Glaucoma

Question 1

What is the main characterization of glaucoma?

Answer 1

(Elevation of intraocular pressure incompatible with ocular health)

Question 2

What are possible causes for secondary glaucoma?

Answer 2

(Lens luxation, uveitis, hyphema, intraocular neoplasia, melanocytic glaucoma of cairn terriers, pigmentary uveitis of golden retrievers, pseudophakia/aphakia, and trauma)

Question 3

What is a unique to cats cause of glaucoma?

Answer 3

(Aqueous humor misdirection → aqueous fluid goes behind the lens instead of in front of it and pushes the lens + iris forward, will see decreased space between the cornea and lens)

Question 4

What is the most common cause of secondary glaucoma in cats?

Answer 4

(Uveitis, otherwise the list is similar to dogs for other causes)

Question 5

What are acute clinical signs of glaucoma?

Answer 5

(Blepharospasm, corneal edema, episcleral injection, dilated pupil, and variable vision)

Question 6

What are chronic clinical signs of glaucoma?

Answer 6

(All acute signs, buphthalmos, haab’s striae, lens subluxation, and cupped optic nerve)

Question 7

What is the primary means of diagnosing glaucoma and assessing efficacy of glaucoma therapy?

Answer 7

(Tonometry)

Question 8

What are the goals of glaucoma therapy?

Answer 8

(Maintenance of vision where possible, patient comfort in all cases, and prophylaxis in “at risk” eyes)

Question 9

When are prostaglandin analogues contraindicated in glaucoma cases?

Answer 9

(Anterior chamber lens subluxations → will close the pupil behind the lens)

Question 10

(T/F) Topical carbonic anhydrase inhibitors can be used in all species, have no contraindications, and though they may cause local irritation they do not cause systemic side effects.

Answer 10

(T)

Question 11

Miotics should be avoided in glaucoma secondary to what two diseases?

Answer 11

(Anterior lens luxation and uveitis)

Question 12

Give the drug class for the following drug(s):

Latanoprost/travoprost/bimatoprost

Answer 12

(Prostaglandin analogues)

Question 13

Give the drug class for the following drug(s):

IV mannitol

Answer 13

(Systemic hyperosmotic medication)

Question 14

Give the drug class for the following drug(s):

Oral glycerin

Answer 14

(Systemic hyperosmotic medication)

Question 15

Give the drug class for the following drug(s):

Dorzolamide/brinzolamide

Answer 15

(Carbonic anhydrase inhibitors)

Question 16

Give the drug class for the following drug(s):

Demecarium bromide

Answer 16

(Miotic)

Question 17

Give the drug class for the following drug(s):

Pilocarpine

Answer 17

(Miotic)

Question 18

Give the drug class for the following drug(s):

Timolol maleate/betaxolol

Answer 18

(Beta blockers)

Question 19

Give the drug class for the following drug(s):

Dorzolamide-timolol

Answer 19

(CAI and beta blocker combo)

Question 20

(T/F) It is okay and sufficient for a patient who had severe glaucoma (IOP was 60) to be hovering around an IOP of 22-24 mmHg.

Answer 20

(F, high normal IOP is undesirable in a glaucoma patient)

Question 21

(T/F) Medical prophylaxis significantly delays onset of primary glaucoma in the second eye.

Answer 21

(T)

Question 22

What type of maintenance medication for glaucoma is especially beneficial for prophylaxis in the other eye?

Answer 22

(Miotics)

Question 23

What are the two main surgical goals for a glaucoma patient?

Answer 23

(Decrease aqueous production and increase aqueous outflow)

Question 24

How is decreased aqueous production surgically obtained in glaucoma patients?

Answer 24

(Cyclodestructive procedures → cyclophotocoagulation or cyclocryotherapy)

Question 25

How is increased aqueous outflow surgically obtained in glaucoma patients?

Answer 25

(Aqueous shunts/gonioimplants)

Question 26

What are the salvage procedure options for an end stage glaucoma patient?

Answer 26

(Enucleation, evisceration/intrascleral prosthesis, and chemical ciliary body ablation)

Question 27

What medication is injected into the ciliary body in chemical ciliary body ablation procedures in a glaucoma patient?

Answer 27

(Gentamicin +/- steroid, used in blind eyes only, outcome is unpredictable)