Glaucoma

Question 1

What is glaucoma?

Answer 1

Glaucoma is optic disk atrophy with characteristic cupping. Cupping is thinning of the outer rim of the optic nerve.

Question 2

What are some exam findings of glaucoma?

Answer 2

Glaucoma usually presents with increased intraocular pressure (IOP) and progressive peripheral visual field loss if untreated.

Question 3

What are options for treating glaucoma?

Answer 3

1. pharmacologic

2. surgical

Question 4

What is primary closed angle glaucoma?

Answer 4

Primary open angle glaucoma is due to enlargement or forward movement of the lens against the central iris (pupil margin) leading to obstruction of normal aqueous outflow through the pupil. Fluid will then build up behind the iris, pushing the peripheral iris against the cornea and impeding flow through the trabecular meshwork.

Question 5

What is secondary closed angle glaucoma?

Answer 5

Secondary open angle glaucoma results from hypoxia inducing vasoproliferation in the iris that contracts the angle. The hypoxia is typically due to retinal disease from diabetes mellitus or vein occlusion.

Question 6

What is chronic closed angle glaucoma?

Answer 6

Chronic closed angle glaucoma is often asymptomatic with damage to the optic nerve and peripheral vision.

Question 7

What is acute angle closure glaucoma?

Answer 7

This is a true ophthalmologic emergency. Increased intraocular pressure pushes the iris forward resulting in abrupt angle closure.

Question 8

What are signs of acute angle glaucoma closure?

Answer 8

1. very painful, red eye
2. Sudden loss of vision
3. Halos around lights
4. Rock hard eye
5. frontal headache

Question 9

What do you not give during acute angle closure glaucoma?

Answer 9

Do not give epinephrine because of its mydriatic effects furthering closing the angle.

Question 10

What is primary open angle glaucoma?

Answer 10

Primary open angle glaucoma does not have a clear cause.

Question 11

What is secondary open angle glaucoma?

Answer 11

Secondary open angle glaucoma is due to blocked trabcular meshwork from WBCs (uveitis), RBCs (vitreous hemorrhage) or retinal elements (retinal detachment).

Question 12

What is open angle glaucoma associated with?

Answer 12

1. increasing age
2. frican American race
3. family history

Question 13

What are symptoms of open angle glaucoma?

Answer 13

Open angle glaucoma is often painless. It is more common than closed angle glaucoma in the USA.