Wk 3 Glaucoma

Question 1

Patients with glaucoma lose their __ vision

Answer 1

peripheral

Question 2

Glaucoma can go __ for a long time

Answer 2

unnoticeable

Question 3

What is glaucoma?

Answer 3

Eye disorder that increases IOP

Question 4

What is open-angle glaucoma?

Answer 4

Blockage of trabecular meshwork that slows the drainage of aqueous humor

Question 5

Patients with what type of glaucoma are usually asymptomatic?

Answer 5

open-angle

Question 6

Closed-angle glaucoma is a __ problem

Answer 6

structural

Question 7

Where is the narrow angle in closed angle glaucoma?

Answer 7

Between cornea and iris

Question 8

What happens in closed-angle glaucoma?

Answer 8

Narrow angle between cornea and iris prevent aqueous humor from being absorbed

Question 9

Closed-angle glaucoma must be treated within 24 hours or…

Answer 9

Blindness may be permanent

Question 10

How does closed-angle glaucoma present?

Answer 10

As a painful red eye

Question 11

What is the treatment for chronic open-angle glaucoma?

Answer 11

Medications that decrease aqueous humor production, or cause mitosis/opening of trabecular meshwork

Question 12

Why is treatment compliance an issue for open-angle glaucoma?

Answer 12

May need to do eyedrops QID for an asymptomatic disease

Question 13

What happens if medications do not work for open-angle glaucoma? what’s next?

Answer 13

Argon laser trabeculoplasty (ALT)

Question 14

Where is an ALT done?

Answer 14

Outpatient setting

Question 15

What type of anesthetic is used in an ALT?

Answer 15

Topical

Question 16

How does an ALT work?

Answer 16

The laser hits the trabecular meshwork and opens the flow of channels

Question 17

What is the gold standard for diagnosing angle-closure glaucoma?

Answer 17

gonioscopy

Question 18

What is the initial medication therapy for acute angle-closure glaucoma?

Answer 18

Beta blocker topical agent

Carbonic anhydrase inhibitor

Question 19

What drug is a carbonic anhydrase inhibitor?

Answer 19

acetazolamide

Question 20

What else is an initial emergent treatment for acute angle-closure glaucoma?

Answer 20

Constrict the pupil! Lowers IOP

Question 21

What should be a priority to treat in a patient with acute angle closure glaucoma?

Answer 21

Pain and nausea to prevent IOP from being aggravated

Question 22

Patients with acute-angle closure glaucoma should stay __ and avoid __

Answer 22

calm, activity

Question 23

What are the next steps once a patient with acute angle closure glaucoma has stable IOP?

Answer 23

Iridotomy

Question 24

What is an iridotomy?

Answer 24

Provider punches holes in the iris

Question 25

What is an iridectomy?

Answer 25

Section of iris cut out to treat closed-angle glaucoma

Question 26

What are the screening recommendations for 40-60 year olds for glaucoma?

Answer 26

Every 3-5 years

Question 27

What are the screening recommendations for patients greater than 60 years old?

Answer 27

Every 1-2 years

Question 28

If a patient is African American, what are the screening recommendations for glaucoma?

Answer 28

Periodic starting age 20-39

Question 29

For acute pain with angle-closure, darken the room AFTER…

Answer 29

the pupils are fully constricted

Question 30

3 other interventions for patients with acute-angle closure glaucoma

Answer 30

Cool compress to forehead
Quiet/private environment
Keep patient and family informed