Glaucoma

Question 1

What is glaucoma?

Answer 1

Ocular disorders characterised by:

• Visual field loss,
• Optic disc cupping,
• Optic nerve damage

Question 2

What is normal intraoccular pressure?

Answer 2

10-20mmHg

Question 3

Pressure in open angle glaucoma?

Answer 3

22-40mmHg

Question 4

Pressure in closed angle glaucoma?

Answer 4

> 60mmHg

Question 5

Pathology of open angle glaucoma

Answer 5

AH drainage through trabecular meshwork is restricted

Question 6

Pathology of closed angle glaucoma

Answer 6

AH outflow is obstructed as iris brows against trabecular meshwork

Question 7

Causes of open angle glaucoma?

Answer 7

MYOC mutation,

Trauma

Question 8

Causes of closed angle glaucoma?

Answer 8

Shallow anterior chambers,
Trauma,
Tumour of the ciliary body

Question 9

Which type of glaucoma is painful? open or closed?

Answer 9

Closed

Question 10

What type of visual loss is experienced in glaucoma?

Answer 10

peripheral

Question 11

Presentation of glaucoma? (7)

Answer 11

Acute painful red eye,
Peripheral reduced vision, 
hazy cornea,
Semidilated pupils, 
Halos around lights, 
Conjunctival injection, 
Hard eye on examination

Question 12

Investigations for glaucoma? (7)

Answer 12

Tonometry (measures IOP),
Fundoscopy,
Visual field assessment,
Cup-to-disc ratio,
Gonioscopy,
Scanning laser ophthalmoscopy,
Scanning laser polarimetry

Question 13

Treatment for glaucoma?

Answer 13

Emergency:
-IV acetazolamide + topical pilocarpine

Beta blockers (decreased IOP by slowing rate of AH production),
Prostaglandins analogues (Decreases IOP by increasing uveoscleral outflow)
Sympathomimetics (decrease AH production),
Carbonic anhydrase inhibitors (eg Acetazolamide),
Miotics (eg Pilocarpine, opens drainage channels in trabecular meshwork)