Glaucoma

Question 1

3 main features

Answer 1

• Cupping of the optic disc is key feature
• Visual field loss - (Damage to optic nerve - get peripheral changes first, then central last)
• Intra-ocular pressure increase

Question 2

Pathogenesis

Answer 2

Aqueous humour drains through trabecular meshwork in the angle between the cornea and iris. overtime, can get drainage problems. This results in an increase in ocular pressure.
This puts pressure on the optic disc, and can impair optic nerve and result in a decrease of vision.

Question 3

Risk factors

Answer 3

Usually found asymptomatic screen

• Genetics
• increasing age
• DM
• myopia
• Black race
• thin cornea

Question 4

Exam

Answer 4

1. Intraocular pressure (normal 11-22)
2. Angle assessment
3. Optic nerve
4. Visual fields

• gonioscope - anterior chamber - see if open or closed.
• Opthalmosocopy
• -> Cup enlarges, (cup to disc ratio >0.6)
• -> loss of nerve fibers - white

Question 5

Management

Answer 5

Topical 
-prostaglandins
-Beta blockers
-Carbonic anhydrase inhibitors
-Alpha Agonists
-Osmotic agents - mannitol 
Lazer 
Surgery - if medical treatment ineffective.

Question 6

What is one of the most common causes?

Answer 6

Uveitis

Question 7

Closed angle

• symptoms
• signs

Answer 7

Rapid onset, pain, redness, blurring, mid dilated pupil.
N&V
When feeling closed eyes, will be hard.
Caused by a rapid elevation of presure inside the eye
Treat with laser iridotomy

Question 8

Infantile glaucoma

Answer 8

• Hazy corneas
• Tearing/watering
• Photophobia
• Bupthalmos