Glaucoma

Question 1

what is glaucoma

Answer 1

a neurodegenerative disease in which IOP is too high for optic nerve and retina to function

Question 2

what is normal IOP

Answer 2

15-25 mmHg

Question 3

units of IOP

Answer 3

mmHg

Question 4

how do we measure IOP

Answer 4

tonometry

Question 5

what is a topical anesthetic to numb the eye

Answer 5

proparacaine

Question 6

types of tonometers

Answer 6

applanation
indentation
rebound

Question 7

CS in both acute and chronic glaucoma

Answer 7

elevated IOP
episceral hyperemia
corneal edema
mydriasis
blindness
(every elephant can make beer)

Question 8

primary cause of glaucoma

Answer 8

goniodysgenesis - iridocorneal angle isnt formed correctly

Question 9

primary glaucoma is unilateral or bilateral

Answer 9

bilateral - will see probs in second eye by 6-12 months

Question 10

breeds predisposed to primary glaucoma

Answer 10

basset-hounds
cockerspaniels
beagles

Question 11

how long must you treat glaucoma

Answer 11

for life

Question 12

secondary causes of glaucoma

Answer 12

anterior lens luxation
uveitis
intraocular neoplasia (melanoma & adenocarcinoma)
hyphema
(antisocial unicorns insult haters)

Question 13

medication for glaucoma

Answer 13

prostaglandin analogue
carbonic anhydrase inhibitor
Beta-blocker
emergency osmotic diuretic

Question 14

prostaglandin analogue: what medication and what does it do

Answer 14

Latanoprost

• increases drainage of AH (through uveoscleral outlfow)
• miosis

Question 15

how often do you give latanoprost

Answer 15

BID

Question 16

carbonic anhydrase inhibitor: what medication and what does it do

Answer 16

Dorzolamide

- decreases production of AH

Question 17

how often do you give dorzolamide

Answer 17

4 times a day (q8)

Question 18

B-blocker: what medication and what does it do

Answer 18

Timolol

• decreases production of AH
• bradycardia

Question 19

How often do you give Timolol

Answer 19

4 times a day (q8)

Question 20

medications: greatest effect to least

Answer 20

latanoprost, dorzolamide, timolol

Question 21

osmotic diuretic: what medication and what does it do

Answer 21

Mannitol IV
- pulls fluid from vitreous

Glycerine

Question 22

When will mannitol not work

Answer 22

when there is uveitis

Question 23

when is the only time mannitol & Glycerine should be given

Answer 23

Acute glaucoma

Question 24

when is mannitol is contraindicated

Answer 24

renal or cardiac dz

Question 25

when is glycerine contraindicated

Answer 25

diabetic patients

Question 26

in an emergency what drug do we use most commonly first to drop IOP

Answer 26

latanoprost (prostaglandin analogue)

Question 27

what kind of drug is latanoprost

Answer 27

prostaglandin analogue

Question 28

what kind of drug is dorzolamide

Answer 28

carbonic anhydrase inhibitor

Question 29

surgery procedures for glaucoma

Answer 29

``` laser ciliary body ablation injection ciliary body ablation drainage implant enucleation evisceration and prosthesis ```

Question 30

what medication would you give a mild glaucoma case

Answer 30

dorzolamide and timolol BID

Question 31

what medication would you give a severe glaucoma case

Answer 31

Latanoprost BID, Dorzolamide and Timolol 4 times/day

Question 32

what do you give a clogged drainage implant

Answer 32

tissue plasminogen activator injection

Question 33

what would you inject for ciliary body ablation

Answer 33

cidovovir | gentamicin

Question 34

what does cidovovir/gentamicin cause

Answer 34

blindness (toxic to retina) | phthisis

Question 35

what antibiotic has good corneal penetration that we would use for evisceration/prosthesis

Answer 35

oflaxacin or ciprofloxacin

Question 36

CS of chronic glaucoma

Answer 36

``` buphthalmos haabs striae lens luxation ciliary flush around cornea cupping of optic nerve (bad hotties like cold cash) ```