glaucoma Flashcards
What is glaucoma?
progressive degeneration of optic nerve
Why is glaucoma often asymptomatic?
don’t know you have until vision changes which are irreversible
How to detect glaucoma early?
eye exams
What does the trabecular network do in the eye?
drains fluid
What is secondary glaucoma?
result from injury or infection
What is normal pressure glaucoma?
optic nerve damaged despite normal pressure
MAYBE
due to low blood supply or sensitive nerve
What causes primary open angled glaucoma?
too much production or low drainage
Risk factors for glaucoma?
age, family, HTN, DM, migraines, CS
What to do if suspect angle closure glaucoma?
ER- laser surgery
What causes angle closure glaucoma?
iris swells and blocks drainage
What sx make you think angle closure?
severe pain, eye red, blurred vision, NV, H/A
What drug puts you at risk of angle closure?
topiramate
What medications can angle closure glaucoma NOT take? is this the same for open?
anticholinergic
ONLY closed
1st line for glaucoma?
prostaglandin analogues and beta blockers
What are the prostaglandin analogues?
‘oprosts’
How does latanoprost work?
increase outflow
What is the most effective agent for glaucoma?
prostaglandin analogues
If latanoprost doesn’t work what is next step?
try a different one in that class
s/e of prostaglandin analogues?
thicker eyelashes, iris darkening, red eyes
Is iris darkening reversible?
MAYBE NO
What beta blockers are used?
betaxolol, timolol, levobunolol
How do bet blockers work?
less productionq
Who should avoid beta blockers?
severe asthma/COPD
If a patient has COPD but needs a beta blocker what do we do?
betaxolol is cardio selective
What is the alpha 2 agonist used and how does it work?
brimonidine
lowers production and increases outflow
What s/e are at higher risk with brimonidine?
red eyes and ocular allergy
What are the carbonic anhydrase inhibitor and how do they work?
dorzolamide and brinzolomide
lowers production
When would we use dorzolamide?
if intolerant of beta blockers
What is the topical cholinergic agent?
pilocarpine
How does pilocarpine work?
more outlfow
Why isn’t pilocarpine used much?
s/e of bad night vision, nearsighted, ciliary spasm (PAIN), retinal detach
How to administer eye drops?
keep eyes closed for 1-3 minutes to lower systemic absorb, wait 5 min between different drops, wait 15 min before putting on lenses
What is the agent in most eye drops that causes irritation?
benzalkonium
What agents may have different preservatives in them?
travaprost and brimonidine
