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PR2156: Integumentary & Ocular Systems > Glaucoma and Age Related Macular Degeneration > Flashcards

Glaucoma and Age Related Macular Degeneration Flashcards

1
Q

What is ocular hypertension?

A

Intraocular pressure >21mmHg

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2
Q

What is a significant modifiable risk factor for glaucoma?

A

Intra-ocular pressure (IOP)

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3
Q

What is the two pathophysiology for glaucoma?

A
  • Increased resistance to aqueous humor drainage through the trabecular meshwork
  • Obstruction of drainage pathways by the iris
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4
Q

What type of vision loss occurs in glaucoma?

A

Peripheral vision loss

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5
Q

What risk factors require referral to an eye doctor for evaluation of glaucoma?

A
  • Older age
  • Fam Hx of glaucoma
  • Black race
  • Use of systemic or topical CS
  • High IOP
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6
Q

What are the two types of glaucoma and their differences?

A

Primary Open Angle Glaucoma:
- open normal appearing anterior chamber angle and raised IOP

Acute angle-closure glaucoma:
- Outflow of aqueous humour from eye is obstructed by bowing of the iris against the trabecular meshwork

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7
Q

Tx options for glaucoma?

A

Prostaglandins (1st) or beta blocker.
If ineffective, switch to alternative first line agents before using combination of both

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8
Q

Non pharm tx for glaucoma?

A

Laser and surgical procedures as last line

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9
Q

Treatment of acute angle closure crisis?

A

Iridectomy (surgical or laser) is definitive treatment

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10
Q

What is given before surgery treatment?

A

Pilocarpin (cholinergic agonist)
Beta blockers
Prostaglandins

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11
Q

Common SE of pilocarpine?

A

Miosis (pupil constricts)

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12
Q

Examples of prostaglandins?

A

Latanoprost, bimatoprost

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13
Q

Example of B-blockers used in glaucoma?

A

Timolol

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14
Q

SE of prostaglandin?

A

Conjunctival Hyperemia

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15
Q

SE of latanoprost?

A

Iris pigmentation

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16
Q

SE of bimatoprost?

A

Eyelid pigmentation
Eyelash lengthening

17
Q

Which classes of medications to lower IOP is preferred in terms of dosing?

A

Prostaglandin and B-blockers (once daily dosing)

18
Q

Example of a-adrenergic agonist + SE

A

Brimonidine, apraclonidine

SE: allergic reactions, irritation, dry eye

19
Q

What to check with pt before switching drugs?

A

Adherence and eye drop technique

20
Q

What are the types of age-related macular degeneration?

A

Dry/non exudated (more common) and wet/exudated

21
Q

What type of vision loss is experienced in ARMD?

A

Central vision loss

22
Q

What are the self-tests to check the health of the macula of each eye?

A
  • Amsler grid
  • Snellen chart
23
Q

What are the RF for ARMD?

A

Smoking (modifiable)
Genetics
European
Females
Fatty diet
Statins

24
Q

Pathophysiology of dry vs wet ARMD

A

Dry: fat-like substance that accumulates at bruch’s membrane

Wet: neovascularisation through brunch’s membrane into retina, forming leavy blood vessels

25
Q

What is given to slow the progression of AMD?

A

AREDS and AREDS2 formula

26
Q

What does AREDS formula contain?

A

Vit. C- 500mg
Vit. E- 400IU
Beta-carotene- 15mg
Copper- 2mg
Zinc- 80mg

27
Q

What does AREDS2 formula contain?

A

Vit. C- 500mg
Vit. E- 400IU
Copper- 2mg
Lutein- 10mg
Zeaxanthin- 2mg
Zinc- 80mg

28
Q

Which formula should be avoided in smokers and why?

A

AREDS formula as beta carotene may increase risk of lung cancer

29
Q

Tx option for wet ARMD?

A

Ranibizumab- anti VEGF A inhibitor

30
Q

What type of dosing is ranibizumab?

A

TREX dosing - freq is reduced to reduce cost

31
Q

How is ranibizumab administered?

A

Intravitreal injection

31
Q

MOA of ranibizumab

A

Prevent the overexpression of VEGFs that causes neurovascularisation that forms leaky leading to edema.

31
Q

What is given before giving ranibizumab?

A

Atropine to cause mydriases (pupil dilation)

PR2156: Integumentary & Ocular Systems (9 decks)

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