Acute Glaucoma Flashcards
What are the different types of gluacoma?
Open and closed angle glaucoma
What is glaucoma?
Optic neuropathy due to raised intra-ocular pressure causing optic nerve damage
What is the cause of open-angle glaucoma?
The iris is clear of the meshwork, but the trabecular network functionally offers an increased resistance to aqueous outflow causing increased IOP
Which open or closed glaucoma is a medical emergency?
Closed
What are the risk for primary open angle glaucoma?
- Age
- Black ethnicity
- Diabetes
- Family Hx
What is the presentation of open-angled glaucoma?
- Insidious loss of peripheral visual field -nasal scotomas progress to ‘tunnel vision
- Painless
- decreased visual acuity
- Central vision remains until end-stage disease
What is the treatment of open angle glaucoma?
*Topical beta blockers to reduce IOP
>Timolol
>contraindicated in asthma, COPD, heart block
*Prostaglandin analogues to increase aqueous outflow
>Lantanoprost +/- beta blockers
*Carbonic anhydrase inhibitors: reduce aqueous humour production
>acetazolamide -topical/oral
How is glaucoma diagnosed?
- Measure IOP
- Visual fields
- Fundoscopy
What is the presentation of acute closed angle glaucoma?
Acute onset!
- Severly painful eye
- Mild photophobia
- Blurred vision
- Red eye
- Tender
- Feel hard
- Hazy cornea (due to corneal oedema)
- Semi-dilated pupil
- Nausea and vomiting
What is the management of acute close angle glaucoma?
- Ophthalmology referral
- IV acetazolamide 500mg
- 4% Pilocarpine drop to constrict pupil
- Diuretics: diamox, mannitol
- Laser a hole in iris for definitive treatment
What is acute angle-closure glaucoma cause by?
Raised IOP secondary to an impairment of aqueous outflow as a closed angle
What are risk factors for acute angle-closure glaucoma?
- Hypermetropia (long sightedness)
- Pupillary dilatation
- Lens growth associated with age
