Miscellaneous

Question 1

What is a Glaucoma?

Answer 1

Group of eye disorders characterised by the VISUAL FIELD LOSS, alterations to the OPTIC DISC and damage to the OPTIC NERVE

Intraocular pressure is usually increased but may be normal

Question 2

Two causes of OPEN ANGLE glaucoma (PAINLESS)

Answer 2

• MYOC mutation

- Obstruction of the Trabecular Meshwork by TRAUMA

Question 3

Two causes of CLOSED ANGLE glaucoma (PAINFUL)

+ two bonus facts

Answer 3

• Shallow anterior chambers
• Trauma and tumor of ciliary body
• Aqueous outflow impeded
• Peripheral zone of iris adheres to TRABECULAR meshwork

Question 4

Characteristics of GLAUCOMA

Answer 4

VIA

• Visual field changes due to peripheral field loss
• Intraocular pressure increased
• Alterations to optic nerve cup

Question 5

Investigations in GLAUCOMA

Answer 5

• Tonometry to measure intraocular pressure
• Gonioscopy to assess iridocorneal angle
• Visual features- TUNNEL VISION is a late feature

Question 6

7 Treatments of GLAUCOMA

Answer 6

• Prostaglandin analogues (LATANOPROST)
• Beta receptor antagonists (BETAXOLOL)
• Alpha 2 agonist (BRIMONIDINE)
• Less selective Alpha agonist (ADRENALINE)- but DO NOT USE IN CLOSED ANGLE GLAUCOMA
• Miotic agents (PILOCARPINE)
• Carbonic anhydrase inhibitors (DORZOLAMIDE)
• Cholinesterase inhibitors (PHYSOSTIGIMINE)