PHA 651 Pharmacotherapy Final

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*glaucoma

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ocular disorders that lead to an optic neuropathy characterized by changes in the optic nerve head (optic disk) associated with loss of visual sensitivity and field

IOP

increased intraocular pressure is thought to play an important role in the pathogenesis, but is NOT a diagnostic criterion for glaucoma. IOP varies with pulse, BP, forced expiration or coughing, neck compression, caffeine intake, posture, gender, general health, and lifestyle (smoking). Circadian variation has the highest values upon wakening and the lowest at about 6pm.
Median IOP 13-18 mmHg, abnormal >22
20-30% of pts with glaucomatous visual field loss have an IOP <21

*types of glaucoma

OAG and PACG
Both can be inherited, congenital, or secondary to disease, trauma, or drugs and can lead to serious complications
Both primary and secondary glaucomas may be caused by a combination of open-angle and closed-angle mechanisms.

drug-induced POAG

corticosteroids (especially ophthalmic)

POAG

primary open angle glaucoma, 2.8 million in US in 2010 (on the rise)
decreased OUTFLOW of aqueous humor outflow due to degenerative process in the trabecular meshwork
onset-gradual and asymptomatic; early stage-decrease in visual field, late stage-loss of peripheral vision
mean progression rate from a full field to blindness takes 25y in untreated pts