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Year Two - Ophthalmology > Acute Angle Closure Glaucoma > Flashcards

Acute Angle Closure Glaucoma Flashcards

1
Q

What is acute angle closure glaucoma (AACG)?

A

It is defined as a condition in which there is narrowing of the anterior chamber angle, resulting in decreased drainage of aqueous humour from the eye through the trabecular meshwork

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2
Q

What is the pathophysiological consequence of acute angle closure glaucoma?

A

It leads to a raised intraocular pressure, specifically within the posterior chamber

This ultimately results in optic nerve damage and vision loss

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3
Q

What are the seven risk factors of aucte angle closure glaucoma?

A

Older Age > 60

Female Gender

East Asian Ethnicity

Family History

Hypermetropia

Pupillary Dilatation

Drug Administration

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4
Q

What is hypermetropia?

A

It is defined as long-sightedness

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5
Q

What is the cause of pupil mid-dilation?

A

A dark room

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6
Q

What are the six drugs assoicated with acute angle closure glaucoma?

A

Noradrenalin

Oxybutynin

Solifenacin

Amtriptyline

Tropicamide

Mydriatic Eye Drops

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7
Q

What are the six clinical features of acute angle closure glaucoma?

A

Unilateral Acute Painful Red Eye

Decreased Visual Acuity

Light Halos

Semi-Dilated Non-Reacting Pupil

Unilateral Headaches

Nausea & Vomiting

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8
Q

What are the three investigations used to diagnose acute angle closure glaucoma?

A

Slit Lamp Examination

Gonioscopy

Tonometry

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9
Q

What are the four features of acute angle closure glaucoma on slit lamp examiantion?

A

Unilateral Red, Teary Eye

Hazy Cornea

Mid-Dilated Pupil

Firm Eyeball on Palpation

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10
Q

What is the gold standard investigation used to diagnose acute angle closure glaucoma?

A

Gonioscopy

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11
Q

What is gonioscopy?

A

It involves the use of a special slit-lamp lens, to visualise the acute angle of the anterior chamber

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12
Q

What is tonometry?

A

It is a test which is used to measure intraocular pressure

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13
Q

What is the feature of acute anlgle closure glaucoma on tonometry?

A

A raised intraocular pressure > 30mmHg

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14
Q

What is the most appropriate management option in suspected acute angle closure glaucoma?

A

An urgent opthamology hospital referral

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15
Q

What is the conservative management option of acute angle closure glaucoma? How?

A

It involves advising the patient to lie flat on their back

It results in gravity opening the anterior chamber angle

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16
Q

When is conservatative management of acute angle closure glaucoma recommended?

A

Delayed admission

17
Q

What are the two pharmaoclogical management options used to manage acute angle closure glaucoma?

A

Eye Drops

IV Acetazolamide

18
Q

When are eye drops used to manage acute angle closure glaucoma recommended?

A

It is the first line immediate management option, alongside IV acetazolamide

19
Q

Which three eye drops are used to manage acute angle closure glaucoma?

A

Pilocarpine

Timolol

Apraclonidine

20
Q

What drug class does pilocarpine belong to?

A

Direct parasympathomimetic

21
Q

How is pilocarpine used to manage acute angle closure glaucoma?

A

It acts on muscarinic receptors of the sphincter muscles in the iris, causing ciliary muscle contraction and pupil constriction

This opens the trabecular meshwork and increases the outflow of aqueous humour

22
Q

What % of pilocarpine is used to manage acute angle closure glaucome in patients with blue eyes?

A

2%

23
Q

What % of pilocarpine is used to manage acute angle closure glaucome in patients with brown eyes?

A

4%

24
Q

What drug class does timolol belong to?

A

Beta-blocker

25
Q

How is timolol used to manage acute angle closure glaucome?

A

It decreases aqeous humour production

26
Q

What drug class apraclonidine belong to?

A

Alpha-2 agonist

27
Q

How is apraclonidine used to manage acute angle closure glaucome?

A

It decreases aqeous humour production

It increases uveoscleral outflow

28
Q

When is IV acetazolamide used to manage acute angle closure glaucoma?

A

It is the first line immediate management, alongside eye drops

29
Q

How is acetazolamide used to manage acute angle closure?

A

It reduces aqeous humour secretions

30
Q

What drug class does acetazolamide belong to?

A

Carbonic anyhydrase inhibitor

31
Q

How is acetazolamide used to manage acute angle closure?

A

It reduces aqeous humour secretions

32
Q

In which circumstance is oral acetazolamide used to manage acute angle closure glaucoma?

A

Delayed admission

33
Q

What dose of oral acetazolamide is used to manage acute angle closure glaucoma?

A

500mg once daily

34
Q

What is the surgical management option of acute angle closure glaucoma?

A

Laser Peripheral Iridotomy

35
Q

What is the definitive management option of acute angle closure glaucoma?

A

Laser Peripheral Iridotomy

36
Q

What is laser peripheral iridotomy?

A

It involves the formation of a small hole in the peripheral iris through laser

This enables flow of aqueous humour from the posterior chamber to the anterior chamber

37
Q

What are the three complications of acute angle closure glaucoma?

A

Acute Angle Closure Glaucoma Reoccurrence

Vision Loss

Central Retinal Vein Occlusion

Year Two - Ophthalmology (12 decks)

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