FN: Glaucoma (chronic open angle) Flashcards Preview

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Flashcards in FN: Glaucoma (chronic open angle) Deck (12):
1

Pathogenesis

- Depends on susceptibility of patients retina and optic nerve to raised IOP damage
- IOP >21mmHg leads to reduced blood flow and damages to optic nerve - optic disc atrophy (pale) and cupping

2

Presentation

Perpheral visual field defect: superior nasal first
Central field is intact therefore acuity maintained until late - presentation delayed until optic nerve damage is irreversible

3

Screening

If risk is high
- >35yrs
- Afro-Caribeen
- FH
- Drugs: steroids
- Co-morbidities: DM, HTN, migraines
- Myopia

4

Investigations

1. Tonometry: IOP >21 mmHg
2. Fundoscopy: cupping of optic disc
3. Visual field assessment: peripheral loss

5

Management

Life long followup

6

Medical Mx

Eye-drops to reduced IOP to baseline
1st line: Betablockers
Prostaglandin analogues
alpha-agonists
Carbonic anhydrase inhibitors
Miotics

7

Betablock action and drug names

Timolol, betaxolol
Reduce aqueous production
Caution in asthma, heart failure

8

Prostaglandin analogues action and drug names

Latanoprost, travoprost
Raise uveoscleral outflow

9

Alpha agonist action and drug names

Brimonidine, apraclonidine
Reduce aqeous production and raised uveoscleral outflow

10

Carbonic anyhdrase inhibitors name and action

Dorzolamide drops, acetazolamide PO

11

Miotics name

Pilocarpine

12

Non-medical options

Laser trabeculoplasty
Surgery (trabeculectomy) if used if drugs fail - new channel allows aqueous to flow into conjuntival bleb

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