Glaucoma Flashcards
What are the acute signs of glaucoma?
B.E.E.P.P.M.E.
(Blind, episcleral injection, epiphora, pale optic disc, pain (blepharospasm),mydriasis, edema)
What are the chronic signs of glaucoma?
T.L.C.C.B.R.
(Tapetel hyperreflectivity, lens (sub)luxation, cupped optic disc. corneal striae, buphthalmos, retinal vascular attenuation)
blind, episceral injection, corneal edema, mydriasis
What does glaucoma look like in cats?
Mydriasis and buphthalmia w/ chronicity
What are the top 3 underlying diseases in secondary glaucoma?
Anterior uveitis (#1 cause of secondary glaucoma in all species)
lens luxation/ subluxation
intra-ocular neoplasia
Diagnosis of secondary glaucoma
IOP >25 mmHg
signs of glaucoma
evidence of uveitis, luxation, or intra-ocular mass
What breeds are predisposed to primary glaucoma?
Beagles, basset hounds, cocker spaniel, nordic breeds
Primary vs secondary glaucoma
Primary: inherited, other eye will develop glaucoma in 6-12 mo. (dogs)
Secondary: address underlying cause (cats and horses)
Primary glaucoma
very acute onset of IOP and CS
initially unilateral, fellow eye affected in 6-12 months
PLD–> ICA compromised–>drainage angle closes–> IOP spike
Secondary glaucoma
Hx is usually not as acute
accompanied by signs of underlying ocular disease
Diagnosis of primary glaucoma
IOP > 25 mmHg
signs of glaucoma
NO secondary causes identified
signalment
Prostaglandin Analogues (lantanprost 0.005% and bimatoprost 0.03%) q 12 hrs
-INCREASE aq humor outflow out the uveoscleral pathway
-potent treatment for K9 primary glaucoma
-causes intense miosis
-Contraindicated: lens luxation, may worsen uveitis
Not effective in cats and horses
Parasympathomimetics (demecarium bromide 0.25%) q 24 hrs + concurrent steroid q 24 hrs
-INCREASE aq humor outflow out the iridocorneal angle
-causes miosis
-prophylactic medication for contralateral eye in primary glaucoma
-control eyes 8 mo to development of glaucoma
-treated eyes 31 mo to development of glaucoma
carbonic anyhydrase inhibitors (dorzolamide 2%, brinzolamide 1%) q 8 hrs
DECREASE aq humor production
-great for primary and secondary glaucoma
-effective in dogs, cats, horses
beta blockers (timolol 0.5%, betaxlol 0.5%) q 12 hrs
-DECREASE aq humor production
-Work synergisitically w/ CAIs
-not very potent as a sole agent
Contraindication: risk of bronchoconstriction in cats w/ asthma, patients w/ cardiac dz as it decreases HR
When to give systemic mannitol 20%?
-basically dehydrates the body
-ER therapy for ACUTE glaucoma
give slowly over 30 min
