24 Questions
What is the primary aim of medical management in glaucoma?
To prevent optic nerve damage
What is the characteristic of open-angle glaucoma?
Impaired aqueous outflow
Which type of medication is preferred as the initial topical treatment for glaucoma?
Beta blockers
What is the role of miotics in the treatment of glaucoma?
Increase aqueous outflow
What is the most common cause of visual loss in people older than 60 years?
Macular degeneration
What is the characteristic of macular degeneration?
Tiny, yellowish spots called drusen beneath the retina
What is the primary mechanism of action of adrenergic agonists in glaucoma treatment?
Decrease aqueous production
What is the importance of periodic follow-up examinations in glaucoma management?
To monitor IOP, optic nerve appearance, and visual fields
What is the characteristic of dry type AMD in terms of vision?
Gradual blurring of vision
What is the main cause of wet type AMD?
Proliferation of abnormal blood vessels under the retina
What is the primary goal of Phytodynamic Therapy (PDT) in AMD?
To reduce the risk of visual loss in certain patients
What is the importance of patient education in PDT?
To minimize damage to the retina during treatment
What is the primary reason for removing the eye patch after the first follow-up appointment?
To assess the success of the surgery
Which of the following is a characteristic of vision improvement after cataract surgery with IOL implants?
Vision improvement is faster than with aphakic glasses or contact lenses
What is the consequence of choroidal neovascularization in wet type AMD?
Leakage of fluid and blood, elevating the retina
What is the primary focus of nursing management in AMD?
Patient education
What is the primary mechanism of damage in the direct mechanical theory of glaucoma?
Damage to the retinal layer as it passes through the optic nerve head
What is the recommended attire for patients undergoing PDT?
Long-sleeved shirt, slacks, and a wide-brimmed hat
What is the fourth stage of glaucoma according to the stages of glaucoma development?
Optic nerve damage
What is the effect of untreated wet type AMD?
Central vision loss over months
What is the consequence of high IOP according to the indirect ischemic theory of glaucoma?
Compression of the microcirculation in the optic nerve head
What is the primary purpose of notifying the surgeon about new floaters after cataract surgery?
To prevent retinal detachment
What is the typical timeframe for vision stabilization after cataract surgery?
6 to 12 weeks
What is the underlying cause of glaucoma according to the given text?
An increase in the intraocular pressure
Study Notes
Visual Loss and Glaucoma
- Visual loss is characterized by progressive loss of vision and visual field defects.
- Glaucoma is classified into two types: open-angle and angle-closure (pupillary block) glaucoma, depending on the mechanisms causing impaired aqueous outflow.
- Primary glaucoma is not associated with any contributing factors, while secondary glaucoma is associated with factors contributing to the rise in IOP.
Medical Management of Glaucoma
- The aim of medical management is to prevent optic nerve damage.
- Periodic follow-up examinations are essential to monitor IOP, optic nerve appearance, visual fields, and side effects of medications.
- Therapeutic regimens consider the patient's health, stage of glaucoma, comfort, affordability, convenience, lifestyle, and personality.
- Medications used to lower IOP include:
- Beta blockers (preferred initial topical)
- Miotics (cholinergics)
- Adrenergic agonists
- Alpha2-agonists
- Carbonic anhydrase inhibitors
- Prostaglandins
Macular Degeneration
- Macular degeneration is the most common cause of visual loss in people over 60 years old.
- It is characterized by tiny, yellowish spots called drusen beneath the retina.
- Most people over 60 years old have at least a few small drusen.
- Central vision is commonly affected, but most patients do not experience total blindness.
Types of Macular Degeneration
- Dry (non-exudative) type:
- Characterized by the slow breakdown of the outer layers of the retina.
- Drusen occur outside of the macular area, causing no symptoms.
- Drusen within the macula cause gradual blurring of vision.
- No known treatment to slow or cure this type of AMD.
- Wet (exudative) type:
- Characterized by the abrupt onset of symptoms.
- Patients complain of distorted vision, straight lines appearing crooked, or broken-up words.
- Resulting from proliferation of abnormal blood vessels growing under the retina.
- Affected vessels can leak fluid and blood, elevating the retina.
Phytodynamic Therapy (PDT)
- Developed to ameliorate choroidal neovascularization (CNV) while causing minimal damage to the retina.
- Can reduce the risk of visual loss for certain groups of patients with classic subfoveal choroidal neovascularization due to macular degeneration.
Nursing Management
- Primarily educational, focusing on patient education and preparation for PDT.
- Instruct patients to bring protective gear (dark sunglasses, gloves, hat, long-sleeved shirt, and slacks) to the PDT setting.
- Emphasize the importance of avoiding direct sunlight and bright lights for 5 days after treatment.
This quiz covers the types of glaucoma, including open-angle and angle-closure, as well as the medical management and assessment of the condition, including periodic follow-up examinations.
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