Glaucoma Flashcards
eye disease which might pre-dispose to glaucoma
thickened cataracts lens, ectopic lens (potentially from trauma), diabetic retinopathy, tumours
where does aqueous humour exit the anterior chamber of the eye?
through the trabecular meshwork
the trabecular meshwork allows the aqueous humour to travel through to the ____ __ _____ into the episcleral venous system
canal of schlemm
prolonged elevation of IOP can cause… (3)
changes in the optic nerve, peripheral visual loss, blindness
acute closed angle glaucoma can be described as…
abrupt total closure of the angle causing a rise in IOP that is not self-limiting
chronic open angle glaucoma can be described as…
elevated IOP from an incomplete angle closure that is often asymptomatic
risk factors for open angle glaucoma are…
raised IOP, black race, FHx, age, hypertension, diabetes
How is open angle glaucoma diagnosed?
fundoscopy with slit lamp, IOP measurement, visual field assessment
Treatment options for open angle glaucoma (8)
prostaglandin analogues, b-blockers, a-agonists, carbonic anhydrase inhibitors, miotics, combination drops, surgery, laser surgery
Prostaglandin analogues example…
lantoprost
Prostaglandin analogues such as lantoprost, decrease IOP by…
increasing uveoscleral outflow
b-blockers used to decrease IOP include
timolol
b-blockers such as timolol decrease IOP by…
decreasing aqueous production
a-agonists used to decrease IOP include…
brimonidine
a-agonists such as brimonidine decrease IOP by…
increasing uveoscleral outflow and decreasing aqueous production
carbonic anhydrase inhibitors used to decrease IOP include…
dorzolomide, acetazolomide (PO)
carbonic anhydrase inhibitors such as dorzolomide decrease IOP by…
decreasing production of aqueous
miotics used to decrease IOP include
pilocarpine
miotics such as pilocarpine decrease IOP by…
decreasing resistance to outflow…they are mAChR agonists
The pupil may appear ______ in acute closed angle glaucoma
fixed and dilated
Common symptoms of acute closed angle glaucoma
nausea, vomiting, halos around lights, worsening in dark room, headache, painful red eye
the onset of acute closed angle glaucoma may be…
hours to days
Things to avoid in acute closed angle glaucoma…(2)
eye patches or darkened rooms - this worsens due to the pupil dilating in the dark
initial treatment of acute closed angle glaucoma includes (3)
b-blockers (timolol), pilocarpine, IV acetazolomide - may also give anti-emetics and analgesia
common complications of acute closed angle glaucoma
CRVO, CRAO, visual loss, repeated episodes in either eye
follow up treatment of acute closed angle glaucoma once IOP has settled
peripheral iridectomy in both eyes - small hole in pupil at 12 o’clock to reduce resistance to aqueous movement
