20 - Glaucoma

Question 1

glaucoma

Answer 1

disorders characterized by increased IOP

-leads to nerve atrophy + periph visual field loss

Question 2

incidence of glaucoma increases w…

Answer 2

age

Question 3

blindness fr glaucoma

Answer 3

largely preventable w early detection + proper treatment

Question 4

angle

Answer 4

the place where the outflow occurs

-bc angle is where iris meats the cornea

Question 5

primary open-angle glaucoma POAG

Answer 5

most common type

• outflow of aqueous humor is decr in trabecular meshwork
• drainage becomes clogged

Question 6

angle-closure glaucoma (ACG)

Answer 6

due to reduction in outflow of aqueous humor fr angle closure

Question 7

ACG possible causes

Answer 7

• caused by lens bulging forward due to aging

- pupil dilation in pt w anatomically narrow angles

Question 8

ACUTE angle-closure glaucoma

Answer 8

precipitated by situations in which pupils stay partially dilated long enough to cause an acute + rise in IOP

Question 9

ACUTE angle-closure glaucoma possible causes

Answer 9

• drug-induced mydriasis
• emotional excitement
• darkness

Question 10

POAG manifestations

Answer 10

• slow w/o pain or pressure
• tunnel vision w only small center field
• peripheral vision is absent

Question 11

Acute ACG manifestations

Answer 11

• sudden + severe pain in or around eye
• n/v
• colored halos around lights
• blurred vision
• ocular redness

Question 12

subacute/chronic ACG manifestations

Answer 12

• gradual
• blurred vision
• seeing colored halos around lights
• ocular redness
• eye or brow pain

Question 13

Normal glaucoma pressure

Answer 13

10-21 mmHg

Question 14

POAG pressure

Answer 14

22-32 mmHg

Question 15

AACG

Answer 15

> 50 mmHg

Question 16

POAG + slit lamp microscopy diagnostic

Answer 16

norm angle

Question 17

AACG + slit lamp microscopy diagnostic

Answer 17

either more narrow angle or flat anterior chamber angle

• edematous cornea
• fixed moderately dilated pupil

Question 18

in ACG, central visual acuity is reduced if..

Answer 18

pt has cornea edema

Question 19

___ may be the first sign of chronic POAG

Answer 19

optic disc cupping

wider, deeper, paler

Question 20

drug therapy for chronic open angle glaucoma

Answer 20

B-adrenergic blocker [betaxolol]

Question 21

B adrenergic blocking glaucoma is CI w…

Answer 21

• bradycardia
• heart blog greatehr than 1 degree
• cardiogenic shock, HF

Question 22

noncardioselective B adrenergic blockers are CI in…

Answer 22

copd or asthma

Question 23

argon laser trabeculoplasty

Answer 23

noninvasive way to lower IOP when meqds are not successful

-laser stim scarring + contractn of trabecular meshwork» opens outflow channels

Question 24

trabeculectomy or filtration surgery

Answer 24

if med or laser therapy is not succesful

Question 25

laser peripheral iridotomy or surgical iridectomy

Answer 25

necessary for long-term tx + preventn of more episodes | -allows aqueous humor to flow thru a NEWLY CREATED OPENING IN IRIS into outflow channels

Question 26

glaucoma screening

Answer 26

40-65 yo: Q2-4yr 65+ yo: Q1-2yr more often for black