glaucoma

Question 1

management of acute glaucoma

pressure
admit
tx

Answer 1

reduce pressure and admit

Patients are often started on a triad of beta blockers (to reduce aqueous production), pilocarpine (to increase uveoscleral outflow) and IV acetazolamide (to reduce aqueous production). Antiemetics and analgesia should be prescribed if required.

Once intraocular pressure is controlled, a peripheral iridectomy may be carried out as definite management. Often, the contralateral eye is treated prophylactically.

Question 2

closed angle sx

systemic
pupil size

Answer 2

systemically unwell with nausea and headaches.
severe ocular pain associated with blurred vision and halos around lights.
The pupil is typically in a fixed-dilated position.

Question 3

what common topical drug can cause high IOP

Answer 3

steriods

Question 4

side effects of steriods to do with the eyes

Answer 4

Raised intraocular pressure
Glaucoma
Accelerated cataract formation
Worsening of some types of viral and bacterial corneal ulcers through its immunosuppressive effects

Question 5

most common features of primary open angle glaucoma

Answer 5

optic disc cupping and peripheral visual field loss,

imagine to rings the cup inside the ring then imagine cup is larger and wider in glaucoma

Question 6

side effects of prostoglandin analogues

Answer 6

Brown pigmentation of the iris is incorrect. This is a side effect of prostaglandin analogues, given for open-angle glaucoma.

Question 7

when laser peripheral iridotomy is performed what is the side effect

Answer 7

There is a high chance of raising intraocular pressure.

Question 8

topical beta blocker given more commomly in acute or chronic

Answer 8

chronic
Topical beta-blocker can be used to reduce intraocular pressure by decreasing the production of aqueous humour. They are often used in chronic open-angle glaucoma and may be given as an initial treatment in acute angle-closure glaucoma to decrease the pressure urgently. However, they are not the definitive treatment.

Question 9

A 68-year-old gentleman was diagnosed with glaucoma and commenced on treatment. He returned in one month for review, his eye pressures had improved but he complains his eyelashes have increased in length. What medicine is likely to have caused his eyelashes to grow in length?

Answer 9

latanoprost

Key side effects of prostaglandin analogues include increased eyelash length, iris pigmentation and periocular pigmentation