Glaucoma Flashcards

1
Q

def. of glaucoma

A

irreversible and pregressive disease of the optic nerve , char. by optic disc cupping and visual field changes

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2
Q

why important

A

leading cause of irreversible blindness in the world

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3
Q

what is glaucoma

A

not a single diasease, but number of diff. with factors in common

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4
Q

only way to reduce chances of blindness from glaucoma

A

early diagnosis and treatment

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5
Q

6 risk factors for glaucoma

A
  1. # 1 is high IOP
  2. age
  3. fam Hx
  4. black
  5. diabetes
  6. shortsighted
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6
Q

what is IOP

A

balance of production and drainage of fluid

- usually under 21

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7
Q

what is fluid flow

A

made in ciliary body>around lens to ant. chamber> out through trabecular mesh to canal of schlem

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8
Q

what is relat. b/w glaucoma and IOP

A

higher IOP is higher risk, but not necc.

- IOP is neither suff. or necc. for glaucoma

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9
Q

what genetic risk

A

involved, but probably multifactorial

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10
Q

what is patho correlate of glaucoma

A

slow death of retinal ganglion cells and their axons which form the optic nerve

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11
Q

3 proposed mechs.

A
  1. mech injury
  2. vacular injury
  3. exitotoxicity
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12
Q

5 important parts of Hx

A
  1. fam Hx
  2. ethnic backgroud
  3. prior eye problems
  4. meds
  5. general health
  6. alergies
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13
Q

what is main Sx of glaucoma

A

none- often by the time it’s noticed, the damage is done

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14
Q

5 key parts of exam to find glaucoma

A
  1. vision
  2. IOP
  3. anterior chamber angle measurement
  4. optic nerve head exam
  5. visual field exam
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15
Q

what is tested on vision

A

central distance vision, not reasding

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16
Q

6 things to look for in the slit lamp

A
  • cataracts
  • prior surgery
  • inflammation
  • excess piment
  • trauma
  • peudo efoliation
17
Q

how to look at the angle

A

gondioscopy - allows us to see open and closed

18
Q

3 parts of fundus exam

A
  1. optic nerve damage
    ‘2. macular degen
  2. other retinal problems
19
Q

2 things to look for at the optic nerve

A
  1. structure of the nerve for signs of damage

2. cup to disc ration (should be under 0.6)

20
Q

6 types of optic nerve changes we might see

A
  1. cupping
  2. disc assymetry
  3. notching
  4. excavation
  5. disc hemmorage
  6. nerve fiber layer defect
21
Q

what is important about visuak field examination

A

change over time is the critical factor

22
Q

4 typical visual field defects in glaucom

A
  1. arcuate
  2. paracentral
  3. nasal step
  4. constricted field
23
Q

what is target in treatment

A

maintain a presdetermined level of pressure

24
Q

3 things monitored in follow-up

A
  1. stability if the optins nerve
  2. visual field
  3. pressure
25
prognosis of acute angle closure
good with rapid treatment, but not if take too long
26
Sx of AAC glaucoma`
1. halos and rrainbows around eye are most common - NV - red eye - blurred central vision
27
signs of AAc
- v. high pressure - conjuntival injection - cloudy cornea - shallow anterior chamber
28
mech if AAC
iris become opposed to the trabecular meshwork preventing aquous outflow
29
AAC risk factors
- hyperopia - age - F>M - familiy - chinese and inuit
30
what does penlight exam show
done on side and shows shadow on the nasal side because of swelling
31
acute MGMT of AAC
emergency - instil anti-glaucoma meds - instil miotic - IV if necc
32
3 classes of treatment for AAC
meds - acutely laser - ASAP srug - only if necc
33
what is definitie mgmt of glausome
punch a hole in the eye with a laser
34
3 precipitating factors for attacke
1. dim illumination 2. stress 3. druga - esp thoe that dilate pupil
35
5 classes of glaucoma meds
1. prostaglandin agonists 2. B-blockers 3. carbonic anhydrase inhibs 4. a-agonists 5. parasympathomimietics AAC 6. hyperosmotics - acute
36
what is gold standard meds
B-blocker - but has same SE as other B blockers
37
mech of carbonic anhydrase inhibs
decrease aqueus production
38
what is laser therapy
laser aimed at trabecular meshwork and the healing causes drainage - don't know why