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Opthalmology > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

What causes glaucoma?

A

Optic nerve damage due to increased intraocular pressure due to blockage in aqueous humour escaping the eye

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2
Q

What causes open angle glaucoma?

A

Gradual increase in resistance to aqueous flow through the trabecular meshwork causing increased pressure

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3
Q

What causes closed angle glaucoma?

A

Iris bulges forward and blocks off trabecular meshwork from anterioir chamber so aqueous humour cannot drain away.

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4
Q

Whats the normal passage of aqueous?

A

Produced by ciliary bodies > around lens under iris > anterior chamber > trabecular meshwork > canal of Schlemm > general circulation

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5
Q

What does increased pressure cause?

A

Cupping of optic disc

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6
Q

What are risk factors for open angle glaucoma?

A 
Age
FH
Black
Myopia (nearsightedness)
Sun exposure
Smoking
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7
Q

What field of vision does glaucoma affect?

A

Peripheral- causes tunnel visoin

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8
Q

How does open angle glaucoma present?

A

Fluctuating onset pain, headaches, blurred vision and haloes around lights, worse at night

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9
Q

How is pressure measured?

A

Goldmann applanation tonometry

Visual fields also need to be assessed

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10
Q

What pressure is treatment started at?

A

24mmHg

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11
Q

What is first line treatment open angle?

A

Lantanoprost PG analogue

Increase outflow

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12
Q

What are side effects of fist line treatment open angle

A

Eyelash growth
Eyelid pigmentation
Iris browning

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13
Q

What are other treatment options for open angle glaucoma?

A

BB Timolol (reduce aqueous produciton
Carbonic anhydrase inhibitors (Dorzolamide)
Sympathomimetics- Brimonidine
Surgery

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14
Q

What operation is done in closed open angle glaucoma?

A

Trabeculectomy- new channel created

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15
Q

What are risk factors for closed angle glaucoma?

A 
Age
FEMALE
FH
CHINESE/EAST ASIAN
Short sighted
Sun exposure and smoking
Oxybutynin and Solifenacin
Tricyclics
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16
Q

What is the presentation of closed angle glaucoma?

A 
Red eye
Teary
Hazy cornea
Decreased acuity
Dilation of pupil fixed
Firm eyeball
17
Q

What is initial management of acute glaucoma?

A

Lie back without pillow
PILOCARPINE eye drops (pupil constriction)
ACETAZOLAMIDE orally- carbonic ahydrase inhibitor so reduced production of aqueous
analgesia and antiemetic

18
Q

Secondary managment of CLOSED ANGLE glaucoma

A 
PILOCARPINE to contrict pupil
Acetylzolamide/Dorzolamide
Mannitol or glycerol to increase osmotic gradient
TIMOLOL
Brimonidine

LASER IRIDOTOMY conclsuive treatment

19
Q

On examination of the optic disc in chronic glaucoma what is seen?

A

Increased cupping

ISNT rule

Opthalmology (9 decks)

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