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MS 2 > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

is a group of eye conditions characterized by progressive damage of the optic nerve

A

Glaucoma

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2
Q

Second leading cause of blindness worldwide

A

Glaucoma

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3
Q

What causes glaucoma?

A

Mainly caused by persistent elevation of intraocular pressure (IOP)

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4
Q

What’s the normal IOP?

A

10-21 mmHg

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5
Q

What’s the diagnostic test for Glaucoma?

A

Tonometry

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6
Q

It is a diagnostic test that provides IOP by measuring the pressure needed to flatten the cornea

A

Tonometry

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7
Q

Precautions during tonometry

A

-Anesthetic eyedrops are instilled prior to procedure
- Patient should not hold breath during procedure as this may overestimate IOP

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8
Q

What are the Risk Factors of Glaucoma?

A

-African American Race
- Cardiovascular Disease
- Diabetes
- Family History of Glaucoma
- Migraine syndromes
- Nearsightedness (myopia)
- Older Age
- Previous eye trauma
- Prolonged use of topical or systemic corticosteroids
- Thin cornea

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9
Q

-Nutrient-filled fluid produces in the posterior chamber and drains in the anterior chamber
- Its volume directly influences the IOP

A

Aqueous Humor

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10
Q

-Mainly Water
- Maintains the shape of the eye

A

Vitreous Humor

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11
Q

Factors affecting AH drainage

A

-Angle created by the iris and cornea
- Integrity of the drainage system

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12
Q

The process of the normal pathway from production to drainage of aqueous humor

A

-Ciliary body produces AH
- AH passes through the pupil into the anterior chamber
- AH drains through the trabecular meshwork into Canal of Schlemm

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13
Q

What maintains a normal IOP?

A

An equal input to output volume of Aqueous Humor maintains a normal IOP.

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14
Q

Anterior Chamber Angle of Primary Open-Angle Glaucoma (POAG)

A

Open

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15
Q

Drainage System of Primary Open-Angle Glaucoma (POAG)

A

Obstructed

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16
Q

Onset of Primary Open-Angle Glaucoma (POAG)

A

Slow- onset beginning with one eye then may progress to the other if left untreated

17
Q

Clinical Manifestations of Primary Open- Angle Glaucoma (POAG)

A

-Persistent dull eye pain in AM
- Tunnel Vision (Loss of peripheral vision)

18
Q

Anterior Chamber Angle of Primary Closed-Angle Glaucoma (PCAG)

A

Closed/Narrowed

19
Q

Drainage System of Primary Closed-Angle Glaucoma (PCAG)

A

Intact

20
Q

Onset of Primary Closed- Angle Glaucoma (PCAG)

A

Rapid-Onset

21
Q

Clinical Manifestations of Primary Closed-Angle Glaucoma

A

-Severe, rapid-onset eye pain
- Halos around lights (Presence of bright circles around light source)
- Blurred Vision
- Nausea/Vomiting

22
Q

Medical Management of Primary Open-Angle Glaucoma (POAG)

A

Topical Medications (Eye Drops) – lowers IOP by increasing outflow of AH or decreasing production of AH

23
Q

Timolol Drug

A

-First line drug of (POAG)
-Beta Blocker
- Action: Decrease AH production
- Side Effects: Hypotension, Bradycardia, Fatigue

24
Q

Acetazolamide

A

-Carbonic Anhydrase Inhibitor
- Action: Decrease AH production
- Side Effects: Stinging/burning sensation in eyes

25
Q

Pilocarpine

A

-Third Line
- Cholinergic Agent (Miotics)
Action: Increases draining of intraocular fluid through trabecular meshwork
-Side Effects: Difficulty seeing at night or in the dark pupil constriction

26
Q

What are the drugs for Primary Open-Angle Glaucoma (POAG)

A

-Timolol
- Acetazolamide
- Pilocarpine

27
Q

What’s the Emergency Medical Management of Primary Closed-Angle Glaucoma?

A

-Supine Position
- Acetazolamide IV/PO then Timolol eye drops
- Analgesics for pain and topical steroids to reduce inflammation
- Anti-emetics if with nausea/vomiting

28
Q

Rationale of Supine Position in Emergency Medical Management

A

-improves lens position thereby removing pupil block

29
Q

Rational to Administer Acetazolamide IV/PO then timolol eye drops

A

To lower IOP

30
Q

After 1 hour of implementing emergency medical management

A

-Pilocarpine 2% or 4% - 2 doses spaced 15 minutes apart
-Mannitol IV or Glycerol IV if IOP is still elevated after 2nd dose of pilocarpine

31
Q

Surgical Management of Primary Open-Angle Glaucoma

A

Laser Trabeculoplasty

32
Q

Uses laser beam directed at the trabecular meshwork to alter its pores resulting to an increase in AH outflow

A

Laser Trabeculoplasty

33
Q

Surgical Management of Primary Closed-Angle Glaucoma (PCAG)

A

-Laser Iridotomy
-Treatment of choice

-Surgical Iridectomy
-Alternative to laser iridotomy when cornea is extremely cloudy, or iris is too thick

34
Q

Creation of an opening in the iris using a laser beam. The opening serves as passageway for the trapped AH in the posterior chamber

A

Laser Iridotomy

35
Q

What to avoid in Glaucoma?

A

Atropine Sulfate
Bendryl
Cogentin

36
Q

Rationale of Avoiding ABCs in Glaucoma

A

Promotes pupillary dilatation bringing the iris closer to the angle of outflow of aqueous humor

MS 2 (27 decks)

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