Glaucoma 2

Question 1

What factors may increase intraocular pressure?

Answer 1

Elevated EVP
bending over, supine, breath holding, elevated central venous pressure, intubation, orbital venous outflow obstruction, playing a wind instrument, Valsalva maneuver, wearing a tight collar or tight necktie, pressure on the eye, blepharospasm, eyelid squeezing and crying (especially in young children), elevated body temperature, hormonal influences, hypothyroidism, thyroid eye disease, and drugs unrelated to glaucoma therapy.

Question 2

What drugs may increase intraocular pressure?

Answer 2

Anticholinergics (may precipitate angle closure), corticosteroids, ketamine, lysergic acid diethylamide (LSD), and topiramate. Caffeine

Question 3

What factors may decrease intraocular pressure?

Answer 3

Aerobic exercise, anesthetic drugs, depolarizing muscle relaxants (such as succinylcholine)

?metabolic or respiratory acidosis,
hormonal influences, pregnancy

Question 4

What drugs may decrease intraocular pressure?

Answer 4

Alcohol, heroin, marijuana (cannabis), vasodilators

Question 5

TVT conclusion

Answer 5

. Both procedures effectively reduced IOP

. At 5 years, tube shunt surgery had a higher cumulative probability of success compared to trabeculectomy with MMC.

. Reduced Need for Additional Surgery with Tube Shunts

. Prefer tube in failed Trab, anticipated to fail Trab (scared conj), secondary glaucoma

OTHER
. tube shunt group tended to use less supplemental medical therapy early on.

. both procedures led to slow rates of visual field loss, with no significant difference between the two