Ophthalmology 1 - Open Angle Glaucoma

Question 1

define glaucoma

Answer 1

optic nerve damage caused by a significant rise in intraocular pressure caused by a blockage in aqueous humour drainage

Question 2

recall the basic anatomy of eye

Answer 2

vitreous chamber - back big chamber of eye

anterior chamber - between cornea and iris

posterior chamber - between lens and iris

A+P chambers - aqueous humour

aqueous humour made by ciliary body

flows back through the trabecular meshwork into canal Schlemm and then general circulation

Question 3

normal intraocular pressure

Answer 3

10-21 mmHg

Question 4

pathophysiology of open angle glaucoma

Answer 4

chronic increase in resistance of the trabecular network to flow

Question 5

risk factors for glaucoma

Answer 5

old age
FH
black
myopia

Question 6

presentation of open angle glaucoma

Answer 6

affects peripheral vision first 
tunnel vision eventually 
fluctuating eye pain 
headaches
blurred vision 
halos around lights at night time

Question 7

measuring intraocular pressure

Answer 7

non contact tonometry - puff of air at cornea to screen general pressure of eye (opticians use)

Goldmann applanation tonometry - gold standard, slit lamp device directly measures

Question 8

fundoscopy oepn angle glaucoma

Answer 8

optic disc cupping

Question 9

management of open angle glaucoma

4 meds
1 surg

Answer 9

if 24mmHg + in eye

latanoprost - prostaglandin anglogue increases outflow

timolol - beta blocker reduces humour production

dorzolamide - carbonic anhydrase inhibitors reduce production

brimonidine - sympathomimetics reduce production

trabeculectomy if eye drops ineffective