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Undeleted > Glaucoma > Flashcards

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
Q

prognosis of acute angle closure

A

good with rapid treatment, but not if take too long

26
Q

Sx of AAC glaucoma`

A
  1. halos and rrainbows around eye are most common
    - NV
    - red eye
    - blurred central vision
27
Q

signs of AAc

A
  • v. high pressure
  • conjuntival injection
  • cloudy cornea
  • shallow anterior chamber
28
Q

mech if AAC

A

iris become opposed to the trabecular meshwork preventing aquous outflow

29
Q

AAC risk factors

A
  • hyperopia
  • age
  • F>M
  • familiy
  • chinese and inuit
30
Q

what does penlight exam show

A

done on side and shows shadow on the nasal side because of swelling

31
Q

acute MGMT of AAC

A

emergency

  • instil anti-glaucoma meds
  • instil miotic
  • IV if necc
32
Q

3 classes of treatment for AAC

A

meds - acutely
laser - ASAP
srug - only if necc

33
Q

what is definitie mgmt of glausome

A

punch a hole in the eye with a laser

34
Q

3 precipitating factors for attacke

A
  1. dim illumination
  2. stress
  3. druga
    - esp thoe that dilate pupil
35
Q

5 classes of glaucoma meds

A
  1. prostaglandin agonists
  2. B-blockers
  3. carbonic anhydrase inhibs
  4. a-agonists
  5. parasympathomimietics AAC
  6. hyperosmotics - acute
36
Q

what is gold standard meds

A

B-blocker - but has same SE as other B blockers

37
Q

mech of carbonic anhydrase inhibs

A

decrease aqueus production

38
Q

what is laser therapy

A

laser aimed at trabecular meshwork and the healing causes drainage - don’t know why

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