Glaucoma

Question 1

The apposition of iris to the trabecular meshwork, which results in increased intraocular pressure:

Answer 1

Angle-Closure Glaucoma

Question 2

Suddenly symptoms of blurred vision, seeing haloes around lights, red eye, pain, headache, nausea and vomiting:

Answer 2

Acute Angle-Closure Glaucoma presentation

Question 3

The sudden and severe IOP elevation can quickly damage the optic nerve, resulting in:

Answer 3

Acute Angle-Closure Glaucoma

Question 4

Is a true ophthalmic emergency, and a delay in treatment can result in blindness:

Answer 4

Acute Angle-Closure Glaucoma

Question 5

When the pupil is mid-dilated, the distance between the iris and the lens is the shortest and can come into contact in individuals at risk for angle closure. When this occurs, aqueous humor cannot flow through the pupil into the anterior chamber, pushing the iris against the trabecular meshwork, so the aqueous humor cannot flow out of the eye, increasing IOP:

Answer 5

Pathophysiology

Question 6

The normal IOP is:

Answer 6

10-21mmHg

Question 7

In AACG, the IOP typically exceeds:

Answer 7

40mmHg

Question 8

Pupillary block, Plateau iris, Use of medications, Increased iris thickness, Increased iris volume with dilation, Hyperopia, and Increased lens thickness in phacomorphic angle closure:

Answer 8

Mechanisms that can contribute to primary angle closure

Question 9

AACG is more common in:

Answer 9

+40 years, Women, Asian persons, Persons with hyperopia, +Family history and Who have had AACG in one eye

Question 10

Is a medical emergency that needs to be treated immediately:

Answer 10

AACG

Question 11

Even with immediate treatment, AAC may result in:

Answer 11

Vision loss

Question 12

Haloes and blurry vision result from

Answer 12

Corneal edema

Question 13

The attack may have been precipitated by pupillary dilation, which may result from activities such as:

Answer 13

Movie theater, Taking medications that contain antihistamine or Using dilating eye drops

Question 14

occluded anterior chamber angle in the affected eye and predisposing angle configuration (narrow occludable angle) in the contralateral unaffected eye (ophthalmic exam):

Answer 14

Gonioscopic visualization

Question 15

Tonometry demonstrates:

Answer 15

An elevated IOP

Question 16

Conjunctival injection, Fixed or sluggish and mid-dilated pupil, Shallow anterior chamber, Corneal epithelial edema and Bullae, and Flare (ophthalmic exam):

Answer 16

Slit-lamp exam

Question 17

May reveal a swollen optic disc in an acute attack:

Answer 17

Ophthalmoscopy

Question 18

May reveal a excavation if episodes have been chronic or repetitive:

Answer 18

Ophthalmoscopy

Question 19

Vesicles on the anterior subcapsular lens

Answer 19

Glaucoma flecks

Question 20

the most common cause of AACG:

Answer 20

Pupillary block

Question 21

Persons with susceptible anatomy have a narrow occludable angle, usually of less than:

Answer 21

20°

Question 22

HCTZ, Sulfamethoxazole and Topiramate:

Answer 22

Medications that can cause AACG

Question 23

“Individuals with hyperopia have ______ eyes, with shorter diameter, so the intraocular structures are spaced closer together”:

Answer 23

Smaller

Question 24

“Lens volume _________ with age and can decrease the amount of space in the anterior chamber”:

Answer 24

Increases

Question 25

Ultrasound biomicroscopy and Anterior segment optical coherence tomography:

Answer 25

Imaging studies

Question 26

The definitive treatment of AACG is:

Answer 26

Surgical

Question 27

Lowering the IOP minimizes damage to the:

Answer 27

Optic nerve

Question 28

If the IOP cannot be lowered sufficiently with meds:

Answer 28

Anterior Chamber Paracentesis

Question 29

Are used to help clear up the cornea, to reduce intraocular inflammation and to decrease iris edema:

Answer 29

Mediations for eye pressure and inflammation

Question 30

“In some cases, a _____ agent is used to prevent AAC recurrence”:

Answer 30

Miotic

Question 31

The treatment of choice for pupillary-block:

Answer 31

Laser iridotomy

Question 32

“If the cornea is extremely cloudy or the iris is too thick and an opening cannot be created using laser, _____________________ can be performed”:

Answer 32

Incisional peripheral iridectomy

Question 33

“If the patient has both a narrow occludable angle and a visually significant cataract (blurry vision due to cataract), ____________ is the treatment of choice”

Answer 33

Cataract surgery

Question 34

Meds:

Answer 34

Alpha-adrenergic agonists, Beta-blockers, Miotic agents, Carbonic anhydrase inhibitors and Prostaglandin

Question 35

Brimonidine and Apraclonidine

Answer 35

Alpha-adrenergic agonists

Question 36

Levobunolol, Betaxolol and Timolol:

Answer 36

Beta-blockers

Question 37

Pilocarpine:

Answer 37

Miotic agents

Question 38

Acetazolamide, Methazolamide, Dorzolamide and Brinzolamide:

Answer 38

Carbonic anhydrase inhibitors

Question 39

Latanoprost, Travoprost and Bimatoprost:

Answer 39

Prostaglandin

Question 40

Acute Glaucoma Treatment (First 60min):

Answer 40

Pilocarpina 2%, Timolol, Brimonidina, Acetazolamida oral, Corticoide topico ou Indentacao Corneana

Question 41

Se após tratamento a PIO diminui, pupila se contrai e a córnea fica clara:

Answer 41

Crise Bloqueada -> Iridotomia com Laser

Question 42

Após Iridotomia com Laser:

Answer 42

Timolol, Brimonidina e Corticóide tópico

Question 43

Se após tratamento permanecer com a crise não bloqueada:

Answer 43

Manitol Venoso —> Cirurgia