Podcast
Questions and Answers
What is the primary goal of medications in the management of glaucoma?
What is the primary goal of medications in the management of glaucoma?
- To alleviate the symptoms of corneal edema
- To provide neuro-protection to the optic nerve
- To increase the production of aqueous humor
- To reduce the intraocular pressure by increasing the rate of aqueous outflow and/or reducing the production of aqueous humor (correct)
Which of the following factors is NOT considered when prescribing medications for glaucoma?
Which of the following factors is NOT considered when prescribing medications for glaucoma?
- Potency of the medication
- Interactions with other medications
- Method and ease of administration
- Patient's age (correct)
What is the purpose of establishing a baseline IOP value in glaucoma management?
What is the purpose of establishing a baseline IOP value in glaucoma management?
- To monitor the progression of the disease
- To determine the target pressure for treatment
- To assess the effectiveness of medication
- To take into account diurnal variation in pressure (correct)
What is the target pressure reduction for patients with moderate damage to the optic nerve?
What is the target pressure reduction for patients with moderate damage to the optic nerve?
How often should visual fields be re-checked after diagnosis and initiation of medication?
How often should visual fields be re-checked after diagnosis and initiation of medication?
What is the frequency of stereoscopic optic nerve photos after diagnosis and initiation of medication?
What is the frequency of stereoscopic optic nerve photos after diagnosis and initiation of medication?
What is the primary purpose of the disclaimer provided by the Institute?
What is the primary purpose of the disclaimer provided by the Institute?
According to the disclaimer, what type of warranty does the Institute disclaim?
According to the disclaimer, what type of warranty does the Institute disclaim?
What is the implication of the Institute's statement regarding specific companies or products?
What is the implication of the Institute's statement regarding specific companies or products?
Under what circumstances does the Institute exclude implied warranties?
Under what circumstances does the Institute exclude implied warranties?
What is the consequence of using the information contained in the publication?
What is the consequence of using the information contained in the publication?
What is the primary goal of pharmacological management of glaucoma?
What is the primary goal of pharmacological management of glaucoma?
Which of the following classes of medications is used to reduce the production of aqueous humor?
Which of the following classes of medications is used to reduce the production of aqueous humor?
What is the mechanism of action of prostaglandin analogs in glaucoma management?
What is the mechanism of action of prostaglandin analogs in glaucoma management?
Which of the following medications is a sympathomimetic agent used in glaucoma treatment?
Which of the following medications is a sympathomimetic agent used in glaucoma treatment?
What is the benefit of using combination therapy in glaucoma management?
What is the benefit of using combination therapy in glaucoma management?
Which of the following classes of medications is associated with the most significant systemic side effects?
Which of the following classes of medications is associated with the most significant systemic side effects?
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Study Notes
Medication Management in Glaucoma
- Medication is the first choice in managing glaucoma, aiming to reduce intraocular pressure (IOP) by increasing aqueous outflow and/or reducing aqueous humor production.
- Different families of glaucoma medications have specific modes of action, side effects, and contraindications.
Prescribing Medications
- Important factors to consider when prescribing medications include:
- Potency
- Additive effects
- Interactions with other medications
- Comorbidities
- Side effects
- Method and ease of administration
- Cost
Acute Angle Closure
- Patients with acute angle closure are given medications to reduce:
- IOP
- Corneal edema
- Level of pain
- These medications prepare the patient for laser therapy or surgery.
Medical Management
- Effective management of glaucoma requires accurate and repeatable measurements of IOP.
- Establishing a baseline IOP value takes into account diurnal variation in pressure.
- Diurnal variation in IOP is determined by making multiple measurements of the pressure at various times throughout the day.
Target Pressure
- Setting a target pressure helps slow further progression of the disease.
- The target pressure is not static and must be reset if the patient continues to progress.
- The more damaged the optic nerve, the greater is the required IOP reduction.
Classification of Damage
- A classification of mild, moderate, and severe damage is used to determine target pressure reduction:
- Mild damage: 20-30% reduction
- Moderate damage: 30-40% reduction
- Severe damage: 40-50% reduction
Adherence and Compliance
- After diagnosis and initiation of medication, re-check:
- Visual Fields: 6 months, then 3-6 months for the first 18 months, then yearly
- RNFL Assessment: same as visual fields
- Stereoscopic Optic Nerve Photos: yearly
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