Glaucoma Flashcards

1
Q

normal IOP

A

13-21 mmHg

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2
Q

high IOP

A

> 21 mmHg

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3
Q

NT glaucoma is characterized by

A

+ glaucomatous changes
normal IOP

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4
Q

glaucoma is characterized by

A

+ glaucomatous changes
elevated IOP

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5
Q

ocular HTN is characterized by

A
  • glaucomatous changes
    elevated IOP
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6
Q

risk factors for glaucoma

A

-high iop
-age
-FH
-race/ethnicity
-inc. cup to disc ration
-thin central cornea thickness
-ocular perfusion pressure
-T2DM
-myopia

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7
Q

who needs to be treated for glaucoma

A

all with elevated IOP AND confirmed disc changes/field defects

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8
Q

what is the treatment goal for IOP

A

lower IOP 25% or more below pretreatment levels

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9
Q

1st line options for glaucoma (2)

A

prostaglandin analogs > beta blockers

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10
Q

2nd line for glaucoma

A

brimonidine (combo w/ timolol) > dorzolamide (combo w/ timolol) > solo CAIs > netarsudil/omidenepeg

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11
Q

examples of prostaglandin analogs

A

bimatoprost
latanoprost
lanatnoprostene bunod
tafluprost
travoprost
unoprostone

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12
Q

side effects of PG analogs

A

conjunctival hyperemia, hypertrichosis, iris pigmentation changes
systemic- infection, headache

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13
Q

contraindications to PG analogs

A

existing ocular inflammation (keratitis, iritis, uveitis, macular edema)

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14
Q

which PG analogs (2) have highest efficacy?
which has least AEs?

A

high eff- bimatoprost, latanoprostene bunod
least AE- omidenepeg

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15
Q

examples of beta blockers

A

betaxolol
carteolol
levobunolol
metipranolol
timolol

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16
Q

side effects of beta blockers

A

local irritation, tachyphylaxis
systemic- cardiac, pulmonary, CNS

17
Q

contraindications to beta blockers

A

sinus bradycardia, heart block, heart failure, pulmonary

18
Q

example of alpha agonist

A

brimonidine

19
Q

side effects of brimonidine

A

conjunctival hyperemia, irritation, allergic reactions, tachyphylaxis
systemic- drowsiness, xerostomia

20
Q

what is available in combo with brimonidine?

A

timolol

21
Q

examples of carbonic anhydrase inhibitors

A

brinzolamide & dorzolamide (topical)
acetazolamide & methazolamide (PO)

22
Q

what is available in combination with dorzolamide?

A

timolol

23
Q

when to treat ocular HTN

A

those with OH AND risk factors such as ethnicity, FH, thin central cornea, large cup to disc, and IOP >25 mmHg

24
Q

when to treat normal tension glaucoma

A

those with NTG AND documented progression of visual field loss

25
Q

wild iop fluctuations, rapid vision damage, unilateral, signaled by prodrome

A

infrequent AACC (angle closure)

26
Q

risk factors for angle closure

A

shallow anterior chamber depth (eastern Asian), FH, hyperopia, age

27
Q

drugs to lower IOP for AACC
initial treatment

A

IV or PO CAI (acetazolamide)
topical beta blocker
topical alpha agonist (apraclonidine)

28
Q

agent used in initial treatment for AACC to fix the angle

A

topical pilocarpine

29
Q

side effects of pilocarpine

A

spasms, headache, brow ache, lid twitch

30
Q

secondary agents given PRN for AACC for additional IOP lowering if initial agents have no effect on IOP after 1 hour

A

hyperosmotics (PO glycerin or isosorbide, IV mannitol)

31
Q

chronic PACG treatment

A

same as PAOG