Cells of the zona fasciculata and zona reticularis lack aldosterone synthase (CYP11B2) that converts corticosterone to aldosterone, and thus these tissues produce only the weak mineralocorticoid corticosterone. However, both these zones do contain the CYP17A1 missing in zona glomerulosa and thus produce the major glucocorticoid, cortisol. Zona fasciculata and zona reticularis cells also contain CYP17A1, whose 17,20-lyase activity is responsible for producing the androgens, dehydroepiandrosterone (DHEA) and androstenedione. Thus, fasciculata and reticularis cells can make corticosteroids and the adrenal androgens, but not aldosterone.
If you have routine examinations and you develop glaucoma, the chances of serious vision loss from glaucoma are very remote. However, late detection or non-compliance may result in vision loss. One may think of glaucoma being analogous to a house on the beach. If a house is in good shape and is hit by a series of storms, then the house will survive the storms with little damage (high eye pressure with a healthy nerve). However, if the foundation of the house has been damaged by previous storms there is a significant chance that the house will either be further damaged or swept away by the storm (a damaged nerve can not take the excess pressure from glaucoma). Thus, the key to preserving vision is early detection with aggressive treatment. The chronic, progressive nature of the disease makes it difficult for the patient to faithfully take their medication - the key to preserving vision.
Clinical features. The presentation of phacomorphic glaucoma is similar to acute angle-closure glaucoma. Patients may experience severe pain and headache secondary to elevated IOP, blurred vision, perception of halos around lights, nausea, vomiting, bradycardia, and sometimes diaphoresis. 4 Clinical features may include corneal edema, conjunctival injection, and a mid-dilated pupil. The intumescent lens may be observed pushing the iris forward and reducing the anterior chamber depth. Anterior chamber cells and flare may also be present.