Primary Open Angle Glaucoma

Question 1

What is glaucoma?

Answer 1

An optic neuropathy due to raised intraocular pressure. (IOP)

Question 2

Name some risk factors for primary open angle glaucoma?

Answer 2

• Family history
• Black patients
• Myopia
• Hypertension
• Diabetes Mellitus.

Question 3

What are some features of POAG?

Answer 3

• Peripheral visual field loss - nasal scotomas progressing to ‘tunnel vision’
• Decreased visual acuity
• Optic disc cupping

Question 4

Who gets POAG and how often is it detected?

Answer 4

POAG is found in 2% of the people older than 40 years.

It is often detected during routine optometry appointments as it can be insidious.

Question 5

How are most POAG patients managed?

Answer 5

Managed with eye drops that lower intra-ocular pressure.

Question 6

Name a prostaglandin analgoue, it’s MOA s/e?

Answer 6

Latanoprost, Travaprost

It increases uveoscleral outflow.

Once daily administration.

S/E Can cause the iris to turn brown.

Question 7

Name a beta-blocker, it’s MOA s/e?

Answer 7

Timolol

Reduces aqueous production

Avoid in asthmatics and patient’s with heart block.

Question 8

Name a sympathomimetic, it’s MOA s/e?

Answer 8

Brimonidine

Reduces aqueous production and increases outflow.

Avoid if taking MAOI or TCA

Can cause Hyperaemia.

Question 9

Name a carbonic anhydrase inhibitor, it’s MOA s/e?

Answer 9

Dorzolamide

Reduces aqueous production

Can cause sulphonamide-like reactions.

Question 10

Name a miotic, it’s MOA s/e?

Answer 10

Pilocarpine (a muscarinic receptor agonist)

Increases uveoscleral outflow.

S/E: constricted pupils, headache and blurred vision.

Question 11

What surgery can be done in refractory cases?

Answer 11

Trabeculectomy

Question 12

What is the normal range for intraocular pressure?

Answer 12

10-21 mmHg