Introduction

Question 1

What is the definition of glaucoma?

Answer 1

An optic neuropathy in which there is progressive, characteristic loss of the neuro-retinal rim tissue which can be slowed or arrested by a reduction in IOP. If undetected, untreated or insufficiently treated a progressive loss of visual function can result.

Question 2

What characteristic changes are seen with primary glaucoma?

Answer 2

1. Abnormalities of RNFL
2. Abnormalities of NRR
3. An increase in cupping
4. Disc haemorrhages

Question 3

Is it the commonest cause of blindness in world today?

Answer 3

No, the second

Question 4

Which continent has the largest proportion of glaucoma (combined total of CAG and OAG)?

Answer 4

China 19% of OAG and 48% of CAG

Question 5

How does NICE divide COAG?

Answer 5

POAG = IOP > 21mmHg

NTG = IOP <21mmHg

Question 6

How does NICE define COAG?

Answer 6

Any patient with ONH changes with/without VF loss with open angles on gonioscopy.

Question 7

What are the clinical features of OHT?

Answer 7

1. Open angles on gonioscopy
2. Untreated IOP > 21mmHg (confirmed X2)
3. Absence of optic disc and surround damage and VF defect
4. Includes:
   
   1. OHT with PDS
   2. OHT with PXF
5. Absence of any other secondary cause of increased IOP i.e. trauma

Question 8

What are the clinical features of COAG?

Answer 8

1. Open angles on gonioscopy
2. Suspicious ONH and surround with normal or equivocal VF
3. IOP > 21mmHg = POAG suspect
4. IOP< 21mmHg = NTG suspect
5. Includes variants:
   
   • Suspect COAG with PDS
   • Suspect COAG with PXF