Practical insight on low tension glaucoma

ABSTRACT

Low tension glaucoma challenges the concept that damage for high intraocular pressure is the sole mechanism in the pathogenesis of glaucomatous optic atrophy. Vasospasm and vaso-occlusion may be additional risk factors for patients with low tension glaucoma. We examined which of these factors may be responsible for low tension glaucoma. Twelve selected patients with low tension glaucoma underwent the following diagnostic studies to evaluate the etiological risk factors for each patient. The facility of aqueous outflow was measured using the Electronic Digital Tomography - 103 unit. Cold water immersion automated perimetry and platelet aggregation assessment using the Packs -4 machine were also performed. An impaired facility of aqueous outflow was noted in 100% of our cases; cold water immersion of both hands retarded the retinal sensitivity and exaggerated the present field defects in 41.6% and increased platelet aggregation was observed in 33.3% of the cases. Achieving a reduction in intraocular pressure to "normal" levels did not completely rectify the situation nor did it always prevent progression of the disease. We concluded that each patient requires individual assessment and individual management