Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
223 Cards in this Set
- Front
- Back
(T/F) Glutamate antagonists is being studied to see if they can prevent glaucoma
|
F - Glutamate agonists
|
|
(T/F) Neurotrophins may be an effective neuroprotector for glaucoma.
|
T
|
|
(T/F) Nitraseoxide sensatase can block the production of nitrous oxide, which is a free radical that can damage the eye.
|
T
|
|
What is the only proven method to stop/slow down glaucoma?
|
IOP control
|
|
Does structural or functional damage occur first in early glaucoma? What is the clinical relevance?
|
Structural damage. But this is often hard to see.
|
|
(T/F) The OHTS study found that when patients with ocular hypertension converted to glaucoma, ___ of the time, the first sign was VF loss. The European Glaucoma Prevention Study found that the percent was ___.
|
40%, 60%
|
|
What picks up defects earlier? FDT or White-On-White (WOW)/
|
FDT
|
|
(T/F) The best way to monitor glaucoma damage in (early/middle/late) stage glaucoma is with perimetry.
|
Late
|
|
What perimetry type is the standard of care for glaucoma? Why?
|
White-On-White (WOW) Standard Automated Perimetry (SAP) Threshold. Because it has progression analysis software.
|
|
Is the FDT good for early detection or management of glaucoma? Why?
|
Early detection b/c it picks up glaucoma ??% of the time. Also, there is no progression software to track changes.
|
|
If we were to use the Humphrey to screen for glaucoma, what is better (C40/C80)?
|
C80
|
|
FTD screening for glaucoma is best done with the (C20-5/N30-5)
|
N30-5
|
|
(T/F) White-On-White threshold testing picks up glaucoma better than an FDT
|
F
|
|
What kind of defect does fixation errors cause in perimetry?
|
They smear out true visual field defects.
|
|
(T/F) Early glaucoma damage evidence in VF is often inconsistent.
|
T
|
|
(T/F) IOPs do not fluctuate in early glaucoma.
|
F
|
|
What criteria does the patient have to meet to have a threshold test done for glaucoma?
|
Done for all glaucoma suspects.
|
|
(T/F) A patient with everything normal but signs of structural damage should be treated for glaucoma.
|
T
|
|
Name 7 high risk factors for glaucoma.
|
Large CDs, asymmetric CDs, nerve fiber layer defects, notches, higher IOPs, asymmetric IOPs, family history.
|
|
What is Short Wavelength Automated Perimetry (SWAP)? Advantages? Disadvantages?
|
Blue stimulus on yellow background. Detects glaucoma damage and progression earlier, but lots of variability.
|
|
(T/F) The Matrix has VF loss progression software
|
F
|
|
Name 4 factors that cause generalized depression on VFs.
|
Tiny pupils (<3 mm), Things that mess up the cornea (previous gonio, pachymetry), cataracts, tiredness.
|
|
(T/F) If a patient changes from a .1 CD to a .2 CD, but everything else is normal, they have glaucoma.
|
T
|
|
What tools are recommended to detect and treat glaucoma in your practice?
|
Detect with FDT. Treat with White-On-White perimetry.
|
|
What is the working distance for FDT, Octopus, Matrix, Humphry? What kind of adds do we add for the ones that aren’t at infinity?
|
Infinity, 30 cm, Infinity, 30 cm. +3.00D
|
|
What phenomenon might cause a pt to do better on their second threshold test?
|
The learning effect.
|
|
How often should we get VFs when treating an early/advanced glaucoma pt?
|
3 per year. 3-6 per year.
|
|
What test should we do with advanced glaucoma patients? What extra thing do we need to do in this case?
|
10-2 VF because it tests central 10 degrees. Foveal threshold MUST be on.
|
|
What is the difference between EVENT and TREND analysis that is built into our Humphreys?
|
Event is snapshot. Trend tracks change.
|
|
What is the likely culprit of doing a Humphrey test and finding that the patient doesn’t have a blind spot?
|
They don’t have their other eye patched.
|
|
What are the 3 phases of glaucomatous VF loss?
|
Elevated IOP but no VF change. 2) Unstable VF defects 3) Paracentral scotoma/nasal step.
|
|
What is baring of the blindspot?
|
Vertical enlargement of the blind spot that happens with glaucoma.
|
|
What other 6 things might cause an artifactuous baring of the blind spot?
|
Small pupil, blur (wrong lens), media opacity, wrong age entered, learning curve, fatigue
|
|
What are the 3 classic VF defects in early glaucoma?
|
Paracentral scotoma, nasal step, temporal sector defect
|
|
What is a paracentral scotoma? How big is it? How far from fixation is it?
|
Small scotoma (5-20 degrees) in arcuate region of VF. Can be as close as 1 degree away from fixation.
|
|
What VF defect is often found with paracentral scotomas?
|
Nasal Step.
|
|
(T/F) Nasal steps are the #1 most common isolated single defect in glaucoma
|
F – Paracentral scotoma.
|
|
(T/F) Fixation is often affected first in early glaucoma.
|
F
|
|
Nasal steps occur with a paracentral scotoma ___% of the time.
|
75%
|
|
Nasal steps are the #___ most common VF defect. It is found first ___% of the time.
|
2. 20%
|
|
A nasal step should be at least ___ degrees big.
|
10
|
|
What is the best technique/tools to use when examining the ONH?
|
Slit lamp and fundus lens.
|
|
What is the best mag when looking at the ONH head with a slit lamp and fundus lens? What beam thickness?
|
16x is best. Can do optic section to look at contour of cup.
|
|
(T/F) Glaucoma produces pallor outside of the cup.
|
F
|
|
(T/F) Nerve fiber layer defects and VF defects are very specific to glaucoma
|
F
|
|
What is the characteristic pattern of glaucomatous ONH damage?
|
Cup increases and is filled with pallor.
|
|
What kind of people have large cups?
|
People with large nerves (Myopes, African Americans).
|
|
What kind of people have small cups?
|
Hyperopes.
|
|
On the Welsch Allen ophthalmoscope, which aperture is the size of a normal ONH?
|
Middle one.
|
|
What makes up the rim tissue?
|
Axons
|
|
What part of the ONH is the rim tissue?
|
The stuff outside of the cup.
|
|
What is the ISNT rule?
|
The inferior rim tissue is thicker than the Superior. The Nasal is thicker than superior/inferior.
|
|
What area of the rim tissue is it most difficult to see pallor? Why?
|
Temporal because this rim tissue is very variable!
|
|
(T/F) It is best to judge CDs by contour, not color.
|
T
|
|
Which part of the ONH rim tissue is rarely affected by glaucoma?
|
Nasal
|
|
(T/F) Peripapillary atrophy is a specific sign of glaucoma
|
F
|
|
What are the 2 zones of peripapillary atrophy? (Alpha, beta)
|
Alpha is thin, irregular, blotchy line of pigment that gets thicker with more glaucomatous ONH damage on the outside. Beta is on the inside and contains choroidal vessels.
|
|
What is the Laminar Dot Sign?
|
When a person who did not have laminar dots gets them.
|
|
If you see laminar dots in a patient’s eye, do they have the Laminar Dot Sign?
|
No, because it could be congenital. Except if you see it at the inferior and superior rim tissues, then that is characteristic of glaucoma.
|
|
What is saucerization of the ONH?
|
When there are multiple levels of cupping. (Like stairs)
|
|
What is a circumlinear vessel and how is it relevant to CD ratio estimation?
|
A vessel that rides the edge of the cup. If we continue to see it right on the edge of the cup, then we know the cup didn’t change.
|
|
A cup asymmetry of .1 will be found in ___% of patients. An asymmetry of .2 will be found in ___% of patients.
|
8%, 1%
|
|
What is the most common cause of peripapillary atrophy?
|
Age
|
|
When cupping occurs on the ONH via glaucoma, what area(s) cup first?
|
Superior/Inferior areas.
|
|
How can we determine if peripapillary atrophy is a cause of glaucoma?
|
Compare its location to visual field losses.
|
|
(T/F) A papillary atrophy width change precedes glaucomatous damage by years.
|
T
|
|
Laminar dots start as (round/oval) and then progress to (round/oval)
|
Round, Oval.
|
|
(T/F) Drance hemes are dot blot hemorrhages.
|
F – Flame hemorrhages
|
|
(T/F) Drance hemes do not always need to be near the ONH.
|
F
|
|
(T/F) Drance hemes are often found found in photos more then through clinical observation.
|
T
|
|
Why are drance hemes significant?
|
They can precede glaucomatous damage by months, years to 6 years.
|
|
(T/F) Seeing a drance heme is reason enough to start glaucoma therapy.
|
T
|
|
What 8 things could cause a flame heme on the ONH?
|
Low tensions, chronic open angle glaucoma, aspirin, warfarin/Coumadin, fish oil, Anemia, migranes, drusen.
|
|
(T/F) We see flame hemes in diabetics.
|
F – Dot blot hemes
|
|
(T/F) HBP can cause flame hemes with no other symptoms.
|
F – By this point, we’ll probably have swollen ONH and other signs.
|
|
(T/F) A PVD where the Weiss ring pulls away from the retina often leads to flame hemes.
|
F – Dot blot hemes
|
|
(T/F) An AION will likely produce a single flame heme that looks like a drance heme.
|
F – It will make lots of big hemes.
|
|
___% of flame hemes will cause a visual defect
|
60%
|
|
What might happen in the place where a drance heme is?
|
Focal nothch, NFL loss and VF loss.
|
|
What 3 things should we think about if we see a drance heme in a pt we’re managing?
|
Compliant? 2) IOP spike we don’t know about? 3) Need to lower target IOP?
|
|
What is meant by baring of the circumlinear vessel?
|
Cupping progressed beyond a circumlinear vessel.
|
|
What is an acquired pit?
|
Focal excavation of rim tissue near the edge of the disc.
|
|
In literature, acquired pits happen in ___% of patients. Dr. Comer sees them in ___% of patients.
|
20%. 1%
|
|
___% to ___% of nerve fiber layer loss must occur for us to see it clinically.
|
30-50%
|
|
Imaging can pick up ___% of nerve fiber layer loss.
|
10-20%
|
|
What 3 things could preceed glaucomatous ONH damage?
|
Drance hemes, peripapillary atrophy, nerve fiber loss.
|
|
(T/F) Generalized NFL loss is easier to detect than focal.
|
F
|
|
What 2 techniques are good for picking up NFL loss?
|
DO, Fundus lens
|
|
What is the danger of going too high mag for NFL loss evaluation with a fundus lens? What mage is best?
|
10-16x is best. If too high, will mistake normal NFL spread as damage.
|
|
What parts of the ONH is it easiest to see the NFL?
|
Superior/Inferior.
|
|
(T/F) Increasing visibility of medium sized vessels indicate possible NFL loss.
|
T
|
|
(T/F) It is acceptable to compare the superior and inferior portions of the ONH to compare for NFL loss.
|
F – You should compare eye to eyes!
|
|
How big should a possible slit defect be so we know it’s real?
|
The size of a vessel or larger up to 2-3x.
|
|
How do wedge defects form?
|
Slit defects coalesce together.
|
|
(T/F) Wedge and slit defects are lighter bands of area.
|
F – Darker.
|
|
(T/F) If you see lots of striations, then you have NFL loss.
|
F. That’s good!
|
|
How does the presence of a wedge defect and a drance heme tell us different things about glaucomatous damage?
|
Wedge defect shows past damage. Drance heme indicates current damage.
|
|
How do we know we have a real RNFL slit defect?
|
It runs to the ONH and is the same size or 2-3x larger than vessels.
|
|
What are 2 advantages of using imaging technology?
|
1) Glaucoma identification 2) Tracking of glaucoma change
|
|
What do you get with an HRT? Advantages? Disadvantages?
|
ONH image and RNFL image. Good picture of ONH. Bad picture of RNFL.
|
|
What is the GDX good for?
|
Imaging the RNFL
|
|
What 3 things does Optivue RT give us?
|
NFL image. Nerve head topography. Paramacular retinal ganglion cell layer.
|
|
What generation is the OCT Zeiss?
|
3rd gen. Not as good as 4th.
|
|
(T/F) Imaging is covered by Medicare for late stage glaucoma. Why?
|
False. Because VF damage is a better way to see how late stage glaucoma is changing.
|
|
What is the difference between 4th gen OCTs and 3rd gen OCTs?
|
65x faster and 2x better resolution. Therefore, you can compare better and pt movement isn't an issue.
|
|
What is an A Scan?
|
Coherent light is shot into the eye along the long axis and the reflectance from various layers of the retina come back to the instrument.
|
|
What is the difference between A and B scan?
|
B scans are a series of A scans along one line.
|
|
What is the best thing about the HRT?
|
It gives good optic nerve topography.
|
|
What is the best thing about the GDX?
|
It gives a good look at the NFL.
|
|
What does the Optivue RT give in addition to the HRT and GDX?
|
Paramacular ganglion cells scan.
|
|
(T/F) Proper imaging can replace our clinical exam.
|
F
|
|
(T/F) Thicker corneas can prevent meds from reaching the back of the eye.
|
T
|
|
If a patient has a ___ nm cornea, then meds won't reach the back of the eye. Therefor, _____ should be considered.
|
625+ nm. Laser trabeculoplasty.
|
|
Name the conditions we need to do a prone dark room provocation test.
|
Lights off. Head down so facing floor. Eyes open or closed. No sleeping. Hour.
|
|
How do we reverse angle closure from a dark room provocation test?
|
Turn on the lights -> Pupil shrinks -> pupillary block stops -> Iris pulled away from TM
|
|
If a dark room provocation test brings an ___mmHg or greater rise in IOP, then the patient is at risk for a pupillary angle closure.
|
8
|
|
What is the formula for ocular blood flow?
|
Ocular blood flow = BP - IOP
|
|
Does BP rise or lower at night?
|
Lower
|
|
Does IOP rise or lower at night?
|
Rise
|
|
Why are the BP and IOP changes at night when sleeping supine a possible cause of glaucoma?
|
BP lowers. IOP rises. Less ocular blood flow -> decreased profusion -> ONH damage
|
|
(T/F) Beta Blockers are good for lowering IOP but keeping BP high at night?
|
F - Prostaglandis and CAIs are better. BBs lower BP.
|
|
(T/F) Timolol is a good choice to keep IOPs low at night.
|
F - All BBs don't lower BP when sleeping
|
|
(T/F) Alphagan is a good choice to keep IOPs low at night.
|
F - They work minimally.
|
|
Why are prostaglandings preferred over CAIs for keeping IOPs low at night?
|
B/c you take them once per day. CAIs should be taken TID. But they can be used together if you need to.
|
|
What tool gives an indication of ocular blood flow? How?
|
Pascal tonometer because it gives ocular pulse amplitude which is the difference between diastolic and systolic eye pressure.
|
|
(T/F) There are no symptoms in open angle glaucoma
|
T
|
|
(T/F) It is acceptable to treat an ocular hypertensive for glaucoma.
|
T - especially if other strong risk factors.
|
|
What is the average corneal thickness?
|
575 nm
|
|
(T/F) It is appropriate to give an ocular hypertensive with 25/25 IOPs glaucoma treatment if their cornea is 575 nm?
|
F - It is better to see them in 6 months or 1 year.
|
|
(T/F) There is no acute risk with open angle glaucoma.
|
F - A patient with prior central or branch vein obstruction. We want to prevent another one.
|
|
(T/F) There is a cure for glaucoma
|
T
|
|
(T/F) You cannot go blind because of glaucoma
|
F
|
|
A ___ nm decrease in central corneal thickness equates to a ___% risk increase of glaucoma
|
40 nm, 70%
|
|
What is the average CD ration for an African American?
|
.5 to .6
|
|
A pt has "borderline" IOPs one week. The next week, they are "normal". Should we treat?
|
Yes - because the drastic change in IOPs shouldn't occur.
|
|
If angles are .12, is there a risk of open angle glaucoma?
|
No because the angle is still open. Open angle glaucoma is when the aqueous reaches the TM but can't leave.
|
|
We do a one eyed therapeutic trial of a drug on a patient. The next week, the IOPs for both eyes are lower. Keep using the drug?
|
No. The lowering of IOP is due to another factor, not the drug.
|
|
Do we need to do one-eyed therapeutic trials every time we introduce a new drug?
|
Yes.
|
|
What is the first line med for glaucoma?
|
Prostaglandins.
|
|
Which eye do we choose for the one-eyed therapeutic trial?
|
The eye with the higher IOP.
|
|
What 3 things do we look for to get a good response to a drug during a one-eyed trial?
|
Only 1 IOP reduced by the percent we expect. Pt was compliant. Side effects are tolerable.
|
|
How much should the IOP lower for a prostaglandin? BB?
|
20-30%
|
|
Why would we use BBs over prostaglandins when they have more systemic side effects?
|
Cheaper. ($4 per bottle)
|
|
Why is it important to check the pulse when giving BBs?
|
Systemic side effects can cause cardiac risk
|
|
When should we follow up on a prostaglandin? BB?
|
4 weeks. 3 weeks.
|
|
A person uses BBs says they now get winded more easily. Discontinue?
|
Yes - Pulmonary side effect is bad.
|
|
When is the best time to take a prostaglandin?
|
Before sleep.
|
|
One eyed patients. Glaucoma management change?
|
Yes. Treat more aggressively because they only have 1 eye!
|
|
A person has unilateral glaucoma. How treat?
|
Ease them into therapy with one eye. Eventually, will need to bring in both eyes in a month to a year because glaucoma is often bilateral.
|
|
How does target pressure change with severity of glaucoma damage?
|
Greater damage -> lower target pressure.
|
|
(T/F) The lower the pressure, the harder it is to lower it even more.
|
T
|
|
(T/F) If optic nerve damage is noted, but no VF loss, we should treat for glaucoma.
|
True.
|
|
What is the maximal tolerable medical therapy for a pt?
|
The most medications that a pt can take.
|
|
What is the main goal of glaucoma treatment?
|
VA preservation.
|
|
What is the 2nd goal of glaucoma treatment?
|
Keep compliance
|
|
(T/F) Lowering IOPs is the only proven way to slow the progression of glaucoma
|
T
|
|
(T/F) A 20% risk of getting glaucoma in 5 years is significant enough to start treatment.
|
T
|
|
CD ratios for Latino pts is ___ to ___
|
.4 to .5
|
|
If you can see VF loss with confrontations, is glaucoma damage bad?
|
Yes.
|
|
What drug that we use in clinic all the time could cause IOP increase? How?
|
Relaxes ciliary muscle fibers, so IOP can increase.
|
|
We give tropicamide to a pt and their IOP shoots up. What drug do we give to bring them down?
|
Alpha 2 agonists
|
|
What is a target pressure for glaucoma management?
|
Whatever I estimate the IOP to be to slow/stop glaucomatous change.
|
|
What is the minimal IOP reduction we want with a patient with minimal damage or just high risk?
|
25-30%
|
|
What is our target IOP when glaucomatous VF loss in central 5 degrees, spittling fixation, or double acuates?
|
10 mmHg
|
|
Is it harder to get an IOP from 30 -> 20 or 12 -> 10?
|
12 -> 10.
|
|
What did the Collaborative Normal Tension Glaucoma Study (CNTGS) find?
|
Normal tension glaucoma pts (never > 21) had 60% glaucoma progression without treatment.
|
|
(T/F) A patient can have a non-progressive form of low tension glaucoma.
|
F - It must be progressive.
|
|
What is the target IOP reduction for low tension glaucoma?
|
30%
|
|
What did the Advanced Glaucoma Intervention Study (AGIS) find about African Americans vs. Caucasians?
|
African Americans like ATT and Caucasians like TAT. T = Trabeculectomy surgery. A = Argon laser trabeculoplasty
|
|
What percent of pressure reduction did the Advanced Glaucoma Intervention Study (AGIS) find to prevent glaucoma progression? Exact parameters?
|
50%. Near 10 mmHg and minimal variation to always keep it < 18 mmHg
|
|
What is the average IOP lowering with surgery and drugs?
|
40% and 37%
|
|
What did the Collaborative Initial Glaucoma Treatment Study (CIGTS) find was better at preventing VF loss? Surgery or Drugs?
|
Same.
|
|
Do we prefer surgery or drugs to prevent glaucomatous damage?
|
Drugs because less side effects (1/2 line VA loss, 3x more cataracts, dry eyes, red eyes, irritated eyes, etc.)
|
|
(T/F) Meds are an acceptable first line treatment for glaucoma.
|
T
|
|
If one eye IOP is 27 and the other is 18, do we want both to be 18?
|
No. Reduce both by 30%
|
|
(T/F) High IOP fluctuation is linked to glaucomatous damage progression
|
T
|
|
If the rate of VF damage is 3 dbs per year, is that bad? What do we do?
|
Yes. Treat it more aggressively.
|
|
How much will a 1 IOP decrease reduce the risk of glaucoma progression?
|
10%
|
|
What is combigan?
|
Timoptic and Alphagan
|
|
What is Cosopt?
|
Timoptic and Dorzolamide
|
|
What are 3 reasons why we don't want to pile excessive drug combos on?
|
Compliance, cost, side effects.
|
|
When setting the target IOP, do we use the (highest/lowest) IOP. Even if it is from another doctor's office.
|
Highest.
|
|
(T/F) Always start with one medication when initiating chronic open angle glaucoma treatment.
|
T - But F for angle closure glaucoma!
|
|
(T/F) Try to use the lowest concentration of drugs initially.
|
T
|
|
How long should a patient wait between drops?
|
15 mins
|
|
What is the pouch technique?
|
When we put a drop of drugs in the lower culdesac
|
|
What is better to write? q8H or TID?
|
q8H b/c a patient may take all three drops in the morning.
|
|
When changing glaucoma medications, should we substitute first or add another one?
|
Substitute
|
|
(T/F) Travatan -> Lumigan is an acceptable substitution to bring down IOPs.
|
T
|
|
(T/F) Travatan -> Xalatan is an acceptable substitution to bring down IOPs.
|
F - They are very similar. But T - If managing side effects b/c Xalatan has less side effects.
|
|
(T/F) Drug combinations may result in reduced results compared to individual drugs
|
T
|
|
Why are prostaglandins great?
|
25-30% IOP reduction. Once a day. Works all day. Few systemic side effects.
|
|
Why are BBs not a great as prostaglandins?
|
Don't work at night. List of side effects.
|
|
What are the 5 contraindications for prostaglandins?
|
Pregnancy. History of uveitis, herpes simplex keratitis, cataract surgery, CME
|
|
If the pt is using Ca Channel blockers, what glaucoma drug should we avoid?
|
BBs
|
|
If the pt is using MAO inhibitors, what glaucoma drug should we avoid?
|
Adrenergic Agonists (all - alpha 1, alpha 2, non-selective)
|
|
What are the cap colors for prostaglandins? Alphagan? Combigan? CAIs?
|
Teal, Purple, Blue, Rust
|
|
What are the cap colors for .5% BB? .25% BB? Anticholinergics like tropicamide?
|
Yellow, light blue, red
|
|
What are the cap colors for Cholinergics like Pilocarpine? Cosopt?
|
Green, rust and yellow
|
|
After adding a prostaglanding, what drug class do we want to use next? Why? Schedule?
|
CAIs. Good additive effect. TID.
|
|
(T/F) Oral CAIs are a good addition to use with prostaglandins.
|
F - Topical only!
|
|
If we don't reach our target pressure, should we add a new drug or substitute?
|
Substitute.
|
|
What drug should young patient avoid? Why?
|
Pilo. Because produces ciliary spasm, so always accommodating. So will be massively blurred!
|
|
What drug should older patients avoid? Why?
|
Pilo. Tiny pupils decrease light coming in. Also increases blocking effect of cataracts.
|
|
What drug should you avoid if the pt has anterior uveitis? Why?
|
Pilo. Because it causes ciliary spasm and vasodilation which cause more pain and inflammation, leading to posterior synechiae.
|
|
What drug should aphakes and pseudoaphakes avoid? Why?
|
Epinephrine/Propine b/c increases risk of CME
|
|
What drug should be stopped before surgery? What is a good replacement?
|
Prostaglandin. Alphagan
|
|
What drug should people with retinal detachment risks avoid? Why?
|
Miotics. Can increase risk of tears.
|
|
What drug should Corneal Endothelial Disease pts avoid? Why?
|
CAIs. It will compromise the endothelium.
|
|
What drug should you avoid if you have breathing problems?
|
BBs.
|
|
What drug should you avoid if you have kidney problems?
|
CAIs
|
|
What drug should you avoid if you have liver problems?
|
CAIs
|
|
What drug should you avoid if you have heart or lung problems?
|
BBs
|
|
What drug should you avoid if you are pregnant? What should you use?
|
Prostaglandins. Alphagan.
|
|
What drug should you avoid if you have low BP?
|
BBs
|
|
What drug should you avoid if you have diabetes?
|
BBs
|
|
How does Dr. Comer define an angle that is not narrow?
|
Must see TM in 2 angles.
|
|
What 3 drugs should narrow angle pts avoid?
|
BBs, propine, epinephrine
|
|
(T/F) A large bottle should be ordered from the start to save the pt money.
|
F - First see if it works. Also make sure the pt has a reason to come back. (1-3 refills)
|
|
What instructions should a BB installing pt follow?
|
Do at night so your eyes are closed 3-4 mins afterwards (b/c you're sleeping!)
|
|
What 2 drugs/drug classes tend to not work as much when used BID instead of TID?
|
Alphagan and CAIs
|
|
At what point should laser trabeculoplasty be considered? Why?
|
When patient needs more than 2 meds b/c compliance will be bad.
|
|
How much will cataract remove reduce IOP?
|
2-4 mmHg
|