Flashcards in Glaucoma Deck (53)
Primary open angle glaucoma is more common in what races?
Blacks and latinos
What is the second leading cause of blindness?
Worldwide, how many people have glaucoma?
over 60 million
What is the difference between open angle glaucoma and closed angle glaucoma?
Open angle - aqueous has open access to trabecular meshwork
close angle - trabeculum is blocked by iris and aqueous cannot drain from eye. IOP rise
What is the leading cause of irreversible blindness in the US?
How many Americans have Glaucoma in the US?
How many genes have been linked to glaucoma?
5 - 10
What is the MYOC gene thought to affect?
protein unfolding in the TM
What is the E50K mutation though to affect?
familial POAG. Optineurin collects in OPL of retina and decreases retinal ganglion cells without affecting IOP
What's the difference between infantile and juvenile glaucoma?
infantile - before 2 years of age
juvenile - after 2 years of age
What is the clinical triad that indicates congenital/infantile glaucoma?
Why does the eye look bluer in congenital/infantile glaucoma?
Choroid is more easily visualized through thinner sclera
What are diurnal IOP norms?
about 3.7 - normal
over 5 - should be watched
over 10 - definitely suspect
What are optic disc size norms?
2.69 +/- 0.70 mm
two deviations away is considered macro/micro
Optic disc is typically larger in what meridian? Cups are typically larger in what meridian?
disc - larger vertical
cup - larger horiztonal
How much of the asian population have narrow angles that put them at risk for glaucoma?
1/200 whites are at risk...
The prevalence of glaucoma at age 20 is __% and does what every decade?
at age 20 - 0.25%
Doubles every ten years
Females are more at risk for what type of glaucoma?
No significant difference in POAG
How much does glaucoma cost the US every year?
Why is there a link between hypothyroidism and POAG?
patients tends to have more hyaluronic ad in the TM which increases outflow resistance.
Why is there a link between hyperthyroidism and POAG?
1. Enlarged EOMs compromising venous outflow, elevating episcleral venous pressure
2. Fibrotic EOMs indent the globe. IR pushing on globe when patients look up
What is the link between Raynaud's syndrome/migraines and POAG?
vasoconstriction may lead to decreased vascular perfusion to the optic nerve
What is the link between carotid artery disease and IOP?
decreases IOP due to decreased perfusion pressure
What is the link between corticosteroids and POAG? Who takes corticosteroids?
increase IOP in 5-6% of normals after 4-6 weeks. Increases TM cell size. Increase in glucoaminoglycans in TM, suppression of endothelial phagocytosis of aqueous debris, steroid particles obstruct outflow
RA, asthma, COPD
What substances can lower IOP?
Alcohol, nitro, digitalis, beta blockers, Ca channel blockers, marijuana (for 3 hours)
Why does corneal edema happen more in angular closure glaucoma vs POAG?
angle closure - rise in IOP much more rapid than POAG
What percent damage is required to present an RAPD in glaucoma?
30% more damage in one eye than the other
Color vision usually presents what defect in Glaucoma?
Are myopes or hyperopes more prone to glaucoma?
Myopes. May be due to the fact that myopes go to the eye doctor more.