Glaucoma Flashcards
what is glaucoma?
progressive optic neuropathy due to high IOP caused by blockage of aqueous humour drainage
what is optic neuropathy?
damage to the optic nerve
two types of glaucoma
- closed angle (AACG)
2. open angle
what is closed angle glaucoma?
angle is blocked by iris being pushed forward due to fluid increase in posterior chamber
what must be done in AACG
pressure must be reduced to avoid blindness
what precipitates AACG?
NA
mydriatics
anticholinergics
tricyclics
presentation of AACG
red eye sudden visual loss with blur halos around lights headache, N&V due to extreme pain cloudy cornea dilated pupil (ischaemia of sphincter pupillae)
management of AACG
drops to lower IOP
laser iridotomy
what drops lower IOP?
pilocarpine hyperosmotic agents e.g. glycerol and mannitol timolol brimonidine acetazolamide
what is open angle glaucoma?
trabecular meshwork becomes clogged so fluid cannot escape and pressure builds
presentation of open angle
often asymptomatic
can have visual field defect or tunnel vision
appearance of fundoscopy of open angle glaucoma
cupped disc due to loss of retinal ganglion cells in neuro-retinal rim
diagnosis of open angle
visual fields
Goldmann applanation tonometry
fundoscopy
pharmacological management of open
beta blockers
CA inhibitors
prostaglandin analogues (FIRST LINE)
alpha-adrenergic agonists
surgery options in open
trabeculopathy (open angle to open meshwork)
what drugs decrease production of aqueous humour?
beta blockers e.g. timolol
CA inhibitors e.g. dorzolamide
which drugs increase outflow of aqueous humour
prostaglandin-analogues e.g. latanoprost
adverse of latanoprost
eyelash growth
eyelid and iris pigmentation (browning)
which drugs decrease production and increase outflow
sympathomimetics e.g. alpha-adrenergic agonists - brimonidine
