Lumboperitoneal shunts are channels which facilitate drainage of CSF from the lumbar subarachnoid space to the peritoneal cavity
It can be used in conditions such as Pseudotumor cerebri and hydrocephalus for decreasing the intracranial pressure
The advantage of of lumboperitoneal shunt over ventriculoperitoneal shunt is that there is less incidence of intracranial complications
Some of the disadvantages are risk for scoliosis, sciatica and back pain
There is also the risk of the tube getting blocked and resultant increase in CSF pressure with worsening of clinical status

Pseudotumor cerebri – also known as benign intracranial hypertension / idiopathic intracranial hypertension is a condition characterised by increase in the intracranial tension in the absence of any intracranial mass lesion.
Etiology:

The exact etiology of benign intracranial hypertension is not known
Since it is seen  more in women in the childbearing age, it has been suggested that some hormonal changes may be involved in it’s pathogenesis
It is usually associated with recent weight gain

Pathogenesis

There is increase in intracranial tension
Signs of increased intracranial tension such as papilloedema appear
The clinical picture is similar to that …

Attachment of anterior surface of vitreous to the posterior surface of the intraocular lens.

It is a surgical procedure in which slits are made in the optic nerve sheath to relieve the pressure on the optic nerve
It is done in cases of Idiopathic Intracranial Hypertension (pseudo tumor cerebri)

Procedure:

The orbit is entered into via a surgical incision in the skin
The eyeball is pushed to one side and the optic nerve is identified
Slits are made in the optic nerve sheath
The fluid drains out and the compression on the optic nerve is relieved

Uses:

Preservation of optic nerve function in cases of idiopathic intracranial hypertension not responding to medical …

Idiopathic Intracranial Hypertension (Pseudo tumor cerebri)

Optic nerve sheath fenestration

Increase in cup disc ratio is known as cupping
Occurs in glaucoma
Degree of cupping can be correlated with stage of glaucoma

Normal cup disc ratio is 0.3 – 0.4
In early glaucoma – 0.6
In advanced glaucoma – 0.7 – 0.9

Ratio of the size of optic cup to that of the optic disc
Normally 0.3 to 0.4
Increased in case of glaucoma – known as cupping

White, cup shaped area in the centre of the optic disc
The size of the cup relative to the disc (cup to disc ratio) increases in glaucoma and is used for its diagnosis

The fibers comprising the optic nerve exit the eyeball through a opening in the sclera in its posterior aspect.
This opening is is covered by a mesh – lamina cribrosa sclerae
The mesh is composed of bundles of collagen fibers with pores in between
The optic nerve fibers pass through the pores in the lamina cribrosa
Lamina cribrosa helps to maintain the pressure difference between the eye and the extraocular tissue
When the intraocular pressure increases as in glaucoma, the lamina cribrosa is pushed posteriorly and compression on optic nerve fibers and blood vessels can …