Sensory disorders or meningitis

Question 1

risk factors of glaucoma (10)

Answer 1

black or asian race
Older age

CV dz
DM
Migraine syndromes
Obstructive sleep apnea
Thin cornea

Previous eye trauma
Prolonged use of topical or systemic corticosteroids

FmHx glaucoma

Question 2

what is the difference btw wide angle and narrow angle glaucoma?

Answer 2

wide-angle- anterior chamber is open and appears nml.
-usually affects both eyes but one more severe than the other

narrow angle- obstruction in aqueous humour outflow due to complete or partial closure of the drainage system –> increased IOP

Question 3

two types of wide angle / narrow angle glaucoma

Answer 3

wide angle:
normal-tension glaucoma
ocular HTN

narrow angle:
acute angle-closure glaucoma
subacute angle-closure

Question 4

clinical manifestations of normal-tension glaucoma

Answer 4

IOP <21 mm hg
optic nerve damage –> visual field defects

Question 5

wide angle tx

Answer 5

if med tx unsuccessful:

LT decreases IOP by 20%

if continued optic nerve damage despite med therapy and LT –> glaucoma filtering surgery

Question 6

clinical manifestations of ocular htn

Answer 6

elevated IOP

possible ocular pain or HA

Question 7

tx for ocular htn

Answer 7

goal: lower IOP by at least 30%

Question 8

clinical manifestations of acute angle-closure glaucoma

Answer 8

rapidly progressive:
visual impairment
periocular pain
conjunctival hyperemia
congestion

Pain may be associated with n/v, bradycardia, profuse sweating

Reduced central visual acuity, severely elevated IOP, corneal edema

Pupil is vertically oval, fixed in a semidilated position, unreactive to light and accomodation

Question 9

tx for acute angle-closure glaucoma

Answer 9

ocular emergency:
administer hyperosmotics
acetazolamide
topical ocular hypotensive agents

Possible laser iridotomy (incision in iris) to release blocked aqueous and reduce IOP

Other eye treated with pilocarpine eye drops and/or surgical management to avoid a similar spontaneous attack

Question 10

clinical manifestations of subacute angle-closure

Answer 10

transient blurring of vision, halos around lights
temporal HA
and/or ocular pain

pupil may be semidilated

Question 11

tx for subacute angle-closure

Answer 11

prophylactic peripheral laser iridotomy

can lead to acute or chronic angle-closure glaucoma if untreated

Question 12

what is used to assess IOP

Answer 12

tonometry

Question 13

type of visual field testing done for glaucoma

Answer 13

central

Question 14

what is used to insepct the nerve disc

Answer 14

ophthalmoscopy

Question 15

why is acute angle-closure glaucoma considered a medical emergency

Answer 15

b/c blindness may suddenly occur