Open Angle Glaucoma

Question 1

Definition

Answer 1

Raised ocular pressure causing damage to optic nerve (optic neuropathy)
-Trabecular Meshwork clear BUT blocked internally

Question 2

Risk Factors

Answer 2

Age > 65yrs
FHx
Afro-Carribbean
Ocular Hypertension
Diabetes
Myopia (eyeball too large)

Question 3

Clinical Features

Answer 3

Asymptomatic*

Gradual peripheral visual loss

Question 4

Investigations

Answer 4

• Tonometer ocular pressure (>22 mmHg)

- Optic disc cupping ++

Question 5

Management

Answer 5

MEDICAL

1. Prostaglandin analogue e.g. LATANOPROST
   - SE: browning of iris, hypotension, bradykinsia
2. Beta-blockers e.g. TIMILOL
   - NOT asthmatics
3. A2-adrenoceptor agonist e.g. BRIMONIDINE
   - NO if MAOi or TCA
   - SE: hyperaemia
4. Carbonic anhydrase inhibitors e.g. DORZOLAMIDE
5. Miotics e.g. PILOCARPINE
   - SE: constricted pupil, headache, & blurred vision

SURGICAL

1. Laser trabeculoplasty
2. Trabeculectomy (fistula between anterior chamber and subconjunctival space)