Understanding Glaucoma Pathophysiology
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Questions and Answers

Which of the following statements is TRUE about the prevalence of glaucoma?

  • Prevalence of glaucoma is greater in men than women until the age of 65.
  • Prevalence rates of glaucoma are significantly higher in Caucasian populations.
  • Glaucoma is the leading cause of blindness in the elderly population.
  • Glaucoma is a silent disease, with the progression often unnoticed by the individual. (correct)

    • What is the primary cause of vision loss associated with glaucoma?

  • Blockage of blood vessels supplying the retina, leading to cell death.
  • Inflammation of the cornea, which impairs the ability to focus light.
  • Degeneration of the optic nerve, potentially due to elevated intraocular pressure. (correct)
  • Damage to the retina caused by the increased intraocular pressure.

    • Which type of glaucoma is characterized by a sudden and rapid rise in intraocular pressure?

  • Secondary glaucoma
  • Angle closure glaucoma (correct)
  • Normal tension glaucoma
  • Primary open angle glaucoma

    • What is the defining characteristic of primary open angle glaucoma?

    <p>A clogging of the trabecular network at the point where the iris and cornea meet, impairing aqueous humor drainage. (D)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for developing glaucoma typically?

    <p>High blood pressure (C)</p> Signup and view all the answers

    Which of the following is a risk factor for developing glaucoma?

    <p>All of the above (D)</p> Signup and view all the answers

    Which type of glaucoma is characterized by gradual, irreversible vision loss if untreated?

    <p>Primary open angle (B)</p> Signup and view all the answers

    What is the name of the diagnostic test used to measure intraocular pressure?

    <p>Tonometry (D)</p> Signup and view all the answers

    What is a common symptom of complete acute angle closure glaucoma?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the name of the change in the optic nerve that can be detected during an ophthalmoscopic exam?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following pharmacologic treatments increases the outflow of fluid from the eye?

    <p>Miotics (D)</p> Signup and view all the answers

    Which of the following is NOT a common symptom of complete acute angle closure glaucoma?

    <p>Dry eyes (A)</p> Signup and view all the answers

    What is the primary reason for early detection and treatment of glaucoma?

    <p>To prevent further vision loss (A)</p> Signup and view all the answers

    Flashcards

    Glaucoma

    A leading cause of preventable blindness, especially in the elderly.

    Primary open-angle glaucoma

    A type of glaucoma caused by clogged drainage, leading to increased intraocular pressure.

    Angle closure glaucoma

    Results from rapid intraocular pressure increase due to blocked drainage; can be a crisis.

    Risk factors of glaucoma

    Increased intraocular pressure and demographic factors like gender and race.

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    Optic nerve damage

    The primary cause of vision loss in glaucoma due to increased intraocular pressure.

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    Normal tension glaucoma

    Type of glaucoma with normal intraocular pressure but still causes damage to the optic nerve.

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    Acute angle-closure glaucoma

    A sudden increase in intraocular pressure leading to severe symptoms and quick vision loss if untreated.

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    Tonometry

    A diagnostic test that measures intraocular pressure to detect glaucoma.

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    Optic nerve cupping

    A condition where the optic nerve develops a larger 'cup' shape due to nerve fiber damage, indicative of glaucoma.

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    Pharmacologic treatments for glaucoma

    Medications that either increase fluid outflow or decrease fluid levels in the eye to manage glaucoma.

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    Visual field assessment

    A test to evaluate the peripheral and central vision to detect changes indicative of glaucoma.

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    Study Notes

    Glaucoma

    • Second leading cause of blindness among older adults, a preventable cause of vision loss
    • Gender differences: up to age 65, more women affected; after 65, no difference; among Black people, more prevalent
    • Often progresses silently

    Glaucoma Pathophysiology

    • Vision loss due to optic nerve damage
    • Increased intraocular pressure (IOP) a risk factor
    • Not always present
    • Categories
      • Primary open-angle:
        • Clogged trabecular network where iris and cornea meet
        • Impaired aqueous humour drainage leading to increased IOP
      • Angle-closure (narrow angle):
        • Rapid IOP from blocked aqueous humour drainage
        • Complete closure is a crisis; Asian descent and hyperopia are risk factors
      • Normal tension:
        • Normal IOP; progressive damage; poor blood flow to optic nerve

    Glaucoma Clinical Manifestations

    • Risk factors: age, black race, diabetes, eye trauma, long-term steroid use
    • Primary open angle:
      • Cornea adapts to increasing pressure without swelling
      • No subjective symptoms
      • If untreated: gradual, irreversible vision loss, blind spots in the field of vision, decreased blood supply to retina initially limited to periphery; progresses centrally
      • Responds well to pharmacologic treatment
    • Complete acute angle closure (acute glaucoma crisis):
      • Induced by increased pupil dilation (e.g., drugs, darkened room, stress)
      • Permanent optic nerve damage leading to rapid vision loss (days to weeks)
      • Eye pain, headache, nausea, blurred vision, rainbows around lights at night
      • May result in chronic glaucoma and cataracts
      • Greater chance of permanent vision loss

    Glaucoma Diagnostic Criteria

    • Early detection improves outcomes, managing and decreasing vision loss
    • Methods to asses:
      • Tonometry: measures intraocular pressure (non-contact, air-puff)
      • Ophthalmoscopic exam
      • Fundus examination
        • Detecting changes: optic nerve cupping (nerve fiber loss), progressive pallor (pale appearance of damaged optic nerve), and hemorrhage
      • Visual field assessment
      • Confocal laser optical coherence

    Glaucoma Treatment

    • Pharmacologic treatment:
      • Increase outflow of fluid: miotics, epinephrine-based medication
      • Decrease fluid levels: beta blockers, carbonic anhydrase inhibitors, alpha-adrenergic agonists
      • Increase fluid flow through secondary drainage: prostaglandin analogs
    • Surgical treatment:
      • Laser surgery: trabeculoplasty (correcting the trabecular meshwork to promote fluid outflow), iridotomy (incision into the iris to promote fluid outflow), cyclophotocoagulation (correcting ciliary tissue to decrease fluid production)
      • Conventional surgery: trabeculectomy (surgical removal of a small portion of the trabecular meshwork to create new drainage)

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    Description

    This quiz explores the critical aspects of glaucoma, focusing on its causes, risk factors, and clinical manifestations. Learn about the different types of glaucoma, including primary open-angle and angle-closure, as well as the impact of gender and ethnicity on its prevalence. Test your knowledge on this preventable cause of vision loss.

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