Eye Conditions Flashcards
What is glaucoma and what are its signs and symptoms?
Glaucoma is a group of eye disorders characterised by:
1) Optic nerve damage
2) Loss of visual field associated with pathological cupping of the optic disc.
Often linked to raised intraocular pressure (however glaucoma can occur even with normal IOP levels)
What is the most common form of glaucoma?
Chronic Open-Angle Glaucoma:
1) Drainage of aqueous humour through the trabecular meshwork is restricted
2) Angle between iris and cornea is normal
3) Condition can remain asymptomatic for years
What is acute angle closure glaucoma?
Acute angle-closure glaucoma:
1) Outflow of aqueous humour from the eye is totally obstructed by bowing of the iris against the trabecular meshwork.
2) It is characterised by its abrupt onset of symptoms,
3) Sight-threatening medical emergency that requires urgent reduction of intraocular pressure to prevent loss of vision.
What is the first line treatment for glaucoma?
360° Selective Laser Trabeculoplasty
What is the recommended treatment for glaucoma if 360° Selective Laser Trabeculoplasty is declined or waiting for treatment?
A topical prostaglandin analogue, such as latanoprost, tafluprost, travoprost, or bimatoprost
What do you do if initial treatment with a topical prostaglandin analogue is not tolerated?
An alternative prostaglandin analogue should be tried before switching to a topical beta-blocker such as betaxolol, levobunolol hydrochloride, or timolol maleate.
What do you do if treatment with a topical beta-blocker is not tolerated
1) Carbonic anhydrase inhibitors such as brinzolamide or dorzolamide
2) Topical sympathomimetic such as apraclonidine [unlicensed use] or brimonidine tartrate, or a
3) Topical miotic such as pilocarpine [unlicensed use],
Given either as monotherapy or as combination therapy.
When is pharmacological therapy not needed in glaucoma?
Intraocular pressure < 24 mmHg
What treatment is recommended for patients with advanced open angle glaucoma?
Patients with advanced chronic open-angle glaucoma should be offered glaucoma surgery with pharmacological augmentation (with mitomycin [unlicensed use])
What is the emergency treatment for closed angle glaucoma?
Let the person lie flat with their face up and head not supported by pillows, as this may relieve some of the pressure on the angle.
1) Pilocarpine eye drops, one drop of 2% in blue eyes or 4% in brown eyes;
2) Acetazolamide 500 mg orally to reduce production of aqueous humour
3) Analgesia;
4) Anti-emetic,
What is the first line management for mild dry eye?
1) Hypromellose
Initial frequent applications that can taper off as symptoms improve.
2) Carbomers and polyvinyl alcohols
Last longer due to higher viscosity - usually given at night as can affect vision
What is the first line treatment for moderate to severe dry eyes?
1) 6–8
week trial of mild treatments (hypromellose, carbomer, polyvinyl alcohol)
What do you offer a patient if first line treatment for moderate to severe dry eyes fails?
Offer lubricants containing sodium hyaluronate, hydroxypropyl guar, or carmellose sodium
What is age related macular degeneration?
A progressive eye condition that primarily affects individuals aged 55 and older. It leads to a gradual loss of central vision, impairing the ability to read, write, recognise faces, and drive.
AMD affects the macula, the central area of the retina responsible for sharp vision
How do you treat age related macular degeneration?
Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are the first-line treatment, administered by experienced healthcare professionals.
e.g. Ranibizumab
