Ophtalmology - ACUTE ANGLE GLAUCOMA Flashcards
How is acute angle glaucoma different from open angle glaucoma? [2]
When the iris bulges forward to completely seal off the trabecular meshwork.
What are the risk factors for Acute angle glaucoma? [5]
- Increasing Age
- F > M (4x)
- FHx
- Chinese/Asian Ethnicity
- Shallow anterior chamber
Which types of medications can lead to acute angle closure glaucoma? [3]
- Adrenergic Medications
- Anticholinergic Medications
- Tricyclic Antidepressants
Give an example of adrenergic medication [1]
Noradrenaline
Give an example of anticholinergic medication [2]
Oxybutynin
Solifenacin
Give an example of tricyclic antidepressant [1]
Amitryptyline
How does acute angle closure glaucoma usually present? [5]
General unwellness coupled with:
- Painful red eye (severe)
- Blurred Vision
- Halos around lights
- Headache, N+V
On examination of a patient suspected of acute angle closure glaucoma, what do you expect to find? [7]
- Red eye
- Teary
- Hazy Cornea
- Decreased Visual Acuity
- Fixed pupil size
- Firm eyeball on palpation
After referring a patient to the ophthalmologist, what do you do for a patient suspected of acute angle closure glaucoma whilst waiting for an ambulance? [4]
- Lie patient on back without pillow
- Pilocarpine eye drops (2% blue / 4% brown)
- Acetazolamide 500mg Oral
- Analgesia / antiemetic
How does pilocarpine work? [4]
It is a miotic agent, so works on muscarinic receptors:
- Constriction of pupils
- Ciliary muscle contraction
This allows flow of aqueous humour to the trabecular meshwork.
How do carbonic anhydrase inhibitors work? Give one example [2]
Reduced production of aqueous humour.
Acetazolomide
What is the definitive surgical treatment for acute angle closure glaucoma? [2]
Laser iridotomy
Allows aqueous humour to flow from posterior chamber to anterior chamber
