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Opthamology > Gluacoma > Flashcards

Flashcards in Gluacoma Deck (16)
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1
Q

What special investigation allows a view of the iridocorneal angle?

A

Gonioscopy

2
Q

What would you see on gonioscopy on a patient with open angle glaucoma?

A

The trabecular meshwork would appear normal but functionally there is an increased resistance to the drainage of the fluid and causing an elevated occular pressure.

3
Q

Who gets closed angle glaucoma?

A

Hypermetropic (Long sighted)

4
Q

What might people experience in the weeks before a closed angle gluacoma?

A

Coloured halos around bright lights

Headaches

5
Q

What is meant by secondary glaucoma?

A

Blockage of the trabecular meshwork by:

  1. Blood due to blunt trauma
  2. Uveitis
  3. Pigment from the iris
  4. Steroids increase the resistance of the meshwork and may cause glaucoma
  5. Trauma may directly damage the trabecular meshwork and impair drainage
  6. Choriodal melanoma
  7. Cataracts may swell and push the iris forward, closing the drainage angle
6
Q

What are the signs and symptoms of a chronic open angle glaucoma?

A
Usually symptomless in the early stages
White eye and clear cornea
Raised intraocular pressure
Visual field defect 
Cupped op-tic disc
7
Q

What is the visual field defect in glaucoma?

A

An upper arcuate scotoma

8
Q

What is the usual first line treatment for open angle glaucoma?

A
Prostoglandin analogues (eg latanoprost)
if this isn't tolerated then a beta blocker is second line followed by a carbonic anhydrase inhibitor
9
Q

How to prostoglandin analgoues work?

A

Increaing the passage of aqueous through the uveoscleral pathway

10
Q

How do beta blockers work in gluacoma?

A

Supressing aqueous secretion

11
Q

How do carbonic anhydrase inhibitors work?

A

Decreasing aqueous secretion

12
Q

What are some of the risks of IV acetazolamide treatment?

A

Tingling in the limbs

Stevn Johnson syndrome

13
Q

how does pilocarpine work in glaucoma?

A

Increased outflow

14
Q

if medication does not work in open angle glaucoma then what are the other options?

A
Laser trabeculoplasty 
Surgical treatment (Trabeculotomy)  which involves creating a fistula between the anteior chamber and the subconjuntival space.
15
Q

What do you see on examination of someone with acute angle closure glaucoma?

A
Reduces visual acuity 
Red eye
Pain 
Cloudy cornea
Fixed and mid dilated pupul
16
Q

What is the treatment for acute angle closure glaucoma?

A

Acetazolamide (IV and oral)
Pilocarpine (Topical)
Beta blocker (Topical)