glaucoma

Question 1

what is glaucoma

Answer 1

optic neuropathy resulting in progressive irreversible vision loss

Question 2

what are the four main subtypes of glaucoma ?

Answer 2

open angle glaucoma , angle closure glaucoma, secondary glaucoma and congenital glaucoma

Question 3

what are the risk factors for open angle glaucoma ?

Answer 3

increased intraocular pressure
aging 
positive family history
afro Caribbean
decreased central corneal thickness
high myopia 
eye injury or surgery

Question 4

what are the treatment options for open angle glaucoma ?

Answer 4

medications
laser
filtration surgery

Question 5

what are the medications used for open angle glaucoma ?

Answer 5

prostaglandin analogues: latanoprost bimatoprost

beta blockers: timolol

Question 6

what is the first line treatment for open angle glaucoma?

Answer 6

prostaglandin analogue like latanoprost and bimatoprost

Question 7

what are the side effect of prostaglandin analogues?

Answer 7

pigmentation , increased eye lash length, stinging sensation

Question 8

what are the contraindications of using beta blockers

Answer 8

using beta blockers such as timolol are contraindicated in asthmatics, COPD and heart failure

Question 9

how do beta blockers work with glaucoma

Answer 9

decrease production

Question 10

how do prostaglandin analogues work with glaucoma

Answer 10

they increase drainage through uveoscleral outflow

Question 11

other than prostaglandin analogues and beta blockers what other medications can be taken for open angle glaucoma?

Answer 11

carbonic anhydrase inhibitors such as acetazolamide which are usually taken with beta-blockers , and selective alpha 2 agonist

Question 12

what are the risk factors of angle closure glaucoma ?

Answer 12

hypermetropia ( long sightness)
cataracts
mydriatrics (medications that make the eye pupil dilate)
abnormal iris configurations

Question 13

what are the symptoms of angle closure glaucoma

Answer 13

sudden onset of pain 
blurred vision 
colored halos around light 
frontal headache
nausea and vomiting

Question 14

what are the signs of angle closure glaucoma ?

Answer 14

corneal oedema
fixed mid-dilated pupil
increased intraoccular pressure

Question 15

what are the steps of managment in angle closure glaucoma ?

Answer 15

1. First urgently refer to an ophthalmologist
2. Then we can give systemic treatments:
   IV mannitol to decrease IOP and oedema
   Acetazolamide (CAI)
   Anti emetics
3. Topical
   give betablockers
   selective a2 agonists
   steroids

Question 16

what is the definitve treatment for angle closure galucoma ?

Answer 16

peripheral laser iridotomy
lens extraction
guarded filtration procedure