Glaucoma Flashcards
Define glaucoma. What are the 2 main types?
- an increase in ocular pressure due to the reduced outflow of aqueous humour from the inner chamber of the eye
- Chronic Open Angle Glaucoma
- Acute Closed Angle Glaucoma
What are the symptoms of Chronic Open Angle Glaucoma?
- BILATERAL GRADUAL visual loss
- peripheral to central - TUNNEL VISION
- mild non-specifics - headaches, poor adaptation to light
What investigations would you do for suspected glaucoma? What findings would be indicative for glaucoma?
- Fundoscopy - cupping
- visual field testing - peripheral loss
- tonometry (ocular pressure testing) - <21mmHg
What is the first line topical treatment for COAG? and the other lines too?
- Prostaglandins - latanoprost - 1st 1st 1st 1st
- alpha agonists - briminonide
- beta blockers - timolol
- carbonic anhydrase inhibitors - dorolamide
prostaglandins first!!!!
alpha beta carba
better prostrates are alpha caribous
What is the surgical treatment for glaucoma?
trabeculotomy - cuts a new path to let out the humour
What are the risk factors for Acute closed angle glaucoma?
- Advanced age
- Asian
- Atropine
What symptoms would you expect to see in Acute closed angle glaucoma?
- Sudden onset unilateral painful RED eye
- HARD on palpation
- blurred vision +/- halos
- unresponsive pupil
- w/ other non-specific features - headaches, nausea, vomiting
MEDICAL EMERGENCY
What investigations would you want in a presentation of rapid onset painful red eye that’s hard to palpate and has an unresponsive pupil?
Tonometry - <30mmHg = ACAG
Gonioscopy - viewing of the angle
What is the treatment for an Acute Closed Angle Glaucoma?
Topical:
- constrict the pupil - pilocarpine drops (parasympathomimetic)
- alpha agonists, beta blocker, systemic carba,
Definitive treatment:
-laser iridotomy
What drugs can cause an acute closed angle glaucoma?
- Adrenergic drugs - adrenaline
- Anticholinergic drugs - ATROPINE
- Tricyclics
