.
Self-Assessment and CME Credit
Each volume of the BCSC is designed as an independent study activity for ophthalmology residents and practitioners. The learning objectives for this volume are given on page 1. The text, illustrations, and references provide the information necessary to achieve the objectives; the study questions allow readers to test their understanding of the material and their mastery of the objectives. Physicians who wish to claim CME credit for this educational activity may do so by following the instructions given at the end of the book.
This Section of the BCSC has been approved as a Maintenance of Certification Part II self-assessment CME activity.
Conclusion
The Basic and Clinical Science Course has expanded greatly over the years, with the addition of much new text, numerous illustrations, and video content. Recent editions have sought to place greater emphasis on clinical applicability while maintaining a solid foundation in basic science. As with any educational program, it reflects the experience of its authors. As its faculties change and medicine progresses, new viewpoints emerge on controversial subjects and techniques. Not all alternate approaches can be included in this series; as with any educational endeavor, the learner should seek additional sources, including Academy Preferred Practice Pattern Guidelines.
The BCSC faculty and staff continually strive to improve the educational usefulness of the course; you, the reader, can contribute to this ongoing process. If you have any suggestions or questions about the series, please do not hesitate to contact the faculty or the editors.
The authors, editors, and reviewers hope that your study of the BCSC will be of lasting value and that each Section will serve as a practical resource for quality patient care.
Objectives
Upon completion of BCSC Section 10, Glaucoma, the reader should be able to
state the epidemiologic features of glaucoma, including the social and economic impacts of the disease
list recent advances in the understanding of hereditary and genetic factors in glaucoma
describe the physiology of aqueous humor dynamics and the control of intraocular pressure (IOP)
describe the clinical evaluation of the glaucoma patient, including history and general examination, gonioscopy, optic nerve examination, and visual field
list the clinical features of the patient considered a glaucoma suspect
describe the clinical features, evaluation, and treatment of primary open-angle glaucoma and normal-tension glaucoma
list the various clinical features of and therapeutic approaches for the secondary open-angle glaucomas
state the underlying causes of the increased IOP in various forms of secondary open-angle glaucoma and the impact that these underlying causes have on disease management
describe the mechanisms and pathophysiology of primary angle-closure glaucoma
describe the pathophysiology of secondary angle-closure glaucoma, both with and without pupillary block
describe the pathophysiology of and therapy for primary congenital and juvenile-onset glaucomas
describe the various classes of medical therapy for glaucoma, including efficacy, mechanism of action, and safety
state the indications for, techniques used in, and complications of various laser and incisional surgical procedures for glaucoma
Introduction to Glaucoma: Terminology, Epidemiology, and Ge ne tics
Highlights
The term glaucoma refers to a group of optic neuropathies characterized by optic disc excavation, or cupping, and corresponding patterns of vision loss.
Glaucomas are classified by age of onset (childhood vs adult onset), etiology (primary vs secondary), and gonioscopic assessment of the iridocorneal angle (open vs closed).
Elevated intraocular pressure (IOP) is a major risk factor for glaucoma; however, a large proportion of patients with primary open- angle glaucoma have IOP in the statistically normal range.
Glaucoma is a major public health prob lem and is the leading cause of irreversible blindness worldwide.
Many genes and genomic regions have been found to be associated with vari ous types of glaucoma.