Primary Open Angle Glaucoma Flashcards
What is glaucoma?
An optic neuropathy due to raised intraocular pressure. (IOP)
Name some risk factors for primary open angle glaucoma?
- Family history
- Black patients
- Myopia
- Hypertension
- Diabetes Mellitus.
What are some features of POAG?
- Peripheral visual field loss - nasal scotomas progressing to ‘tunnel vision’
- Decreased visual acuity
- Optic disc cupping
Who gets POAG and how often is it detected?
POAG is found in 2% of the people older than 40 years.
It is often detected during routine optometry appointments as it can be insidious.
How are most POAG patients managed?
Managed with eye drops that lower intra-ocular pressure.
Name a prostaglandin analgoue, it’s MOA s/e?
Latanoprost, Travaprost
It increases uveoscleral outflow.
Once daily administration.
S/E Can cause the iris to turn brown.
Name a beta-blocker, it’s MOA s/e?
Timolol
Reduces aqueous production
Avoid in asthmatics and patient’s with heart block.
Name a sympathomimetic, it’s MOA s/e?
Brimonidine
Reduces aqueous production and increases outflow.
Avoid if taking MAOI or TCA
Can cause Hyperaemia.
Name a carbonic anhydrase inhibitor, it’s MOA s/e?
Dorzolamide
Reduces aqueous production
Can cause sulphonamide-like reactions.
Name a miotic, it’s MOA s/e?
Pilocarpine (a muscarinic receptor agonist)
Increases uveoscleral outflow.
S/E: constricted pupils, headache and blurred vision.
What surgery can be done in refractory cases?
Trabeculectomy
What is the normal range for intraocular pressure?
10-21 mmHg