Diagnosis and management of secondary glaucoma: Dural fistula and intracranial hypotension

Abstract

Glaucoma can occur as a secondary disorder in two situations. Firstly, where there is episcleral venous hypertension. In cases of dural fistula the diagnosis is straightforward: presentation, diagnosis and management will be discussed. In other situations the aetiology of episcleral venous hypertension is controversial, such as the Radius Maumenee syndrome. Secondly there has been recent interest in the importance of the pressure gradient across the lamina cribrosa. The occurrence of papilloedema in cases of low intra‐ocular pressure is well established while glaucomatous optic nerve damage in cases of intra‐cranial hypotension is controversial. The evidence will be reviewed.