Lecture 11

Question 1

What causes primary glaucoma?

Answer 1

Unknown cause

Question 2

What causes Secondary glaucoma?

Answer 2

Cause is unknown could be due to a tumour, contacts or diabetes

Question 3

What is ocular hypertension?

Answer 3

Raised intraocular pressure in the eye

Question 4

How is glaucoma diagnosed?

Answer 4

Dye in eye to observe the optic nerve
Visual field examination
Measure eye pressure
Determine if open or closed glaucoma (gonioscopy)
Measure the thickness of cornea (pachymetry)

Question 5

Define primary open angle glaucoma

Answer 5

Caused by blockage in the trabecular mesh work which drains the anterior chamber of the eye to the episcleral veins through the canal of schlemm
Leads to pressure build up due to inadequate drainage of aqueous and vitreous humour

Question 6

What is humour?

Answer 6

Fluid in the eye and it drains via the trabecular mesh work

Question 7

Symptoms of primary angle glaucoma

Answer 7

Medical emergency
Severe pain
Headache
Change in vision

Question 8

How is primary angle closure glaucoma managed?

Answer 8

Diuretics
Pilocarpine
Prostaglandins, beta blockers, sympathomimetics
Surgery

Question 9

What are the issues with preservatives?

Answer 9

Cause side effects and can interact with contact lenses

Question 10

What are miotics?

Answer 10

Involves construction of the pupil of the eye
Pulls iris away from trabecular mesh work - improves outflow opening up the angle further

Question 11

What are miotics used for?

Answer 11

Acute glaucoma

Question 12

What are the side effects of miotics?

Answer 12

Increased gastric acid secretion, affect HR and blood pressure as well as worsen asthma and seizures

Question 13

Examples of a miotics

Answer 13

Pilocarpine - used to reduce pressure inside the eye

Question 14

What do prostaglandin analogues do?

Answer 14

Increase uvoscleral outflow - outflow through the eye and out

Question 15

Give examples of prostaglandin analogues

Answer 15

Bimatoprost, travoprost, latanoprost

Question 16

What are carbonic anyhdrase inhibitors?

Answer 16

Decrease production of intraocular fluid
Increase perfusion of eye
Reduction in intraocular pressures

Question 17

Example of a carbonic anhydrase inhibitor

Answer 17

Dorzolamide

Question 18

What do symothomimetics do?

Answer 18

Very effective at reducing humour production and increase outflow

Question 19

What are the side effects of sympathimimetics?

Answer 19

Blurred vision, discomfort, headache, nausea, hyperaemia

Question 20

Example of sympathomimetics

Answer 20

Brimodine

Question 21

What are beta blockers used for in the eye?

Answer 21

Reduces aqueous humour production

Question 22

What are the issues with beta blockers?

Answer 22

Increased heart rate and asthmatic patients feeling more breathlessness

Question 23

Define trabeculoplasty

Answer 23

Form of laser surgery that is used to lower intraocular pressure in glaucoma

Question 24

Define tracbeculectomy

Answer 24

Type of glaucoma surgery performed on the eye that creates a pathway for fluid inside the eye to be drained

Question 25

Role of anti metabolites

Answer 25

Prevent scarring by inhibiting the manipulation of cells which produce scar tissue

Question 26

Example of antimetabolites

Answer 26

Mitomycin C or 5 flurouracil

Question 27

Define visocanaloostomy

Answer 27

Remove part of the eye

Question 28

Define deep sclerectomy

Answer 28

Widen the drainage tubes in the eye

Question 29

Define cyclodiode laser

Answer 29

Destroys tissue in eye responsible for aqueous formation

Question 30

How is closed angle glaucoma managed?

Answer 30

Medical treatment, laser treatment no surgical treatment
Aim to reduce intraocular pressure and slow progression of nerve damage
Reduce amount of AH produced or increase drainage through the trabecular mesh work

Question 31

Define glaucoma

Answer 31

Optic nerve which connects the eye to the brain becomes damaged

Question 32

Define acute angle closure glaucoma

Answer 32

Caused by the drainage in the eye becoming slightly blocked which raises the pressure in the eye