Etiological Assessment of Secondary Glaucoma via Orbital CT Scan : A Diagnostic Review of 73 Patients

Secondary glaucoma arises as a complication of another ocular or systemic condition, including trauma, uveitis, neovascularization, steroid use, intraocular tumors, or hemorrhage. This prospective, observational, diagnostic accuracy and descriptive study, conducted on 73 patients, was to determine the diagnostic efficacy of orbital CT scan in identifying etiological factors of secondary glaucoma in patients with unexplained intraocular pressure elevation. It shows that 53.5% of patients were females with mean age of 50.6 years. Neoplast ic conditions represented the largest etiological category (34.2%), with melanoma being most frequent (9.6%). CT scan demonstrated exceptional diagnostic performance with sensitivity 93.4%, specificity 100%, positive predictive value 100%, and negative pre dictive value 76.5%. Contribution rates varied significantly by pathology : tumors 94.4%, trauma/foreign bodies 87.5%, vascular lesions 87.5%, but only 33.3% for primary/secondary glaucoma without structural abnormality (χ² = 16.7, p < 0.001). Age signific antly correlated with etiology (F = 8.92, p < 0.001), with retinoblastoma exclusively in pediatric patients and vascular pathology predominating in geriatric populations.
This study demontrates that Orbital CT scan has an excellent diagnostic accuracy for identifying structural etiologies of secondary glaucoma, particularly neoplastic, traumatic, and vascular causes. Its integration into diagnostic algorithms for atypical or refractory glaucoma presentations can significantly improve etiological detection and guide targeted therapeutic interventions.