ophthalmology Flashcards
lecture 59
risk factors glaucoma
age (40+) or race
corneal thickness or eye injury
use of steroids or hypertension (can affect pressure)
nearsighted or farsighted
diabetes or sickle cell anemia (especially untreated)
symptoms of open
none in the early stage
patchy blind spots in peripheral vision
vision difficulty in central vision
diagnosis of open
measuring of IOP
testing for optic nerve damage
vision loss assessment
corneal thickness measurement
inspection of drainage canal
symptoms of closed
medical emergency!!
severe HA or blurred vision
severe pain or halos around light
NV or redness in eye/cloudy cornea
drugs that increase aqueous humor outflow
prostaglandins
rho kinase inhibitors
cholinergics
drugs that block aqueous humor production
beta blockers
carbonic anhydrase inhibitors
drugs that increase outflow and reduce production
alpha-2 agonists
how is open glaucoma treated?
either by increasing aqueous humor outflow, blocking aqueous humor production, or both
what drugs are prostaglandins?
latanoprost
bimatoprost
travoprost
tafluprost
bimatoprost
goal of prostaglandins
decrease IOP by 30%
warnings of prostaglandins
eyelash increase (both length/number)
darkening of eyelid, iris, skin, and eyelash
se of prostaglandin
blurred vision
stinging
light sensitivity
drug of rho kinase inhibitors
netarsudil/latanoprost
SE of rho kinase inhibitors
burning
corneal disease
conjunctival hemorrhage
conjunctival hyperemia
drugs of cholinergics
carbachol
pilocarpine
cholinergic warnings
use caution in patients with history of retinal detachment or corneal abrasion
SE of cholinergics
corneal clouding
pupil constriction
hypotension
bronchospasm
cramping in the abdomen/GI distress
beta blocker drugs
betaxolol
timolol
carteolol
levobunolol
CI of beta blockers
sinus bradycardia
other heart related conditions
bronchospastic disease
SE of beta blockers
blurred vision
stinging
bradycardia
breathing problems
how would the SE of beta blockers be minimized?
closing eyes for 1-2 minutes
carbonic anhydrase inhibitor drugs
dorzolamide/timolol (drop)
acetazolamide (oral)
brinzolamide/brimonidine (drop)
methazolamide (oral)
warnings of carbonic anhydrase inhibitors
sulfonamide allergy
SE of eye drop carbonic anhydrase inhibitors
blurred vision
burning
blepharitis
taste disturbance
SE of oral carbonic anhydrase inhibitors
ataxia
confusion
photosensitivity
nausea
metabolic acidosis
alpha-2 agonists drug
apraclonidine
brimonidine
brimonidine/timolol/brinzolamide
warnings of alpha-2 agonists
CNS depression
SE of alpha-2 agonists
blurred vision
dry eyes
xerostomia
sedation/confusion
conjunctival hyperemia (redness)
what is first line treatment of open glaucoma?
prostaglandins analogs
beta blockers
alpha-2 agonists (ish)
what is second line treatment of open glaucoma?
carbonic anhydrase inhibitors
alpha-2 agonists (ish)
what is third line treatment for open glaucoma?
rho kinase inhibitors
what is the last line treatment for open glaucoma?
cholinergics
treatment of closed glaucoma
hyper osmotic agents
surgery
hyperosmotic agents drug
mannitol (IV)
glycerin (po)
surgery option
iridotomy –> tiny holes in iris to allow fluid drainage
what medications are safe to take after iridotomy?
anticholergics
topiramate
chronic steroids
decongestants
antidepressants
