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38 Cards in this Set
- Front
- Back
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what percentage of IOP drop is seen with the docosanoid uniprostone isopropyl
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only 15%
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what is possibly the safest systemic glaucoma drug
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uniprostone isopropyl
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what are the ocular side effects of the docosanoid uniprostone isopropyl
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similar to prostaglandins you could see iris darkening, and should use caution with pts that have a history of HSV or iritis. it may also cause spk
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should or could a hyperosmotic solution be used on a regular basis to treat glaucoma
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no they should only be used in emergency situations such as acute angle closure glaucoma
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provided it is available what hyperosmotic would you use on a diabetic pt that is suffering from an acute angle closure
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isosorbide 45%
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they hyperosmotic glycerol 50% has a high risk for what pt population
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diabetics there is a hyperglycemic risk
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how is the hyperosmotic glycerol administered. hint......it is not an eye drop
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drink over cracked ice
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mannitol should be avoided with pts that have _______
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renal dz
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is the hyperosmotic drug mannitol a drug that you can administer in your office
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no the pt must be hospitalized
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what is the "next wave" of glaucoma treatment, the new thing they are working on
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neuroprotection
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what are two things that ginko biloba does
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it is a blood flow enhancer and a nitric oxide inhibitor
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can you test a pt for genetic components for certain types of glaucoma
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yes you can test for congenital and POAG
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how many genes are involved in testing for congenital glaucoma
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there is a diagnostic kit available that test for 3 gene
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how many genes are involved in testing for POAG
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6 genes
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what is the goal for gene therapy
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to either turn off bad genes or create genes that produce medicine for affected area
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can steroids be used to reduce IOP
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in SOME cases yes. Like inflammatory glaucomas such as uveitic or chemical burns
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what portion of the eye do steroids work on to reduce pressure in the eye
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they reduce inflammation of the ciliary body and this may reduce aqueous secretions
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what should be the first drugs used on a glaucoma pt
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a beta blocker BID or even better would be a prostaglandin HS
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what would you do for a glaucoma pt that you started on a prostaglandin but you are not seeing results two weeks later
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you should add a beta blocker
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you have a pt on prostaglandins for treatment of glaucoma. how long do you wait before you before adding another drop? what if they are on a beta blocker
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2 weeks. 4 weeks for anything other than prostaglandins
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you have had your glaucoma pt on a combo of a beta blocker and a prostaglandin but you are not seeing the results that you want. what can you do next
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you could add a monocular CAI TID to the regimen.
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how often should you see a glaucoma pt?
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4x a year for pressures and 2x a year for fields
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currently you have a glaucoma pt on a beta blocker, prostaglandin and a cai monocular. You are not seeing the results that you want, what next?
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refer for ALT/SLT or trabeculectomy
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as a last resort what could you prescribe to your glaucoma pts that have had surgery and are still in need of relief
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consider oral CAI
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what kind of a goal should you set for a glaucoma pt?
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20 to 30% drop is a good goal make sure to set a range not a number for your own protection
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what is a good procedure to teach pts so that they get better absorption of their eye drops
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punctal occlusion
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if a pt comes in for a 2 week follow up and you find out that they are not being compliant with their glaucoma drops what is your next step
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try to re emphisize how important it is and try to help integrate the drops into their day for them. and then have them back for another 2 week follow up
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what is better argon laser trabeculoplasty or selective laser trabeculoplasty
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SLE is b/c it is a cold laser so there is no burning or scaring like there is with ALT. SLE also allows for repeated treatment unlike ALT
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what is teh most common complication with POAG eyes after ALT
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transient IOP rise immediately post op
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when is the long term IOP drop apparent after ALT
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6-8 weeks after surgery
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what percentage of people are successfully treated for POAG with laser trabeculaplasty
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70 to 80% with less than 50% having adequet control after 5 years
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in incisional surgery for glaucoma the new fluid filled space b/t the anterior chamber and the subconj space is called what
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a bleb
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what type of glaucoma surgery has a hole all the way thru the sclera but is covered with a conj flap
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sclerostomy
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what type of glaucoma surgery has a hole all the way thru the sclera but is covered with a scleral flap
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trabeculectomy
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what can be done to help improve a sclerostomy in lowering IOP
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a tube or valve could be inserted to facilitate outflow of aqueous
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what could you advise the pt to do if their bleb is closing and raising IOP
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ask them to do ocular massage to keep it open
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what are some early complications with incisional surgery for glaucoma
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hypotony or wound leak, flat anterior chamber, choroidal detachment, or endophthalmitis
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what are 2 procedures done for end stage glaucoma that destroys destroys the ciliary body epi to decrease aqueous production
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cryocyclotherapy or transscleral YAG laser cryophotocoagulation
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