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Vision abnormalities (smartypance.com)
Terms in this set (19)
What is open angle glaucoma?
Impaired aqueous outflow through a diseased trabecular meshwork causing increasing IOP leading to a gradual increase in pressure and progressive
peripheral visual field loss.
What is closed angle glaucoma?
Occurs when the iris dilates and pushes against the lens of the eyes, disrupting the flow of aqueous humor into the anterior chamber. The pressure in the posterior chamber then pushes the peripheral iris forward and blocks the angle.
Which is more common open or closed angle glaucoma?
Open angle glaucoma accounts for 90% of all cases of glaucoma.
What is the classic triad seen in acute closed angle glaucoma?
Injected conjunctiva, cloudy cornea, and fixed
How can you differentiate acute angle-closure glaucoma from iritis?
Iritis will present similarly to acute angle-closure glaucoma except look for a small
(vs dilated in glaucoma) pupil
How is glaucoma diagnosed?
demonstrating increased intraocular pressure; Ophthalmoscopy with cupping of the optic disc (cup: disc ratio >1:2)
Describe the progression of visual field loss in open-angle glaucoma
Visual loss in open angle glaucoma progresses from
peripheral → central
Describe the progression of visual field loss in macular degeneration
Visual loss in macular degeneration is from
central → peripheral
Treatment of open angle glaucoma
-prostaglandins (lantanoprost, bimatoprost): inc outflow
-beta blockers (timolol, bextalol): dec aqeuous humor production; or
-pilocarpine to inc aqeuous humor outflow
-carbonic anhydrase inhib can work too
-if meds fail, lsaer trabeculoplasty or trabeculectomy
Treatment of closed angle glaucoma
Rapid reduction of IOP
Protection of non-affected eye
Iridectomy is definitive treatment
Secretory inhibitors: systemic CAI (acetazolamide IV or PO 500mg)
Hyperosmotic agents: mannitol IV
Pilocarpine: start once IOP is lowered
Topical agent to lower IOP
How does pilocarpine reduce intraocular pressure?
Pupillary constriction (miosis) and contraction of the ciliary muscle causing the eye to shrink and decreasing the amount of fluid within the eye.
What is a common topical non-selective beta-adrenergic blocker used for open-angle glaucoma to decrease the secretion of aqueous humor?
A result of poor control of extra-ocular muscles resulting in a lack of coordination and improper alignment of the eyes.
Outward turning of the eye, away from the nose
Inward turning of the eye toward the nose (cross-eyed)
Transient partial or complete loss of vision in one eye
How is amaurosis fugax classically described
Vision loss is classically described as a
curtain coming down over one eye
What is seen on the fundoscopic exam of amaurosis fugax?
A fundus exam may reveal
optic disk pallor, a cherry-red macula, and retinal edema
What is the most common cause of amaurosis fugax?
The most common cause of amaurosis fugax is a cholesterol plaque emboli from a carotid artery plaque
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