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23 Cards in this Set
- Front
- Back
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Glaucoma is defined by multiple symptoms including at least 2 of the following:
1. Elevated ______ 2. ____ Disk cupping 3 _____ field loss |
1. Elevated Intraocular eye pressure
2. optic disk cupping 3. visual field loss (peripheral) |
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Glaucoma is the slow death of retinal ____ cells and their axons which form optic nerves
3 possible mechanisms include: - ______ theory - ______ injury - ______toxicity |
Ganglion
- mechanical theory - vascular injury - excitotoxicity |
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Major Risk Factors for developing Glaucoma are:
1. ____ of disease 2. Myopia/_____ disease 3. ____ history of glaucoma 4. increased ____ |
1. stage of disease (IOP)
2. microvascular 3. family history 4. increased age |
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The most commpnly used IOP level is ____ mmHg as the upper limit of normal
Take the baseline IOP level and goal is to decrease by ___% |
21 mmHg
20% |
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True or False:
Once peripheral or central vision is lost from glaucoma, it can be restored via surgical technique? |
False, cannot be restored by any form of treatment
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The only definitively proven treatable risk/disease factor?
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Intraocular Pressure (IOP)
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Measures pressure within the eye
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Tonometry
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Physical exam of the eye
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Fundoscopy
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to see if there is specific loss in the visual field that may be specific to changes that occur in glaucoma
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Visual Field Testing
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Aqueous production is normally (HIGH/LOW) in protein and (WITH/WITHOUT) RBCs or WBCs?
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Normally low protein with no WBC or RBCs
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Goal of therapy is to
1. decrease ___ production and/or 2. decrease flow of ____ |
1. decrease fluid production
2. decreases flow of aqueous fluid |
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Beta Blockers:
- decrease fluid production or improves flow? - Adverse effect category |
- decrease fluid production
- cardiac |
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Cholinergic agonists
- decrease fluid production or improves flow? examples: - Adverse effect category |
Improves flow
pilocarpine, carbachol, phospholine, iodide AEs: occular (miosis, brow ache, decreased vision) |
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Carbonic Anhydrase Inhibitors
- decrease fluid production or improves flow? - examples - Adverse effect category |
- decrease aqueous fluid production
- acetazolamide, dorzolamide, brinzolamide - AEs: GI upset, malaise, renal stones, aplastic anemia |
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Alpha Agonists (non-selective)
- decrease fluid production or improves flow? -examples - Adverse effect category |
Both! decreases fluid and improves flow
ex- epinephrine, dipiverfrin AE- pupil dilation, macular edema, tachycardia |
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Alpha Agonists (selective)
- decrease fluid production or improves flow? -examples - Adverse effect category |
Both! decrease fluid production and improves flow
ex- apraclonidine, brimonidine AE- contact allergy, hypotension in kids <12 |
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Prostaglandin agonists
- decrease fluid production or improves flow? -examples - Adverse effect category |
improves flow
ex- latanoprost, travoprost, bimatoprost AE- iris colour change, lash growth, trichiasis |
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Hyperosmotics
FOR EMERGENT USE ONLY!!! -mechanism -examples - Adverse effect category |
- creates a concentration gradient in the eye
ex- glycerin (po), mannitol (IV) AE diuresis, CV overload, renal insuff, stroke |
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Considered therapy when drugs fail to control IOP adequately
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Argon Laser Trabeculoplasty
- establishes an escape route for aqueous fluid |
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Surgical treatment has a (BETTER/WORSE) response rate than meds?
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Better
80% vs 60% BUT!! after 5 years there's no significant difference |
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Symptoms of Primary angle closure glaucoma
Pain in and around _____ Redness of the _____ Nausea and vomiting _____ed vision a prodrome of _____ colored halos around lights |
the eye
eye blurred rainbow |
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This is an abnormal basement membrane-like material produced in the eye and clogs the trabecular meshwork
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pseudoexfoliation syndrome
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this is when the iris pigment clogs trabecular meshwork
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pigment dispersion syndrome
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