Glaucoma

Question 1

elevated intraocular pressure due to reduced drainage of aqueous fluid through trabecular meshwork

Answer 1

chronic open angle glaucoma

Question 2

obstruction of aqueous humor fluid flow into anterior chamber angle, without elevated intraocular pressure

Answer 2

chronic closed angle glaucoma

Question 3

what is the most common type of glaucoma?

Answer 3

chronic open angle glaucoma

Question 4

what is the pathophysiology of glaucoma?

Answer 4

degeneration of retinal ganglion cells due to increased IOP

Question 5

what is the most common type of glaucoma in Europeans or Africans?

Answer 5

open angle glaucoma

Question 6

what is the most common type of glaucoma in asians?

Answer 6

closed angle glaucoma

Question 7

why is measuring IOP not a good method to test for open angle glaucoma?

Answer 7

some patients may be normal IOP but still have damage to optic nerve

Question 8

clinical presentation that is asymptomatic with possible peripheral vision loss that is not normally noticed

Answer 8

open angle glaucoma

Question 9

how long can central vision loss take to occur in patients with open angle glaucoma?

Answer 9

25 years

Question 10

what 3 types of physical exams should I do for a patient with suspected open angle glaucoma?

Answer 10

1. fundoscopic exam
2. visual field test
3. IOP

Question 11

what would be seen in a fundoscopic exam of a patient with open angle glaucoma?

Answer 11

increased cup-to-disc ratio

Question 12

what is the first line treatment for open angle glaucoma?

Answer 12

topical prostaglandins

Question 13

how do topical prostaglandins treat open angle glaucoma?

Answer 13

increases aqueous outflow

Question 14

how do beta blockers treat open angle glaucoma?

Answer 14

decrease aqueous production

Question 15

what are 2 other possible treatments for open angle glaucoma?

Answer 15

1. laser therapy
2. surgery

Question 16

what are 2 topical prostaglandins that can increase aqueous humor outflow?

Answer 16

1. lantanoprost
2. bimatoprost

Question 17

closure of the anterior chamber angle, leading to decreased drainage of the aqueous humor, causing increased IOP and optic nerve damage

Answer 17

acute closed angle glaucoma

Question 18

what is the pathophysiology of acute closed angle glaucoma?

Answer 18

iris gets lifted and aqueous humor cannot move from posterior chamber to anterior chamber

Question 19

a patient with what condition is at higher risk of acute closed angle glaucoma?

Answer 19

hyperopia/farsightedness

Question 20

clinical presentation of quick increase in IOP of one eye, halos around eyes, severe pain, n/v, conjunctival redness, corneal edema/cloudiness, shallow anterior chamber, and mid-dilated pupil is consistent with which eye condition?

Answer 20

acute closed angle glaucoma

Question 21

what should I do for a patient with acute closed angle glaucoma?

Answer 21

referral

Question 22

what is the gold standard that an ophthalmologist would use for a patient with suspected acute closed angle glaucoma to view the angle?

Answer 22

gonioscopy

Question 23

if a patient with acute closed angle glaucoma cannot see a specialist within 1 hour, what should I do?

Answer 23

reduce IOP with topical, oral or IV medication

Question 24

what is the treatment of choice for a patient with acute closed angle glaucoma?

Answer 24

laser peripheral iridotomy

Question 25

what treatment for acute closed angle glaucoma creates a tiny hole in the peripheral iris, where aqueous humor can flow to angle?

Answer 25

laser peripheral iridotomy