Wk 3 Glaucoma Flashcards
Patients with glaucoma lose their __ vision
peripheral
Glaucoma can go __ for a long time
unnoticeable
What is glaucoma?
Eye disorder that increases IOP
What is open-angle glaucoma?
Blockage of trabecular meshwork that slows the drainage of aqueous humor
Patients with what type of glaucoma are usually asymptomatic?
open-angle
Closed-angle glaucoma is a __ problem
structural
Where is the narrow angle in closed angle glaucoma?
Between cornea and iris
What happens in closed-angle glaucoma?
Narrow angle between cornea and iris prevent aqueous humor from being absorbed
Closed-angle glaucoma must be treated within 24 hours or…
Blindness may be permanent
How does closed-angle glaucoma present?
As a painful red eye
What is the treatment for chronic open-angle glaucoma?
Medications that decrease aqueous humor production, or cause mitosis/opening of trabecular meshwork
Why is treatment compliance an issue for open-angle glaucoma?
May need to do eyedrops QID for an asymptomatic disease
What happens if medications do not work for open-angle glaucoma? what’s next?
Argon laser trabeculoplasty (ALT)
Where is an ALT done?
Outpatient setting
What type of anesthetic is used in an ALT?
Topical
How does an ALT work?
The laser hits the trabecular meshwork and opens the flow of channels
What is the gold standard for diagnosing angle-closure glaucoma?
gonioscopy
What is the initial medication therapy for acute angle-closure glaucoma?
Beta blocker topical agent
Carbonic anhydrase inhibitor
What drug is a carbonic anhydrase inhibitor?
acetazolamide
What else is an initial emergent treatment for acute angle-closure glaucoma?
Constrict the pupil! Lowers IOP
What should be a priority to treat in a patient with acute angle closure glaucoma?
Pain and nausea to prevent IOP from being aggravated
Patients with acute-angle closure glaucoma should stay __ and avoid __
calm, activity
What are the next steps once a patient with acute angle closure glaucoma has stable IOP?
Iridotomy
What is an iridotomy?
Provider punches holes in the iris
What is an iridectomy?
Section of iris cut out to treat closed-angle glaucoma
What are the screening recommendations for 40-60 year olds for glaucoma?
Every 3-5 years
What are the screening recommendations for patients greater than 60 years old?
Every 1-2 years
If a patient is African American, what are the screening recommendations for glaucoma?
Periodic starting age 20-39
For acute pain with angle-closure, darken the room AFTER…
the pupils are fully constricted
3 other interventions for patients with acute-angle closure glaucoma
Cool compress to forehead
Quiet/private environment
Keep patient and family informed
