Glaucoma

Question 1

What are the 2 things that characterize glaucoma?

Answer 1

1. Increased IOP

2. Progressive degeneration of the optic nerve and retina

Question 2

What structure produces aqueous humor?

Answer 2

Ciliary body epithelium

Question 3

Glaucoma is always due to what?

Answer 3

Impaired outflow

Question 4

What are the clinical signs associated with glaucoma?

Answer 4

1. Pain, migraine
2. Vision loss
3. Corneal edema
4. Mydriasis (pupil dilation)
5. Optic nerve cupping
6. Retinal degeneration
7. Episcleral vessel congestion

Question 5

What are the 3 signs of chronicity with glaucoma?

Answer 5

1. Buphthalmos
2. Lens luxation
3. Haab’s striae

Question 6

Which requires topical anesthesia, TonoVet or TonoPen?

Answer 6

TonoPen

Question 7

Which is based on rebound tonometry, TonoVet or TonoPen?

Answer 7

TonoVet

Question 8

Which is based on applanation tonometry, TonoVet or TonoPen?

Answer 8

TonoPen

Question 9

What is normal IOP in dogs and cats?

Answer 9

10 - 20 mmHg

Question 10

What is normal IOP in a horse?

Answer 10

15 - 25 mmHg

Question 11

In health, there should be less than a ____% different in IOP between the right and left eye.

Answer 11

20 - 30%

Question 12

True or False: High IOP is enough to base your diagnosis of glaucoma off of.

Answer 12

FALSE: Glaucoma can only be diagnosed if high IOP is consistent with clinical signs.

Question 13

Which is associated with intraocular disease, primary or secondary glaucoma?

Answer 13

Secondary glaucoma

Question 14

Which conditions might glaucoma develop secondary to?

Answer 14

1. Uveitis
2. Neoplasia
3. Lens luxation

Question 15

Which has a better prognosis, primary or secondary glaucoma?

Answer 15

Secondary

Question 16

Which is typically unilateral first, primary or secondary glaucoma?

Answer 16

Primary (secondary will be either unilateral or bilateral)

Question 17

Is primary or secondary glaucoma more common in dogs?

Answer 17

Primary

Question 18

In which species is secondary glaucoma more common?

Answer 18

1. Cats

2. Horses

Question 19

What causes primary glaucoma?

Answer 19

Goniodysgenesis: a malformation in the iridocorneal angle

Question 20

Which is more at risk of developing primary glaucoma, female dogs or male dogs?

Answer 20

Female dogs

Question 21

What is the average age of developing primary glaucoma?

Answer 21

6-8 years

Question 22

What are the breeds predisposed to primary glaucoma?

Answer 22

1. Bassett hound
2. Siberian husky
3. Samoyed
4. Cocker spaniel
5. Shar pei
6. Chow chow
7. Shiba inu
8. Boston terrier

Question 23

What is the purpose of gonioscopy?

Answer 23

Examine the irido-corneal angle

Question 24

In which species is the irido-croneal angle directly visible?

Answer 24

1. Cat

2. Horse

Question 25

In which species is a goniolens required to view the irido-corneal angle?

Answer 25

Dog

Question 26

With primary glaucoma, you'll want to treat the affected eye and prophylactically treat the opposite eye. What are the 2 medications that are preferenced for this?

Answer 26

1. Demecarium bromide | 2. Prednisolone acetate

Question 27

Which has the highest time to medical failure, Demecarium bromide or Prednisolone acetate?

Answer 27

Demecarium bromide

Question 28

Which drugs should NEVER be used with glaucoma?

Answer 28

Dilating agents (Atropine, tropicamide)

Question 29

When should Timolol not be used or be used cautiously?

Answer 29

Use with care in small patients and those with cardiac disease

Question 30

Which drugs should not be utilized to treat glaucoma if an anterior lens luxation is present?

Answer 30

Constricting agents (Latanoprost, Demecarium bromide, Pilocarpine)

Question 31

Which drugs should be avoided in treating glaucoma if uveitis is also present?

Answer 31

Latanoprost (due to its pro-inflammatory properties)

Question 32

Which two surgical corrections for glaucoma involve decreasing production of aqueous humor?

Answer 32

1. Trans-scleral cyclophotocoagulation | 2. Endolaser cyclophotocoagulation

Question 33

Which surgical correction for glaucoma involves increasing outflow of aqueous humor?

Answer 33

Gonio-implant

Question 34

Chemical ablation of the ciliary body is a salvage procedure to "treat" glaucoma in non-visual eyes. It involves an intravitreal injection of an agent toxic to the ciliary body. What are 2 agents that can be used?

Answer 34

1. Gentamicin | 2. Cidofovir

Question 35

In which species will Latanoprost not work for treatment of glaucoma?

Answer 35

1. Cat | 2. Horse

Question 36

True or False: Atropine may be beneficial in treatment of glaucoma in the horse.

Answer 36

TRUE

Question 37

What type of drug is Demecarium bromide?

Answer 37

Parasympathomimetic

Question 38

What is the MOA of Demecarium bromide?

Answer 38

Increase conventional outflow

Question 39

What does Demecarium bromide cause in the eye that leads to some contraindications? What are those contraindications?

Answer 39

Causes miosis, so contraindicated in pupillary block and may exacerbate uveitis

Question 40

What type of drug is Latanoprost?

Answer 40

Prostaglandin analogue

Question 41

What is the MOA of Latanoprost?

Answer 41

Increases uveoscleral outflow

Question 42

What does Latanoprost cause in the eye that leads to some contraindications? What are those contraindications?

Answer 42

Causes miosis, so contraindicated in pupillary block and may exacerbate uveitis

Question 43

What type of drug is Timolo?

Answer 43

Beta block

Question 44

What is the MOA of timolol?

Answer 44

Decreases aqueous humor production

Question 45

What type of drug is Dorzolamide?

Answer 45

Carbonic anhydrase inhibitor

Question 46

What is the MOA of Dorzolamide?

Answer 46

Decreases aqueous humor production