Glaucoma

Question 1

What are the common examination findings?

Answer 1

1) Symptoms

Acute angle closure:

• Painful red eye and haloes
• Blurring of vision
• Headaches, nausea and vomiting

Primary open angle glaucoma

Asymptomatic until late stages when they get peripheral visual loss

2) Acuity

Acute angle closure

• Reduced

Pimary open angle

• Normal/reduced

3)Cornea

Acute angle closure

• Hazy

Pimary open angle

• Clear

4) Optic Disc

Acute angle closure

• May be difficut to see with hazy cornea

Pimary open angle

• Cupped

Question 2

What are the investigations?

Answer 2

To finish the exam i would like to - Perfrom a full cranial nerve and ENT exam

By the bed - History, obs

Other - Slit lamp and optic disc photography, measure IOP

Question 3

What are the key investigation findings?

Answer 3

WIll show increased IOP

Question 4

What is the treatment?

Answer 4

Conservative - Explain what it is and that it is non reversible of primary. Plan to reduced to pressure to minimise optic nerve damage and progression

Medical - Timolol, lantaprost to increase aquoues drainage or briminodine to stop formation

Surgical - Laser trabecular meshwork, trabeculectomy

ACUTE -

Medical management - topical B blockers, adrenergic agonosits and pilocarpine

Then surgical - iridotomy

Question 5

What are the risk factors?

Answer 5

Primary -

FH

Caucasion

Acute -

Iris dilators

Tricyclics