Glaucoma Flashcards
What are the 4 factors for chronic glaucoma?
Raised intra-ocular pressure
Damage and loss of retinal nerve fibres at optic disc
Visual field loss
Usually blockage of aqueous outflow
What is seen at the optic disc?
Cupping
How do you measure IOP?
Tonometry
What is the normal range for IOP?
10-21 (usually just in teens)
What are risk factors for POAG?
Age
Raised IOP
Afro-carribean origin
Family history
What 4 drug types are used for glaucoma?
Parasympathominetics Sympathominetics Beta blockers Prostaglandins Carbonic anhydrase inhibitors
Name a type of prostaglandin and what it does?
Xalatan
Increase uveoscleral outflow
Makes iris vessels more leaky
Few side effects
What do beta blockers do regarding the eye?
reduce aqueous secretion
systemic side effects
Reduced by shutting eyes for a few mins
Name a type of carbonic anhydrase inhibitor and what it does?
Acetazolamide / Dorzolamide
Lowers IOP
Can cause renal calculi and peri-oral tingling
Name a type of parasympatheminetics and what it does?
Increase outflow
May cause pupil constriction, pain (at brow), dimming of vision, problems at night
Give an example of a synpathominetic and what it does?
Adrenaline, propine, alphagan
Increase outflow
Dilate pupil
May cause hyperaemia and CV issues
What is the usual order of treatment?
Prostaglandin
B-blocker
Trusopt/alphagan
Surgery
What are features of open angle glaucoma?
Blood
Uveitis
Lens protein
Pseudo-exfoliation
What are symptoms and signs of angle closure glaucoma?
Pain N + V Reduced vision Hazy cornea Fixed mid-dilated pupil
What is the treatment for angle closure glaucoma?
Reduce IOP medically
Peripheral iridotomy - surgery or laser
