Glaucoma and Age Related Macular Degeneration Flashcards
What is ocular hypertension?
Intraocular pressure >21mmHg
What is a significant modifiable risk factor for glaucoma?
Intra-ocular pressure (IOP)
What is the two pathophysiology for glaucoma?
- Increased resistance to aqueous humor drainage through the trabecular meshwork
- Obstruction of drainage pathways by the iris
What type of vision loss occurs in glaucoma?
Peripheral vision loss
What risk factors require referral to an eye doctor for evaluation of glaucoma?
- Older age
- Fam Hx of glaucoma
- Black race
- Use of systemic or topical CS
- High IOP
What are the two types of glaucoma and their differences?
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
Tx options for glaucoma?
Prostaglandins (1st) or beta blocker.
If ineffective, switch to alternative first line agents before using combination of both
Non pharm tx for glaucoma?
Laser and surgical procedures as last line
Treatment of acute angle closure crisis?
Iridectomy (surgical or laser) is definitive treatment
What is given before surgery treatment?
Pilocarpin (cholinergic agonist)
Beta blockers
Prostaglandins
Common SE of pilocarpine?
Miosis (pupil constricts)
Examples of prostaglandins?
Latanoprost, bimatoprost
Example of B-blockers used in glaucoma?
Timolol
SE of prostaglandin?
Conjunctival Hyperemia
SE of latanoprost?
Iris pigmentation
SE of bimatoprost?
Eyelid pigmentation
Eyelash lengthening
Which classes of medications to lower IOP is preferred in terms of dosing?
Prostaglandin and B-blockers (once daily dosing)
Example of a-adrenergic agonist + SE
Brimonidine, apraclonidine
SE: allergic reactions, irritation, dry eye
What to check with pt before switching drugs?
Adherence and eye drop technique
What are the types of age-related macular degeneration?
Dry/non exudated (more common) and wet/exudated
What type of vision loss is experienced in ARMD?
Central vision loss
What are the self-tests to check the health of the macula of each eye?
- Amsler grid
- Snellen chart
What are the RF for ARMD?
Smoking (modifiable)
Genetics
European
Females
Fatty diet
Statins
Pathophysiology of dry vs wet ARMD
Dry: fat-like substance that accumulates at bruch’s membrane
Wet: neovascularisation through brunch’s membrane into retina, forming leavy blood vessels
