Glaucoma Flashcards
Glaucoma defined as
irreversible progressive disease of the optic nerve
what % of the population will have glaucoma
1%
1 known modifiable risk factor for glaucoma
elevated IOP
where is aqeuous formed?
in ciliary body
drains through trabecular meshwork
The distribution of IOP is not gaussian –?
skewed towards right - more people wit higher pressures
not everyone with a pressure >21 has glaucoma - they are instead called
ocular hypertensives
to diagnose glaucoma do you need an elevated IOP
no - not necessary not sufficient
If a sibling or parent has open angle glaucoma - your risk is
2-3x higher
3 mechanisms for possible axonal loss of retinal ganglion cellls
1- mechanical injury
2- vascular injurt
3- excitotoxicity
Normal pressure does not
RULE out glaucoma
What is the cup to disc ratio in normal non-edematous nerve
<0.6
Significant optic nerve sign
notching/thinning of rim -
classic visual field defect in glaucoma
- arcuate defect
- paracentral defect
- nasal septal defect
- constricted field
acute angle closure glaucoma signs/symptoms
nausea/loss of vision
- head pain
- acute rise in IOP >60
Slit lamp findings in angle closure
- cornea cloudy
- angle closed
- cataract - frequently coexistent
To test for glaucoma 2 main things needed
1) test visual fields
2) check optic nerve
additional signs of angle closure glaucoma symptoms!
halos/rainbows around lights blurred red dilated pupil pain head/nausea/vomiting
Angle closure glaucoma happens when
you have high pressure, causing optic disc damage and visual field loss
Open angle patients compared with closed angle tend to be
Myopic vs Hyperopia in angle closure
Prevalence of open angle highest in
african american
prevalence of angle closure is highest in
Inuit and chinese
Which glaucoma is an opthalmological emergency
angle closure
Meds used in treatment of acute ACG
- give Beta blocker
alpha agonist
carbonic anhydrase inhibitors
Pilocarpine
precipitating factors that may lead to AACG
- Emotional stress
- Drugs that dilate pupil
- common cold/allergy meds
- Dim light
how do you treat glaucom
- reduce production
increase outflow
Chronic treatment examples for glaucoma therap
1- Prostaglandins
2- beta blocker
3- alpha agonist
4- carbonic anhydrase inhib
Angle closure treatment
parasympathomimetic
Emergency lowering of IOP
hyperosmotic
