312: Eye, ear, nose and dermatological medicines

Question 1

What causes glaucoma?

Answer 1

Glaucoma is caused by the optic nerve becoming damaged to the point where it leaves the eye. It is usually caused by fluid building up in the front part of the eye, which increases pressure inside the eye.

Question 2

What is the watery fluid in the eye called?

Answer 2

The aqueous humour is the watery fluid in the eye.

Question 3

What are the tiny drainage channels in the eye called?

Answer 3

The trabecular meshwork are the tiny drainage channels in the eye.

Question 4

If there is a problem with the fluid draining out of the eye what will happen?

Answer 4

If there is a problem with the fluid draining out of the eye then the pressure in the eye will increase.

Question 5

What symptoms might someone with glaucoma experience?

Answer 5

Someone with glaucoma will probably not experience symptoms, or may have their peripheral vision affected.

If they do experience symptoms these could be:

• intense eye pain
• nausea and vomiting
• red eye
• headache
• tenderness around eyes
• seeing rings around light
• blurred vision

Question 6

What is the most common type of glaucoma?

Answer 6

Chronic, or primary open angle glaucoma is the most common.

Question 7

What is the cause of chronic (primary open angle) glaucoma?

Answer 7

Chronic glaucoma occurs when the aqueous humour can get to the drainage channels, but they slowly become blocked over time.

Question 8

What is acute glaucoma?

Answer 8

Acute glaucoma occurs when there is a sudden complete blockage of the flow of aqueous humour of the eye.

The fluid is prevented from getting to the channels.

Question 9

What is secondary glaucoma?

Answer 9

Secondary glaucoma occurs as a result of another condition.

Question 10

What is congenital glaucoma?

Answer 10

Congenital, or childhood glaucoma is a result of a rare congenital condition which causes a malformation of the eye.

Question 11

What are risk factors for glaucoma?

Answer 11

• getting older
  
  • most common in 70s-80s
• race
  
  • African/Caribbean/Asian origin
• family
  
  • close relative has had it (parent/sibling)
• short-sightedness

Question 12

How is glaucoma usually detected?

Answer 12

Glaucoma is usually detected through a routine eye test.

Question 13

Which drug(s) are examples of miotics used to treat glaucoma?

Answer 13

Prilocarpine is a miotic.

Question 14

Which drug(s) are carbonic anhydrase inhibitors used to treat glaucoma?

Answer 14

• acetazolamide
• brinzolamide
• dorzolamide

Question 15

Which drug(s) are examples of beta-blockers used for glaucoma?

Answer 15

• betaxolol hydrochloride
• carteolol hydrochloride
• levobunolol hydrochloride
• metipranolol
• timolol maleate

Question 16

Which drug(s) are examples of prostaglandin analogues used to treat glaucoma?

Answer 16

• bimatoprost
• latanoprost
• travoprost

Question 17

What is dry eyes?

Answer 17

Dry eyes is chronic soreness of the eyes associated with reduced or abnormal tear secretion.

Question 18

What is dry eyes syndrome also known as?

Answer 18

Dry eyes syndrome is also known as keratoconjunctivitis sicca.

Question 19

What is the purpose of tears in the eye?

Answer 19

Tears stop the eye from drying out and also protect the eye from infection.

Question 20

What are symptoms of dry eye syndrome?

Answer 20

• irritation in the eye
  
  • sore
  • gritty
  • red
• short-term blurred vision
• sensitive to bright lights
• burning or itching in the eye
• more watery than normal

Question 21

What are risk factors for dry eye syndrome?

Answer 21

• age
  
  • 50+
• medication
  
  • diuretics
  • antihistamines
  • contraceptive pill
  • antidepressants
  • blood pressure medications
• medical conditions
  
  • rheumatoid arthritis
  • blepharitis
  • sjorgrens syndrome
  • lupus
• eye damage
  
  • injury or surgery
• looking at computer screens for too long
• wearing contacts
• spending a long time in air-conditioned or heated environments
• windy, cold, dusty, dry environments

Question 22

What are treatments of dry eye syndrome?

Answer 22

• artificial tears - lubrication
• eye ointment - soothes & lubricates
• get plenty of sleep
• use a humidifier
• wear glasses (not contacts)
• don’t smoke or drink too much

Question 23

What is the ‘traditional’ choice of treatment for dry eye syndrome?

Answer 23

Hypromellose