Module 2: Epidemiology of glaucoma

Question 1

Glaucoma is subdivided by TWO main categories. esp…whats the first row when you breaking glaucoma down. what do you want to know first ?

a. primary vs seconday
b. open vs closed

Answer 1

b. open vs closed. are the first way to classify it. you can add in childhood glaucoma…but we dont deal much with it.

Question 2

Open angle glaucoma is can be classified as ____ and ____.

a. normal tension and high tension
b. primary and secondary

Answer 2

a. normal tension and high tension

Question 3

Angle closure glaucoma can be classified as ____ and _____/

a. normal tension and high tension
b. primary and secondary

Answer 3

b. primary and secondary

Question 4

_____ (normal/high) Tension open angle glaucoma can be classified as primary and secondary _____ tension open angle glaucoma.

Answer 4

HIGH tension glaucoma. you can’t have a primary and secondary NTG.

Question 5

“Primary “ means the problem is

Answer 5

in the angle itself

Question 6

secondary means the problem is

Answer 6

is some place else. Iris, uveitis. something that is interring with outflow. something else is causing the prob.

Question 7

which type of glaucoma is a dx of exclusion?

Answer 7

normal tension glaucoma. (normal tension is when iop is below 21)

Question 8

is a diagnosis reserved for individuals who do not definitively have glaucoma at the present time but have characteristics suggesting that they are at high risk of developing the disease in the future based on a variety of factors.”

Answer 8

Glaucoma suspect

Question 9

is “labeled when typical glaucoma disk changes, visual field defects, and open anterior chamber angles are associated with IOP above 21 mmHg.”
may not be above 21 at every visit

Answer 9

Primary Open Angle Glaucoma - (POAG)

Question 10

Prevalence by region.

which REGION has the higher PREVALENCE of POAG?

Answer 10

AFRICA

Question 11

prevalence by region.

which region has higher prevalence of PACG?

Answer 11

asian regions

Question 12

by race/ancestry

which has narrow angle glaucoma high prevalence

Answer 12

chinese and vitemanese

Question 13

which race has the higher prevalence of normal tension open angle glaucoma?

Answer 13

japanese. the japanese has the higher prevalence rate of OAG and the higher prevalence of NTG.

Question 14

Which age group has a higher prevalence of glaucoma?

Answer 14

older age group no matter location or race.

Question 15

in terms of prjoections what do we expect to see in the future with glaucoma by geographic region

Answer 15

all regions of the world will show an increase

Question 16

in terms of race/ethnicity, what do we expect to see in US?

Answer 16

every racial/ethnicity will show an increase. because the US. population is aging, and glaucoma is an aging dz.

minorities are aging that is what is driving prevalence.

Question 17

a low CCT (central corneal thickness) means the risk of progression glaucoma (poag)

Answer 17

is HIGH

Question 18

A LOW CCT is below

Answer 18

555 um

Question 19

a patient has a dx of htn. the other patient does not have a dx of htn. which patient has a pooled relative risk of glaucoma

Answer 19

the pt with the htn dz. once dx with htn…then you get a risk .

Question 20

a patient has a blood pressure of 116/70. how would you expect this to affect their IOP?

Answer 20

well, its a low bp. A LOW BP IS THE LEVEL WHERE THE EFFECT ON IOP is significant. The effect is a low IOP.

it would be a minimal effect on iop if it was a high blood pressure

Question 21

a ____ (low/high) opp is a risk factor for glaucoma

Answer 21

LOW

Question 22

what two things can lead to a lowering of ocular perfusion pressure?
(hint: bp and iop). what is it? an increase or decrease

Answer 22

a DECREASE IN blood pressure (reason why we have to make pts arent overtreated on their htn meds. call pcp)
an INCREASE IN IOP

Question 23

clinically, PTS WHO ARE TAKING THEIR HTN AT BEDTIME AND THEY HAVE GLAUCOMA ARE AT A SERIOUS RISK OF PROGRESSION

Answer 23

True. because glacuoma patients are sensitive to nocturnal hypotension and those dips in blood pressure seen at bedtime compared to patients who do not have glaucoma.

Question 24

t/f we should treat older patients more aggressively.

Answer 24

false. we need to treat younger patients more aggressively. if dx early in life it slows the death of the onh.

in txt, all we are doing is slowing down the death the of the onh. so that it outlives the body.