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Year 3 Exam 2 > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

What is glaucoma? (Definition)

A

An irreversible, progressive disease of the optic nerve associated with characteristic optic nerve head changes and visual field defects, which untreated results in tunnel vision and eventual blindness.

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2
Q

What is the optic nerve?

A

The nerve that connects the eye to the brain.

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3
Q

What is the optic nerve head?

A

It’s where the optic nerve exits the eye via the lamina cribrosa.

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4
Q

What effect does glaucoma have on the optic nerve?

A

Optic nerve cupping.

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5
Q

What are the ‘normal’ intraocular pressure values?

A

Mean= 16mmHg
SD= 2.5mmHg
Range= 11-21mmHg

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6
Q

What is Acute Angle Closure (AAC)

A

Sudden, dramatic onset of irido-corneal angle closure (emergency).

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7
Q

What is Irido-corneal angle occlusion?

A

The drainage of fluid from the eye is blocked due to the closing of the angles in the eye. This results in an increase in intraocular pressure.

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8
Q

What are the symptoms of Acute Angle Closure (AAC)?

A
  • Painful, red eye
  • Blurred vision/ haloes
  • Nausea/ vomiting
  • Mid- dilated pupil
  • Cloudy cornea
  • Elevated intraocular pressure
  • Closed angle at gonioscopy
  • Glaukomflecken
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9
Q

What topical drugs can cause Drug-induced angle closure (DAC)?

A

Tropicamide, cyclopentolate, phenylephrine, atropine

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10
Q

What nebulised drugs can cause Drug-induced angle closure (DAC)?

A

Ipratropium bromide, salbutamol, ephedrine

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11
Q

What oral or IV drugs can cause Drug-induced angle closure (DAC)?

A

Tricyclic antidepressants, SSRI’s, epinephrine, anticholinergics, atropine

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12
Q

What is POAG?

A

Primary Open Angle Glaucoma

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13
Q

What are the risk factors of POAG?

A
  • High intraocular pressure
  • Age
  • Family history
  • Myopia (short sighted)
  • Genetics (shape of optic nerve head, vascular structure)
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14
Q

How can intraocular pressure be reduced?

A
  • Drugs (eye drops, topical)
  • Laser
  • Surgery
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15
Q

Mode of action of eye drops that decrease intraocular pressure?

A
  • Reduced production of aqueous humour
  • Increased outflow of aqueous humour
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16
Q

Mode of action of prostaglandin analogues in POAG?

A

They increase aqueous outflow via the uveoscleral pathway.

17
Q

Common side effects of prostaglandin analogues?

A
  • Lash growth
  • Iris pigmentation
  • Periocular skin darkening
  • Conjunctival injection (bloodshot eyes, foreign body sensation, ocular irritation)
18
Q

Examples of prostaglandin analogues:

A
  • Latanoprost 0.005%
  • Travoprost 0.004%
  • Bimatoprost 0.01%
  • Tafluprost 0.0015%
19
Q

Mode of action of beta blockers in POAG?

A

They inhibit the stimulation of beta2 receptors which reduces aqueous humour production.

20
Q

Ocular side effects of beta blockers?

A
  • Stinging
  • Dry eye
  • Itching
  • Pain
  • Erythema
  • Corneal disorders
21
Q

Examples of beta blockers used in POAG?

A
  • Timolol 0.1%, 0.25% or 0.5%
  • Levobunolol 0.5%
  • Betaxolol 0.25% or 0.5%
22
Q

Is timolol selective or non selective?

A

Non selective

23
Q

Is levobunolol selective or non selective?

A

Non selective

24
Q

Is betaxolol selective or non selective?

A

Selective (cardio)

25
Q

Examples of alpha agonists used in POAG?

A
  • Brimonidine 0.2%
  • Apraclonidine 0.5% or 1%
26
Q

Mode of action of carbonic anhydrase inhibitors in POAG?

A

They stimulate alpha2 receptors which reduces the production of aqueous humour.

27
Q

Examples of carbonic anhydrase inhibitors used in POAG?

A
  • Dorzolamide 2%
  • Brinzolaminde 10mg/ml
28
Q

Method of action of ocular alpha agonists?

A

They increase uveoscleral outflow and decrease production of aqueous humour.

29
Q

What effect does stimulation of beta2 receptors have on aqueous humour production?

A

Aqueous humour production is under autonomic (sympathetic) control so this increases aqueous humour production.

30
Q

What effect does stimulation of alpha2 receptors have on aqueous humour production?

A

Aqueous humour production is under autonomic (sympathetic) control so this decreases aqueous humour production.

31
Q

Mode of action of muscarinic agonists in POAG?

A
  • Constriction of the pupil
  • Contraction of the ciliary muscle
  • Facilitation of drainage via the Canal of Schlemm
32
Q

Is aqueous outflow inhibited by dilation or constriction of the pupil?

A

Dilation

33
Q

Is aqueous outflow facilitated by relaxation or contraction of the ciliary muscle?

A

Contraction

34
Q
A

Year 3 Exam 2 (19 decks)

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