The pathophysiology of secondary glaucoma in these cases is affected by the type of tumour, location and other tumour-associated factors. Among the many subtypes of uveal tumours, secondary glaucoma is the most prominent among patients with trabecular meshwork iris melanoma. The blockage of vitreous flow due to inflammation in the structures of the trabecular meshwork is also observed in herpetic anterior uveitis patients. In addition to this, angle invasion is a mechanism that is observed to contribute greatly to the development of secondary glaucoma in patients with iris tapioca melanoma, iris lymphoma, choroidal melanoma, and medulloepithelioma. Treatment and management
Pharmacological interventions
Miotic drugs are a class of cholinergic drugs that are frequently employed in the treatment and management of all types of glaucoma. These drugs stimulate the contraction of the pupil causing the iris to pull away from the trabecular meshwork. Consequently, the normal drainage of the aqueous humour is restored, relieving IOP. In addition to causing a direct effect on IOP, these drugs are applied to reduce pigment release (from the iris pigment epithelium) in the treatment of pigmentary glaucoma. Despite the advantages, the widespread use of miotic drugs is limited by its associated side effects. There is an increased risk of development of posterior synechiae in glaucoma secondary to exfoliation syndrome and ocular trauma.
Drainage tube implants are also implicated in treatment of uveitic and inflammatory glaucoma.Minimally invasive glaucoma surgery is performed in order to overcome the risks and adverse effects associated with conventional surgical procedures. However, there are limited studies testing the efficacy of utilising this type of surgery for the treatment of uveitic glaucoma.In addition to the direct reduction of IOP, surgical procedures are used to remove blood, viscoelastic fluid and debris in glaucoma caused by cataract extraction and ocular trauma. They may also be utilized to remove depot steroids in corticosteroid glaucoma and ghost cells from the vitreous humour in ghost-cell glaucoma through a procedure known as vitrectomy. == References ==