Glaucoma Flashcards
What is latanoprost and how does it work?
Used in glaucoma to ‘increase uveoscleral outflow’
It is a prostaglandin analogue
Use once a day
S/e - brown pigmentation of the eye
What is timolol and how does it work?
Beta blocker, reduced aqueous production, in primary open angle glaucoma
Avoid in asthma and heart block
What is brimonidine and how does it work?
Alpha2 adrenoceptor agonist (sympathomimetic)
Reduced aqueous production and increased outflow. In primary open angle glaucoma
Avoid in MAOI and TCA. S/e - hyperaemia
What is dorzolamide and how does it work?
Carbonic anhydrase inhibitor, reduces aqueous production in OA Glaucoma
What is pilocarpine and how does it work?
Miotic, (muscarinic receptor agonist) increases uveoscleral outflow.
S/e- constricted pupil, headache and blurred vision
What surgery is considered in refractory open angle glaucoma?
Trabeculectomy
What Are the features of primary open angle glaucoma?
Peripheral visual field loss
Decreased visual acuity
Optic disc cupping
What features do you see in closed angle glaucoma?
Eye pain/ headache Symptoms worse with mydriasis Semi-dilated non reacting pupil Red eye Decreased visual acuity Halos around lights Corneal oedema leading to hazy cornea Systemic upset eg vomiting, abdo pain
Management of acute close angle glaucoma?
Urgent referral to ophthalmology
Acetazolamide reduce secretion and topical pilocarpine to reduce pupil size
What are the predisposing factors for acute angle closure glaucoma?
Hypermetropia (long sightedness)
Pupillary dilation
Lens growth associated with age
(Impairment in aqueous outflow, causes a rise in intraocular pressure)
Type of Glaucoma - short sited vs long sited
Short- myopia - open angle
Long - hypermetropia - closed angle (lens pushes on iris and block canal)
