Glaucoma

Question 1

Define glaucoma.

Answer 1

Raised intraocular pressure, resulting in either closed angle or open angle glaucoma.

Question 2

Explain the aetiology/risk factors of open-angle glaucoma.

Answer 2

High myopia (very severe nearsightedness)
Diabetes
Eye surgery or injury
High blood pressure
Use of corticosteroids (for example, eye drops, pills, inhalers, and creams)

Question 3

Explain the aetiology/risk factors of closed-angle glaucoma.

Answer 3

Female sex
Hyperopia
Shallow peripheral anterior chamber
Second eye having angle closure
Inuit and Asian ethnicity

Question 4

Summarise the epidemiology of glaucoma.

Answer 4

The number of people affected by glaucoma in the world is approximately 45 million. Closed angle glaucoma is more common in people with smaller eyes e.g. East Asians. Open angle glaucoma is more common in people with hypertension and diabetics, as well as black people.

Question 5

Recognise the presenting symptoms of glaucoma. Recognise the signs of glaucoma on physical examination.

Answer 5

Halos around lights
Aching eye or brow pain
Headache
Nausea, vomiting
Reduced visual acuity
Eye redness
Elevated intraocular pressure (IOP)
Corneal oedema
Fixed dilated pupil
Blurred vision

Question 6

Identify appropriate investigations for glaucoma and interpret the results.

Answer 6

Tonometry
Direct ophthalmoscopy
Indirect ophthalmoscopy
Slit-lamp biomicroscopy
Visual field testing