intro

Question 1

Is IOP a defining component of glaucoma?

Answer 1

No. It is a component that is higher than the tissues of the eye can tolerate. Controllable.

Question 2

Definition of glaucoma

Answer 2

Progression loss of ganglion cell axons causing visual field damage that is related to IOP

ON damage
Loss of ganglion cell axons (thinning of RNFL)
VF defects
Responding to IOP effects.

Question 3

NEI study of open angle glaucoma. how many americans over 40 have glaucoma

Answer 3

Around 3 million

Expect it to double by 2050 because the population is aging and changes in racial proportions.

Question 4

Who has the highest prevalence by race rn? What group has the highest growing rate

Answer 4

AA the most rn

Latino/hispanic populations are growing.

Question 5

AA have a __X prevalence of glaucoma compared to caucasians

AA are __x more likely to go blind from glaucoma than caucasians

AA are ___x more likely to have visual impairments from glaucoma

Answer 5

3X
6-8X
15X

Question 6

Hispanic americans have __x prevalence of glaucoma compared to caucasians according to what study?

Answer 6

4.74%

LALES study

Question 7

TS Vajaranant Study (OAG study) findings

Answer 7

2.7 million person in US with POAG. Highest in those ages 70-79.

Expected 7 million by 2050. with increasing in hispanic population.

**Similar to NEI study, but includes impact of immigration.

Question 8

Global prevalence of glaucoma

Answer 8

60 million in 2010 (3.54%) 3/4 OAG, 1/4 CAG
80 million (18%) by 2020. Greater risk in asians and females. 

Primarily associated with increased life expectancies.

Question 9

Gender and racial and age differences in glaucoma

Answer 9

Females > males
-Prob bc females live longer

Asians affected most by glaucoma. 87% of all angle closure.

Increased risk with age, especially european and hispanic decent

Question 10

___ most likely to have ACG
____ have highest rate of NTG
___ have highest rate of OAG

Answer 10

Asian with ACG
Japanese with NTG
Africans with OAG (especially caribbean’s)

Question 11

Increased risk of OAG

Answer 11

Males, Myopes and African descent

Question 12

Increased risk of ACG

Answer 12

Females, Hyperopes and asian descent

Question 13

Glaucoma causes __% of all US blindness

Answer 13

10%

Question 14

Blindness from glaucoma is # what cause in the US and in the world?

Answer 14

1 non-curable disease in the world

US: #2 behind ARMD
World: #2 behind cataracts

Question 15

Framingham study

Answer 15

3.3% prevalence of glaucoma

Question 16

Barbados Eye Study

Answer 16

Higher IOP= higher prevalence of glaucoma

Question 17

Avg IOP
High IOP
Came from what study?

Answer 17

16mmHg avg
20-21mmHg is high
Armaly study

Question 18

Rotterdam Eye Study

Answer 18

1.1% prevalence of OAG
Double the prevalence in men
40% had IOP under 21

Question 19

Beaver Dam Eye Study

Answer 19

Greater risk with age
Evaluated risk factors such as DM, alcohol, smoking, Migraines.
Looked at IOP associated with diurnal variation

Question 20

Blue mountain eye study

Answer 20

49% of people with glaucoma had previously been diagnosed.

Increased prevalence based on age, family history, SIBLINGS!

Question 21

Los Angeles Latina Eye Survey (LALES)

Answer 21

4.89% prevalence of latinos with OAG. Especially with increased age.

AKA increased risk if latino and over 40

Question 22

Factors influencing IOP

Answer 22

Head and body position (chin down) 
Tight necktie 
Sugar intake
Caffeine 
Coffee 
Valsalva 
Psychological stress
smoking

Question 23

Nearly 50% of new glaucoma dx’s d/c meds in __ months

Answer 23

6 months!!!!

only 30-70% are compliant. Make your pt feel comfortable enough to tell you the truth.

Question 24

Why are there compliance issues?

Answer 24

(40%)Environmental factors- life change, travel.

(32%)Regimen factors- refill, costs, side effects.

(16%)Patient factors- dexterity, memory, motivation

(3%) Physician factors- communication, dissatisfaction

Question 25

Alternative therapy

Answer 25

Sub conj injection. 75% of patients said they would be willing.

Other alternatives: punctal plug, intra canalicular,

Question 26

What % of the world is undiagnosed

Answer 26

50-90%