Glaucoma

Question 1

Glaucoma defined as

Answer 1

irreversible progressive disease of the optic nerve

Question 2

what % of the population will have glaucoma

Answer 2

1%

Question 3

1 known modifiable risk factor for glaucoma

Answer 3

elevated IOP

Question 4

where is aqeuous formed?

Answer 4

in ciliary body

drains through trabecular meshwork

Question 5

The distribution of IOP is not gaussian –?

Answer 5

skewed towards right - more people wit higher pressures

Question 6

not everyone with a pressure >21 has glaucoma - they are instead called

Answer 6

ocular hypertensives

Question 7

to diagnose glaucoma do you need an elevated IOP

Answer 7

no - not necessary not sufficient

Question 8

If a sibling or parent has open angle glaucoma - your risk is

Answer 8

2-3x higher

Question 9

3 mechanisms for possible axonal loss of retinal ganglion cellls

Answer 9

1- mechanical injury
2- vascular injurt
3- excitotoxicity

Question 10

Normal pressure does not

Answer 10

RULE out glaucoma

Question 11

What is the cup to disc ratio in normal non-edematous nerve

Answer 11

<0.6

Question 12

Significant optic nerve sign

Answer 12

notching/thinning of rim -

Question 13

classic visual field defect in glaucoma

Answer 13

• arcuate defect
• paracentral defect
• nasal septal defect
• constricted field

Question 14

acute angle closure glaucoma signs/symptoms

Answer 14

nausea/loss of vision

• head pain
• acute rise in IOP >60

Question 15

Slit lamp findings in angle closure

Answer 15

• cornea cloudy
• angle closed
• cataract - frequently coexistent

Question 16

To test for glaucoma 2 main things needed

Answer 16

1) test visual fields

2) check optic nerve

Question 17

additional signs of angle closure glaucoma symptoms!

Answer 17

halos/rainbows around lights
blurred
red
dilated pupil
pain head/nausea/vomiting

Question 18

Angle closure glaucoma happens when

Answer 18

you have high pressure, causing optic disc damage and visual field loss

Question 19

Open angle patients compared with closed angle tend to be

Answer 19

Myopic vs Hyperopia in angle closure

Question 20

Prevalence of open angle highest in

Answer 20

african american

Question 21

prevalence of angle closure is highest in

Answer 21

Inuit and chinese

Question 22

Which glaucoma is an opthalmological emergency

Answer 22

angle closure

Question 23

Meds used in treatment of acute ACG

Answer 23

• give Beta blocker
  alpha agonist
  carbonic anhydrase inhibitors
  Pilocarpine

Question 24

precipitating factors that may lead to AACG

Answer 24

• Emotional stress
• Drugs that dilate pupil
• common cold/allergy meds
• Dim light

Question 25

how do you treat glaucom

Answer 25

• reduce production

increase outflow

Question 26

Chronic treatment examples for glaucoma therap

Answer 26

1- Prostaglandins
2- beta blocker
3- alpha agonist
4- carbonic anhydrase inhib

Question 27

Angle closure treatment

Answer 27

parasympathomimetic

Question 28

Emergency lowering of IOP

Answer 28

hyperosmotic