Rx Glaucoma

Question 1

Definition of Glaucoma

Answer 1

Group of eye disorders with raised intraocular pressure (IOP) causing optic nerve damage and visual field loss.

Question 2

Normal IOP

Answer 2

10–21 mmHg (average ~15 mmHg), measured by tonometry.

Question 3

Prostaglandin analogues (Latanoprost

Answer 3

Travoprost

Question 4

Beta-blockers (Timolol

Answer 4

Betaxolol)

Question 5

Carbonic anhydrase inhibitors (Acetazolamide

Answer 5

Dorzolamide)

Question 6

Alpha-2 agonists (Brimonidine

Answer 6

Apraclonidine)

Question 7

Cholinergic drugs (Pilocarpine

Answer 7

Carbachol)

Question 8

Osmotic agents (Mannitol IV

Answer 8

Glycerol oral)

Question 9

First-line chronic open-angle glaucoma

Answer 9

Prostaglandin analogues.

Question 10

Emergency acute angle-closure glaucoma

Answer 10

IV mannitol + acetazolamide + pilocarpine.

Question 11

First-line drugs in glaucoma

Answer 11

Prostaglandin analogues (Latanoprost, Travoprost, Bimatoprost) — increase uveoscleral outflow.

Question 12

Beta-blockers in glaucoma

Answer 12

Timolol, Betaxolol — decrease aqueous humor production by ciliary body.

Question 13

Alpha-2 adrenergic agonists

Answer 13

Brimonidine, Apraclonidine — decrease aqueous production and increase uveoscleral outflow.

Question 14

Carbonic anhydrase inhibitors

Answer 14

Dorzolamide, Brinzolamide (topical); Acetazolamide (systemic) — reduce aqueous humor formation.

Question 15

Cholinergic agonists (miotics)

Answer 15

Pilocarpine, Carbachol — increase trabecular outflow by ciliary muscle contraction.

Question 16

Hyperosmotic agents

Answer 16

Mannitol (IV), Glycerol (oral) — rapidly reduce intraocular pressure in acute angle-closure glaucoma.

Question 17

Combination therapy

Answer 17

Examples: Dorzolamide + Timolol (Cosopt), Brimonidine + Timolol (Combigan) — improve compliance.

Question 18

Steroid-induced glaucoma management

Answer 18

Avoid corticosteroids; treat with standard glaucoma drugs.

Question 19

Contraindicated drugs in glaucoma

Answer 19

Anticholinergics, antihistamines, TCAs, sympathomimetics, corticosteroids — risk of angle closure or raised IOP.

Question 20

Key difference in drug choice

Answer 20

Open-angle glaucoma: prostaglandins first-line; Acute angle-closure: hyperosmotics + emergency measures.