Glaucoma

Question 1

what is the function of the aqueous humour?

Answer 1

1. Nutrition
2. Transport of waste products
3. thermoregulation
4. buffering

Question 2

Explain the drainage of the aqeous humour

Answer 2

It collects from the posterior chamber into the anterior chamber. Then travels from the trabecular meshwork, into the sinus venosus sclerae and into the episcleral veins

Question 3

What are the 3 types of glaucoma?

Answer 3

1. Acute angle closure glaucoma
2. Developmental glaucoma
3. Chronic open angle glaucoma

Question 4

The norma pressure in the eye is?

Answer 4

10-20 mmHG

Question 5

What are the different ways to measure intraocular pressure?

Answer 5

1. Digital examination with index fingers
2. Schiotz tonometry which is good for GP
3. Goldmann applanation tonometer
4. Tono-pen
5. Non-contact tonometers which is a puff tonometer

Question 6

To what pressure does primary acute angle closure get up to in hours?

Answer 6

60-100mmHG

Question 7

What causes the intense pain in acute angle closure glaucoma?

Answer 7

The ocular ischaemia and thecorneal odeoma

Question 8

What are 4 symptoms of acute angle closure closure?

Answer 8

1. Red eye
2. Deep seated, intense pain that radiates ipsilaterally, nausea and vomiting
3. Halos around lights
4. Decreased visual acuity-corneal oedema and ocular ischaemia

Question 9

What are the signs of primary acute angle closure glaucoma?

Answer 9

1. Positive eclipse test
2. Ciliary injection
3. Rock hard globe on palpation
4. Mid-dilated pupil, fixed pupil

Question 10

What is emergency treatment of primary acute angle closure glaucoma?

Answer 10

1. Acetazolamide 500mg stat IV or IM
2. Glycerol 1ml/kg stat orally-draws water out of the eye
3. Topical B-blocker 1 drop half-hourly for not more than 2 hours
4. Pilocarpine 1 drop every 15 minutes for 2 hours\
5. Systemic analgesia and emetic

Question 11

What is the definitive surgical treatment of glaucoma?

Answer 11

prophylactic surgical iridectomy

Question 12

What are the ocular abnormalities associated with secondary acute angle closure glaucoma?

Answer 12

1. anterior uveitis
2. advanced cataract
3. lens subluxation and dislocation
4. drugs: miotics

Question 13

What is the most common type of glaucoma?

Answer 13

chronica open angle glaucoma

Question 14

What are the high risk groups for open angle glaucoma?

Answer 14

Older than 50 and African decsent

Question 15

What are the signs of open angle glaucoma?

Answer 15

1. Decreased VA
2. Loss of visual field
3. Optic disc changes
4. The colour becomes pale
5. the cup is large C/D>0.6, vertically oval amd has an undermined edge, laminar dots are present
6. The blodd vessels are nasally displaced
7. Border: nerve fibre layer haemmorhage

Question 16

What is the treatment of primary open angle glaucoma?

Answer 16

1. Topical B-Blockers-reduces aqeuous secretion
2. Topical prostagladin analogues-increases aqeous outflow
3. Topical adrenaline preparations-increases aqeous outflow
4. Topical pilocarpine-increases aquous outflow

Question 17

Developmental glaucoma definition?

Answer 17

Development of the drainage angle known as trabeculodysgenesis-sporadic mutation associated with congenital rubella

Question 18

The age that glaucoma develops depends on when the symptoms:

Answer 18

1. congenital
2. infantile
3. juvenile

Question 19

What are the 3 signs of developmental glaucoma in children?

Answer 19

1. Tearing
2. Photophobia
3. Blephorospasm

Question 20

What is megacornea and buphthalmos?

Answer 20

It is an enlarged globe and only happens in babies as a result of increased intra-ocular pressure

Question 21

What is secondary acute angle closure glaucoma?

Answer 21

It is the abnormalities that reduce aqeous outflow despite an open angle

Question 22

What are the causes of secondary open angle glaucoma?

Answer 22

1. Trabeculitis
2. drugs-steroids
3. clogging of the trabeculum(white cells in uveitis/red cells in hyphaema)