Problem 2: Glaucoma

Question 1

What is glaucoma?

Answer 1

Eye condition where the optic nerve is damaged and may lead to vision loss over time. Linked to the build up of intraocular pressure (IOP) or due to weakness of the optic nerve.

Question 2

What are the different types of glaucoma?

Answer 2

Open-Angle Glaucoma (90%)
Slow gradual blocking of drainage canals, gradual increase in IOP. Wide open angle between iris and cornea.
Angle-Closure Glaucoma
Blocked drainage canals, sudden rise in IOP. Develops very quickly, usually very noticeable and demands medical attention
Normal-Tension Glaucome (NTG)
Optic nerve damaged but not abnormal eye pressure
Congenital Glaucoma
Occurs in babies, incorrect or incomplete development of the eyes drainage canals.

Question 3

What are the symptoms of glaucoma?

Answer 3

OAG: Often not noticeable symptoms, affects peripheral vision first.
ACG: Sudden sight loss / blurred vision, seeing rainbow coloured rings/halo around lights, pain in the eye, redness in the white of the eye, headache, feeling sick or vomitting.

Question 4

What is the cause of glaucoma?

Answer 4

Blockage of drainage canals causing increase in intraocular pressure which can damage the optic nerve.
Risk Factors: age > 60, family history, race, short sights, long sighted, diabetic, steroids.

Question 5

Explain the pharmacology of latanoprost?

Answer 5

Prostaglandin analogue
Increases uveoscleral outflow subsequently reducing IOP. Ciliary muscle relaxation and remodeling of extracellular matrix to increase outflow through trabescular meshwork.

Question 6

Explain why might have a topical beta blocker been avoided?

Answer 6

Systemic side effects?

Question 7

Describe how eye drops are administered appropriately?

Answer 7

Xalatan PIL + video
Directions for use
1. Wash your hands and sit or stand in a comfortable
position.
2. Remove the outer protective cap from the bottle.
3.
affected eye.
4. Place the tip of the bottle close to, but not touching the
eye. Carefully squeeze the bottle until one drop falls into
your eye. Please make sure that you do not squeeze
the bottle too hard, so that no more than one drop
falls into the affected eye.
5. Let go of your eyelid.
6.
nose. Hold for 1 minute whilst keeping the eye closed. This
will prevent the drop from being absorbed into the body. If
prescribed by your doctor, repeat the procedure in your
other eye. If the drop should miss your eye, apply another
drop.
7. Close the bottle.

Question 8

What is normal intraocular pressure?

Answer 8

10-21mmHg