Secondary glaucomas are optic‑nerve‑damaging eye pressure problems that arise as a complication of another ocular or systemic condition rather than occurring on their own. They share final pathways with primary glaucoma but have identifiable causes that also need treatment.
Common Causes
Secondary glaucoma can follow eye injury, uveitis, steroid use, advanced diabetic eye disease, lens problems, or vascular events.
- Neovascular glaucoma develops when abnormal new vessels obstruct the drainage angle.
- Lens‑related glaucomas occur with swollen, dislocated, or leaking lenses.
- Inflammatory glaucoma results from trabecular damage or blockage by inflammatory cells and protein.
- Traumatic and pigmentary glaucomas stem from structural changes after injury or pigment dispersion.
Management
Treatment combines pressure‑lowering therapies with management of the underlying cause, often requiring drops, laser, and surgery.
- Anti‑VEGF injections and panretinal photocoagulation are crucial for neovascular glaucoma associated with retinal ischaemia.
- Steroids may need to be reduced or switched in steroid‑response glaucoma.
- Surgical options include trabeculectomy, tube shunts, and cyclodestructive procedures when medications are insufficient.
- Regular monitoring of optic nerve and visual fields guides long‑term care.
