glaucoma

Question 1

What is glaucoma?

Answer 1

progressive degeneration of optic nerve

Question 2

Why is glaucoma often asymptomatic?

Answer 2

don’t know you have until vision changes which are irreversible

Question 3

How to detect glaucoma early?

Answer 3

eye exams

Question 4

What does the trabecular network do in the eye?

Answer 4

drains fluid

Question 5

What is secondary glaucoma?

Answer 5

result from injury or infection

Question 6

What is normal pressure glaucoma?

Answer 6

optic nerve damaged despite normal pressure
MAYBE
due to low blood supply or sensitive nerve

Question 7

What causes primary open angled glaucoma?

Answer 7

too much production or low drainage

Question 8

Risk factors for glaucoma?

Answer 8

age, family, HTN, DM, migraines, CS

Question 9

What to do if suspect angle closure glaucoma?

Answer 9

ER- laser surgery

Question 10

What causes angle closure glaucoma?

Answer 10

iris swells and blocks drainage

Question 11

What sx make you think angle closure?

Answer 11

severe pain, eye red, blurred vision, NV, H/A

Question 12

What drug puts you at risk of angle closure?

Answer 12

topiramate

Question 13

What medications can angle closure glaucoma NOT take? is this the same for open?

Answer 13

anticholinergic
ONLY closed

Question 14

1st line for glaucoma?

Answer 14

prostaglandin analogues and beta blockers

Question 15

What are the prostaglandin analogues?

Answer 15

‘oprosts’

Question 16

How does latanoprost work?

Answer 16

increase outflow

Question 17

What is the most effective agent for glaucoma?

Answer 17

prostaglandin analogues

Question 18

If latanoprost doesn’t work what is next step?

Answer 18

try a different one in that class

Question 19

s/e of prostaglandin analogues?

Answer 19

thicker eyelashes, iris darkening, red eyes

Question 20

Is iris darkening reversible?

Answer 20

MAYBE NO

Question 21

What beta blockers are used?

Answer 21

betaxolol, timolol, levobunolol

Question 22

How do bet blockers work?

Answer 22

less productionq

Question 23

Who should avoid beta blockers?

Answer 23

severe asthma/COPD

Question 24

If a patient has COPD but needs a beta blocker what do we do?

Answer 24

betaxolol is cardio selective

Question 25

What is the alpha 2 agonist used and how does it work?

Answer 25

brimonidine lowers production and increases outflow

Question 26

What s/e are at higher risk with brimonidine?

Answer 26

red eyes and ocular allergy

Question 27

What are the carbonic anhydrase inhibitor and how do they work?

Answer 27

dorzolamide and brinzolomide lowers production

Question 28

When would we use dorzolamide?

Answer 28

if intolerant of beta blockers

Question 29

What is the topical cholinergic agent?

Answer 29

pilocarpine

Question 30

How does pilocarpine work?

Answer 30

more outlfow

Question 31

Why isn't pilocarpine used much?

Answer 31

s/e of bad night vision, nearsighted, ciliary spasm (PAIN), retinal detach

Question 32

How to administer eye drops?

Answer 32

keep eyes closed for 1-3 minutes to lower systemic absorb, wait 5 min between different drops, wait 15 min before putting on lenses

Question 33

What is the agent in most eye drops that causes irritation?

Answer 33

benzalkonium

Question 34

What agents may have different preservatives in them?

Answer 34

travaprost and brimonidine