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Flashcards in Eye Therapeutics Deck (18):
0

Risk factors for glaucoma

African American
IOP >21 mmHg
Diabetes
Age>60 years old
Hypertension
Long term corticosteroid use
Elderly Hispanic

1

IOP drain

Trabecular
Uveoscleral flow

2

Aqueous humor produced

Ciliary body

3

Modulate aqueous humor

Stimulate/inhibit alpha beta receptors, carbonic anhydrase, Na/K ATPase

4

Mechanisms of treatment
Reduce IOP

Decrease production of aqueous humor from ciliary body

Increase the rate of outflow from anterior chamber

5

Prostaglandin analogs

Increase uveoscleral outflow
-oprost
Can alter iris pigmentation

Tafluprost - once daily in evening

6

Beta blockers

Decrease aqueous humor production

Timolol non selective
Betaxolol - B1 selective (good for pulmonary disease)

7

Miotics

Increase trabecular outflow

Pilocarpine

Brow pain, night time vision loss

8

Sympathomimetics

Alpha beta activity

Increase outflow from both routes

Epinephrine
Dipivefrin - prodrug of epinephrine

Third line to beta blocker, miotics

9

Alpha 2 agonist

Apraclonidine
Brimonidine

10

Carbonic anhydrase inhibitor

Inhibitor aqueous humor production and secretion from ciliary body

1) Dorzolamide, brinzolamide- topical
2) Acetazolamide- oral
Can be used as monotherapy

11

Drugs that may induce glaucoma by increasing IOP

ATVS

Anticholinergic
Tricyclic antidepressant
Vasodilator

Ophthalmic steroids (decrease outflow)
Even OTC nasal steroids

Topiramate

12

Nasolacrimal occlusion

Improves ocular bioavailability and reduced systemic absorption

1-3 minutes

13

Macular degeneration

Wet=worse, less common than dry

Presence of drusen

14

Risk factors for age-related macular degeneration

Age >60
Women
Whites
Blue eye color

Modifiable
Blood pressure
Exposure to sunlight
Diet
Smoking

15

Treat dry AMD

Control risk factors

BEDS

Antioxidants, lutein zeaxanthin

16

Wet AMD treatment

Thermal laser photocoagulation

Ocular photodynamic therapy

17

Emerging therapies

Kennalog - corticosteroid

Anti-vascular endothelial growth factor
(VEGF) - ranibizumab, pegaptanib