Glaucoma (Exam 2) Flashcards

1
Q

Glaucoma: What it’s like

A

Peripheral vision is loss but central vision stays intact

Can go unnoticed because it is not central vision

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2
Q

Glaucoma

A

Eye disorder that INCREASES intraocular pressure

Major cause of blindness (second behind cataracts)

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3
Q

What is the most common cause of blindness

A

Cataracts

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4
Q

Two causes of glaucoma

A

Open angle
&
Closed angle

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5
Q

Open Angle Glaucoma

A

Clogged Kitchen Sink

Problem of reabsorption of aqueous humor (dealing with trabecular meshwork)

Asymptomatic

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6
Q

Close Angle Glaucoma

A

A “structural” problem

Narrow angle between cornea and iris that prevents aqueous humor from being reabsorbed (AH can not even get to trabecular meshwork)

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7
Q

OA glaucoma presents as

A

Asymptomatic

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8
Q

CA glaucoma presents as

A

Painful red eye and must be treated within 24 hrs or blindness may be permanent

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9
Q

Chronic Open Angle: First line therapy

A

Medications:

-Decrease aqueous humor production
-Miosis / opening of trabecular meshwork

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10
Q

Problems with Chronic Open Angle Glaucoma Medicaiton

A

COMPLIANCE

Issues because they have to be given several times per day and the disease can be asymptomatic. So patient forgets or feels like it is not important

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11
Q

Chronic Open Angle Glaucoma: Treatment when drug therapy is not sufficient

A

Argon Laser Trabeculoplasty (ALT)

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12
Q

Argon Laser Trabeculoplasty (ALT)

A

Outpatient procedure

Topical anesthetic

Laser hits damaged trabecular meshwork and opens outflow channels

Plumber opening clogged sink

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13
Q

What is used to diagnose Acute Angle Closure

A

Gonioscopy

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14
Q

Patients comes into ED, what is initial therapy?

4

A

Immediate relief:

Beta-blocker topical agent
+
Carbonic anhydrase inhibitor (acetazolamide)

Miotic eye drops to constrict pupils

Treat pain and nausea because it increases IOP

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15
Q

Why do we want to constrict pupil in closed angle glaucoma

A

Take pressure off of the angle (lower IOP)

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16
Q

What kind of eye drops will we give for CAG

A

Miotic Eye Drops

(we want to pupil to constrict to relieve pressure)

17
Q

Once IOP is stabilized in closed angle glaucoma, what is next?

A

Prepare for iridotomy

18
Q

Surgical Interventions for closed angle glaucoma

A

Iridotomy:
-Punch holes in the iris to allow for aqueous humor to get on the other side of the eyeball

Iridectomy:
-Removal of the iris

19
Q

Health Promotion: How often should you have exam?

A

Every 3-5 years (40-60)

Every 1-2 years (>60)

AA’s periodic (20-39)

20
Q

Acute Interventions for Acute angle closure glaucoma

A

Quick appropriate drug interventions

Acute pain
-if light sensitive = darken room
-Cool compress to head
-Private and calming environment
-Keep patient and family informed

Patient / family support and teaching

21
Q

What is done first? Darken the room or give miotic eye drop

A

We want to give miotic eye drop before darkening room

If we darken the room before then the eye can dilate and we do not want that