acute closed angle glaucoma Flashcards
1
Q
occurs when
A
iris bulges forward and seals off trabecular meshwork
2
Q
where does pressure particularly build up
A
posterior chamber, causing pressure behind the iris worsening the closure angle
3
Q
risk factors
A
age female FHx chinese + east asian origin shallow anterior chamber
4
Q
medications which can precipitate closed angle glaucoma
A
adrenergic meds: noradrenalin
anticholinergic medications
tricyclic antidepressants e.g. amitriptyline
5
Q
presentation
A
unwell acute onset -severely painful red eye -blurred vision -halos around lights -assoc headache, nausea, vomit
6
Q
OE
A
red eye teary hazy cornea decreased visual acuity fixed + dilated pupil firm eyeball on palpation
7
Q
initial Mx
A
- same day ophthalmology assessment
- lie patient on back w/o pillow
- give pilocarpine eye drops
- give acetazolamide 500mg oral
- analgesia, antiemetics
8
Q
pilocarpine
A
acts on muscarinic receptors to cause constriction of pupil –> miotic agent
open up flow for aqueous humour
9
Q
acetazolamide
A
carbonic anydrase inhibitor
reduced production aqueous humour
10
Q
2ry care - medication option
A
pilocarpine acetazolamide hyperosmotics - glycerol, mannitol timolol dorzolamide brimonidine - sympathomimetic
11
Q
definitive Mx
A
laser iridotomy
