Term
|
Definition
optic neuropathy
OPTIC NERVE DAMAGE!
loss of retinal ganglion cell axons
visual field loss
blindness
can present at a wide range of IOP
rate of progression is variable |
|
|
Term
|
Definition
mechanical blockade of the angle by the iris
trabecular meshwork is blocked
AH leaves anterior chamber through trabecular meshwork -> Canal of Schlemm -> aqueous veing
inadequate drainage of AH
optic nerve damage
elevated IOP
IOP > 40 -> optic nerve damage
IOP > 60 -> permanent visual field loss in hours or days |
|
|
Term
| understand how aqueous humor (AH)is formed and its role in glaucoma |
|
Definition
INFLOW:
the AH is produced by the ciliary body via filtration and secretion
ciliary body epithelium secretes solutes Na and HCO3 into the posterior chamber creating an osmotic gradient
H2O moves into the posterior chamber -> aqueous humor
AH inflow into posterior chamber -> pressure
AH pushed between iris and lens -> pupil -> anterior chamber
OUTFLOW:
AH leaves anterior chamber through trabecular meshwork -> Canal of Schlemm -> aqueous vein
IOP = inflow - outflow |
|
|
Term
| pathophysiology of glaucoma and how it may or may not related to increased intraocular pressure (IOP) |
|
Definition
glaucoma is a group of diseases characterized by damage to the optic nerve and visual field loss; usually associated with an increased IOP
progressive loss of retinal glanglion cell axons
irreversible blindness if left untreated
IOP and glaucoma:
median IOP 15.5 +/- 2.5 mmHg
increased IOP DOES NOT EQUAL glaucoma
glaucoma DOES NOT EQUAL increased IOP
IOP is a poor diagnostic tool for glaucoma - circadian changes, pulse, BP, forced expriation or coughing, neck compression, and posture
elevated IOP (>22mmHg) is the SINGLE GREATEST modifiable risk factor for glaucoma
fundus examination:
evaluating "cupping" of fundus (cupping = hollowed out appearance of optic nerve/disc)
cup diameter > 50% of vertical disc diameter = glaucoma
thinning or narrowing of disc rim, progressive change in size/shape of cup, and nerve fiber defect may also indicate glaucoma
cupping = highest sensitivity and specificity for glaucoma than any other finding - no single cutoff criteria yield sufficiently high sensitivity and specificity to make cupping a useful diagnositc test
visual field assessment:
ideally glaucoma should be diagnosed before significant visual field loss
automated perimetry = standard of care for detection and monitoring of glaucoma - requires comprehension and cooperation from patient; caution patients with dementia and/or other mental or physical problems
time consuming with variable specificity and sensitivity |
|
|
Term
| identify and recommend a drug product to treat and/or prevent the formation of glaucoma |
|
Definition
all patient with increased IOP do NOT warrant treatment
topical antihypertensives should be considered when elevated IOP, changes in disc ratio, and changes in central corneal thickness
patients with the following risk factors may warrant therapy:
family history of glaucoma
black ethnicity
severe myopia
one eye
patients with no risk factors should be monitored for glaucoma development |
|
|
Term
| treatment goals of glaucoma |
|
Definition
20-30% reduction in IOP
monocular treatment - adequately assess efficacy of treatment
increase in number of medications = increase in number of ADRs; more difficult to identify which is the offending agent
OPEN ANGLE:
treatment warranted for patients with increased IOP AND optic disc +/- visual field changes
drug therapy = most common treatment
start at low concentration, well tolerated, topical therapy
instill 1 drop per dose
doses > 1 drop = increased cost and ADRs
if 2 drops warranted, separate doses by 10-15 minutes
beta blockers = 1st line
prostaglandin analogs = 1st line
alpha2 adrenergic agonists
carbonic anhydrase inhibitors
cholinergic agonists
trabeculectomy (surgical or laser)
visual field loss does not differ between medical and surgical therapy
CLOSED ANGLE
need for rapid reduction - initial management involved prompt administration of pressure lowering eye drops
allow for iridectomy - laser OR surgery to create hole in iris to allow AH to flow
available therapies:
pilocarpine - traditional drug of choice but is controversial
hyperosmotic agents
secretory inhibitor: beta blocker, alpha2 agonist, prostaglandins, CAI
if IOPP > 60 mmHg, iris may be ischemic and unresponsive to miotics
unaffected eye also treated with miotics to prevent angle closure
emergency regimen of topical agents:
0.5% timolol maleate
1% apraclonidine
2% clonidine
beta blocker, alpha2 agonist and agent to produce miosis
systemic therapy may be warranted to decrease IOP
PO or IV acetazolammide, IV mannitol, oral glycerol or isosorbide
once acute attack is controlled, laser peripheral iridotomy is warranted |
|
|
Term
|
Definition
first line for open angle glaucoma
betaxolol, careolol, levobunolol, metipranolol, timolol
DECREASE IN IOP:
less potent at reducing IOP
20-25%
TIME OF DAY VARIABILITY:
IOP lowering effect may be less at night; should be dosed in the morning
USUAL DOSING FREQUENCY:
daily to BID dosing
MOA:
decrease AH production
ADRS AND COMMENTS:
local - stinging, itching, redness, blurred vision
systemic - depression, fatigue, dizziness, sexual dysfunction, bradycardia, respiratory depression, masking hypoglycemia
consider avoiding in patients with asthma, bradycardia, COPD
betaxolol - selective for beta1 -> decreased systemic effects, decreased IOP lowering
less IOP reduction possible if patient on systemic beta blockers
generic availability
cost effective |
|
|
Term
|
Definition
first line for open angle glaucoma
latanoprost, travoprost, bimatoprost
DECREASE IN IOP:
BEST IOP reduction
25-30%
TIME OF DAY VARIABILITY:
stable
USUAL DOSING FREQUENCY
daily dosing
MOA:
increased outflow
ADRS AND COMMENTS:
conjunctival hyperemia
darkening of iris and periorbital skin pigmentation
increase length and number of eyelashes
local irritation, itching, dryness, blurred vision
expensive |
|
|
Term
| alpha2 adrenergic agonists |
|
Definition
brimonidine, apraclonidine
DECREASE IN IOP:
similar to beta blockers in efficacy
10-25% reduction
TIME OF DAY VARIABILITY:
stable
USUAL DOSING FREQUENCY:
BID to TID
MOA:
decrease AH production
may increase outflow
ADRS AND COMMENTS:
common: fatigue, somnolence, local allergic reactions
dry eyes, stinging, conjunctival hyperemia, foreign body sensation
brimonidine can cross BBB - systemic hypotension and somnolence; respiratory arrest in children < 2 years
contraindicated with MAOIs
apraclonidine - tachyphylaxis and ocular allergy
ocular ADRs (allergic conjunctivitis, hyperemia, ocular puritis) |
|
|
Term
| carbonic anhydrase inhibitors |
|
Definition
brinzolamide, dorzolamide
DECREASE IN IOP:
not as effective as previous treatments
15-20% decrease
TIME OF DAY VARIABILITY:
stable
USUAL DOSING FREQUENCY:
BID to TID
MOA:
decrease AH production
ADRS AND COMMENTS:
local - stinging, redness, dry eyes, blurred vision |
|
|
Term
|
Definition
pilocarpine, carbachol
DECREASE IN IOP:
20-30% decrease
USUAL DOSING FREQUENCY:
up to QID
MOA:
increase outflow
ADRS AND COMMENTS:
ciliary spasm and brow ache
corneal toxicity, conjunctival inflammation, eye redness
transient myopia and blurred vision expected
retinal detachment can occur
systemic (rare): sweating, salivation, nausea |
|
|
Term
| trabeculectomy (surgical or laser) |
|
Definition
GOAL: improve inflow
warranted if patient fails or is intolerant to drug therapy
surgical creation of a channel for AH flow from anterior chamber into subconjunctival space for re-absorption into vasculature
potential complication: cataract formation
surgical site healing and scarring can lead to treatment failure
antiproliferative agents can be used to maintain patency of site
5-FU and mitomycin C:
improve success in high risk cases
prevent scarring of the fistula
poorly healed fistula -> entry portal for bacteria
simple conjunctivitis = medial emergency for patient who has had glaucoma surgery |
|
|
Term
|
Definition
monitor visual fields and disc changes annually
may monitor more frequently for worsening or unstable disease
treatment goals:
prevent vision loss
target IOP
initially target 30% reduction in IOP
depends on baseline IOP and vision loss |
|
|
Term
|
Definition
traditional drug of choice for closed angle glaucoma for rapid IOP reduction
pilocarpine 1% or 2% every 5 minutes for 2-3 doses, then every 4-6 hours
produces miosis to pull iris away from meshwork
may worsen angle closure by increasing papillary block and anterior movement of the lens
can withhold pilocarpine until IOP reduced by other drugs, then give a single drop of pilocarpine |
|
|
Term
| identify which eye disorder a patient may have based on past medical history and presenting symptoms: open angle glaucoma |
|
Definition
OPTIC NERVE DAMAGE
visual field loss
blindness
risk factors: elevated IOP, family history/genetics, age, African American
general: insidious onset
symptoms: none
signs:
disc changes (usually occur first, then visual loss 2nd)
visual loss
+/- elevated IOP
"white eye" glaucoma
either changes in optic nerve OR visual field defects is enough to diagnosis open angle glaucoma |
|
|
Term
| identify which eye disorder a patient may have based on past medical history and presenting symptoms: closed angle glaucoma |
|
Definition
elevated IOP:
IOP >40 -> optic nerve damage
IOP >60 -> permanent visual field loss in hours or days
risk factors: Inuit, Chinese, Asian-Indian ethnicity
general: acute episodes
symptoms:
possibly asymptomatic
prodrome - blurred/hazy vision, halows around lights +/- headache
cloudy, edematous cornea
ocular pain, N/V, abdominal pain, diaphoresis
signs:
hyperemic conjunctiva (red eye)
cloudy cornea
shallow anterior chamber
+/- edematous and hyperemic optic disc
markedly elevated IOP
"red eye" glaucoma
diagnosis:
do NOT dilate the eyes
gonioscopy (lens to visualize angle) is Gold Standard |
|
|
Term
| recommend 1st, 2nd, and 3rd line therapies for glaucoma and when each therapy is warranted: open angle |
|
Definition
1) drug therapy = first line
2) laser trabeculoplasty if patient fails or is intolerant to drug therapy
increases aqueous outflow thus decreases IOP
3) surgical trabeculectomy for patients that have failed both medical and laser therapies with advanced disease |
|
|
Term
| provide patient education on proper administration of eye drops and how to increase the drop's bioavailability |
|
Definition
1) wash hands
goal = maintain sterile environment
2) shake well = gently roll bottle between plams
3) pull down outer portion of the lower eyelid to form a "pocket"
4) grasp the bottle with thumb and fingers, rest hand on nose or cheek
5) look up, instill drop in "pocket"
do not touch eye with bottle or dropper
6) close eye, do not rub or tighly squeeze eyes close
increases bioavailability of the drug
7) recap bottle and store in labeled condition
8) do not tough dropper tip with hands, eye, etc.
***sterility***
9) press finger over nasolacrimal duct to occlude and prevent drainage
10) press finger for 1-3 minutes
increases contact time of drug on eye
increases bioavailability
decreases systemic absorption |
|
|
Term
| when looking at a patient's medication list, identify medications that can affect glaucoma |
|
Definition
INCREASE INFLOW:
beta agonists
DECREASE INFLOW:
beta blockers
alpha blockers
alpha2 blockers
carbonic anhydrase inhibitors
adenylate cyclase agonists
INCREASE OUTFLOW:
cholinergic agents
prostaglandin analogs
DRUG INDUCED OPEN ANGLE GLAUCOMA:
mydriasis
anticholinergics can increase IOP
potent - atropine, homatropin
weak - tropicamide, PHENYLEPHRINE (COMMONLY USED AND CAN EXACERBATE GLAUCOMA)
glucocorticoids can decrease outflow and increase IOP
ophthalmic > nasal, inhaled, systemic
use low potency, dose, duration
low risk:
drugs than may induce or potentiate increased IOP
medium risk:
systemic corticosteroids
succinylcholine
fenoldopam
ophthalmic anticholinergics
nasal/inhaled corticosteroids
high risk = untreated, uncontrolled disease
ophthalmic topical corticosteroids
DRUG INDUCED CLOSED ANGLE GLAUCOMA:
mydriasis:
anticholinergics
sympathomimetics
low risk:
benzodiazepines
theophylline
vasodilators
systemic sympathomimetics
CNS stimulants
carbonic anhydrase inhibitors
monoamine oxidase inhibitors
topical cholinergics
medium risk:
topical and systmic anticholinergics
topical sympathomimetics
heterocyclic antidepressants
phenothiazines
antihistamines
ipratropium
SSRIs
imipramine
topiramate
venlafaxine
high risk = untreated, uncontrolled disease:
n/a |
|
|
Term
|
Definition
disorder of the eyelid/lacrimal gland
also known as a stye
acute infection involving follicle and sebaceous/sweat gland
commonly caused by Staphylococcus
appears as a "pimple" or bump
often uncomfortable, with no serious symtpoms |
|
|
Term
|
Definition
disorder of the eyelid/lacrimal gland
chronic granulomatous inflammation of eyelid
appears "cyst" like
usually occurs on the UPPER LID
caused by secondary obstruction of the ducts to the sebaceous gland
not always an infection
can appear after a stye |
|
|
Term
|
Definition
disorder of the eyelid/lacrimal gland
caused by:
infection at base of lashes (often caused by Staphylococcus)
seborrheic dermatitis (scalp and eyebrow dandruff)
rosacea
malfunctioning oil glands around lash
symptoms:
chronic red, crusty, thickened eyelids
engorged blood vessels at the margin of the eye
crusting is often worse in the morning
hard scales at the base of eyelid
itching, burning, and excessive tearing from foreign body sensation |
|
|
Term
|
Definition
disorder of the eyelid/lacrimal gland
periorbital rash with eyelid swelling and watery discharge
causes:
take a thorough patient history of recent activities
key = look for recent change/new product use
new ophthalmmic drops or ointment
change in cosmetic, facial soap, or shampoo
glaucoma drops - often delay in showing signs/symptoms
generally not associated with fever or tenderness to palpation |
|
|
Term
|
Definition
disorder of the eyelid/lacrimal gland
swelling of conjunctiva (chemosis)
presents with mild fever and tightness of eyelid
causes:
often caused by S. aureus and Streptococci
also caused by H. influenza |
|
|
Term
|
Definition
disorder of the eyelid/lacrimal gland
acute infection of LACRIMAL SAC
results in nasolacrimal duct obstruction
OCCURS IN LOWER LID |
|
|
Term
|
Definition
disorder of the eyelid/lacrimal gland
acute infection of the LACRIMAL GLAND
OCCURS IN UPPER EYELID
causes:
S. aureus, N. gonorrheae, Streptococcus
viruses - mumps, mono, herpes zoster |
|
|
Term
|
Definition
disorder of the eye orbit
OCULAR EMERGENCY!
can further travel to brain resulting in meningitis
causes:
sinusitis - direct extension
dacryocystitis/adenitis
may result after eye surgery and/or trauma
S. aureus, Streptococcus, H. influenza
fungal infections in immunocompromised patients
symptoms:
red eye, blurred vision, fever, purulent discharge
pain upon eye movement
eyelid edema
chomosis (swelling of the conjunctiva)
proptosis (exophthalmos) with restricted eye movement |
|
|
Term
|
Definition
disorder of the eye orbit
unilateral or bilateral proptosis (exophthalmos)
result of Grave's Disease - autoimmune complication resulting in increased thyroid levels |
|
|
Term
|
Definition
disorder of conjunctiva/sclera
acute onset of redness, foreign body sensation, PURULENT DISCHARGE, EXCESSIVE EYELID CRUSTING
typically effects both eyes
causes:
S. aureus, S. epidermidis, S. pneumonia, and H. influenzae
spread by contact - touching, rubbing eye with hand |
|
|
Term
| gonococcal conjunctivitis |
|
Definition
disorder of conjunctiva/sclera
suspected with rapid onset of extreme purulent discharge |
|
|
Term
| viral conjunctivitis (pink eye) |
|
Definition
disorder of conjunctiva/sclera
causes:
adenovirus - epidemic
herpes simplex - often presents unilaterally (bacterial conjunctivitis usually effects both eyes)
symptoms:
watery mucous discharge
conjunctiva hyperemia (increased blood) gives appearance of pink eye
eyelid edema |
|
|
Term
|
Definition
disorder of conjunctiva/sclera
symptoms lasting > 4 weeks
consider alternative causes - chlamydia |
|
|
Term
| allergic conjunctivitis (hay fever) |
|
Definition
disorder of conjunctiva/sclera
causes:
type I hypersensitivity reaction
airborne pollen
Ag-IgE antibody complex binds to mast cells
results in release of histamine and inflammatory mediators
symptoms:
watery discharge - normally not purulent
puritis
eyelid edema |
|
|
Term
| keratoconjunctivitis sicca |
|
Definition
disorder of conjunctiva/sclera
dry and gritty eyes
can result over a course of years
manifestation of Sjogren's syndrome |
|
|
Term
| sunconjunctival hemorrhage |
|
Definition
disorder of conjunctiva/sclera
ruptured blood vessel in eye
harmless
causes:
coughing, straining
trauma
high blood pressure
warfarin |
|
|
Term
|
Definition
disorder of conjunctiva/sclera
benign, self limiting disorder in young adults
acute red eye in sectoral pattern
may cause mild discomfort and tenderness
excessive tearing
vision is often not affected
episceral blood vessels engorged
blood vessels are beneath conjunctiva |
|
|
Term
|
Definition
disorder of conjunctiva/sclera
serious inflammatory condition
severe boring eye pain
often associated with an underlying disease (i.e. rhematic arthritis)
recurrent, vision threatening conditions immediately refer to physician |
|
|
Term
| corneal infiltrate and ulcer |
|
Definition
disorder of the cornea/anterior segment
causes:
bacterial keratitis = most common corneal infection
caused by Pseudomonas aeruginosa, S. aureus, and S. pneumonia
fungal keratitis possibly from corneal injury
more common in contact with plant material
Aspergillus or Fusarium
Candida in debilitated cornea WITHOUT TRAUMA
Acanthamoeba in patients with history of swimming with contact lenses in or using homemade cleaning solution instead of purchasing commercially available formulations
symptoms:
red eye, tearing/discharge, ocular pain, photophobia, foreign body sensation, decreased vision
most common in patients WEARING CONTACT LENS!
question every patient!
disregard to proper hygiene, sleeping with contacts in, overuse or extended wear of soft lens |
|
|
Term
|
Definition
disorder of the cornea/anterior segment
herpes keratitis and ocular opacity
red, painful eye with photophobia and decreased vision
may also present with periorbital rash
not sexually transmmitted |
|
|
Term
|
Definition
|
|
Term
| age related macular degeneration (ARMD) |
|
Definition
idiopathic atrophy of photoreceptors and retinal pigmentated epithelium
non-exudative macular deneration (90% of all cases):
"dry"
bilateral, painless progression of central vision loss
no treatment approved at this time
most patients will wear glasses to offset vision loss
"wet" macular degeneration (minority of patients - 10%):
characterized by choroidal neovascularization
vascular endothelial growth factor (VEGF) = angiogenesis and vascular permability |
|
|
Term
| classify which disorders are considered an emergency and/or may be vision threatening |
|
Definition
refer patients to physician and/or ophthalmologist
foreign body
corneal abrasion
eye injury/trauma
infective conjunctivitis
allergic conjunctivitis
lid inflammation
orbital cellultis |
|
|
Term
| pharmacotherapy for hordeolum |
|
Definition
often no treatment required
resolves spontaneously
non-pharmacologic:
apply WARM compress for 15 minutes QID
homepathic "Stye Eye Relief" from Similasan - conium, graphites, and sulfur
pharmacological:
topical bacitracin or erythromycin ointmnet
apply to lid margin BID
may speed recovery, but can still take up to 4 weeks to resolve
OTC ointment "Stye"
petrolatum/mineral oil - just used to provide comfort to the patient |
|
|
Term
| pharmacotherapy for chalazion |
|
Definition
similar to hordeolum
non pharmacologic:
apply WARM compress for 15 minutes QID
SURGICAL DRAINAGE IS THE 1ST LINE TREATMENT
steroid injection - alternative to drainage
if still present after 4 weeks, refer to ophthalmologist |
|
|
Term
| pharmacotherapy for blepharitis |
|
Definition
maintaining lid hygiene
scrub with baby shampoo BID
erythromycin ointment
sufacetamide-prednisolone suspension or ointment: blephamide |
|
|
Term
| pharmacotherapy for contact dermatitis |
|
Definition
apply COLD compress for 15 minutes QID
oral antihistamines
mild steroid creams |
|
|
Term
| pharmacotherapy for preseptal cellulitis |
|
Definition
mild:
PO amoxicillin or cefuroxime
severe (children < 5 yo):
IV ceftriaxone and vancomycin |
|
|
Term
| pharmacotherapy for dacryocystitis |
|
Definition
PO amoxicillin-clavulanate
TMP-polymyxin drops |
|
|
Term
| pharmacotherapy for dacryoadenitis |
|
Definition
immediately seek medical treatment
requires systemic antibiotics |
|
|
Term
| pharmacotherapy for orbital cellultis |
|
Definition
| IV vancomycin and ceftriaxone x 14 days |
|
|
Term
| pharmacotherapy for thyroid ophthalmopathy |
|
Definition
thyroid inhibition - refer to ophthalmologist and/or physician
artificial tears or ointment may decrease discomfort |
|
|
Term
| pharmacotherapy for bacterial conjunctivitis |
|
Definition
self limiting - often spontaneously resolves in 10-14 days
treatment used to limit symptoms and prevent spread of bacteria
topical antibiotics:
trimethoprim-polymyxin q4-6h x5-7d
ciprofloxacin 8x/day for 1st couple days then QID x5-7d (other FQ = levofloxacin, moxifloxacin, gatifloxacin)
azithromycin BID x1d, then daily for 5-7 days
erythromycin or bacitracin ointment q HS x5-7d
similasan:
homeopathic OTC product
relieves redness, inflammation
NOT an antibiotic |
|
|
Term
| pharmacotherapy for gonococcal conjunctivitis |
|
Definition
| IV ceftriaxone 1g + chlamydia treatment |
|
|
Term
| pharmacotherapy for viral conjunctivitis (pink eye) |
|
Definition
self limiting - may spontaneously resolve in 2-3 weeks
non-pharmacologic:
COOL compresses (warm compress can increase redness and inflammation/irritation)
artificial tears
trifluridine (Viroptic) 5x/day x7-10d |
|
|
Term
| pharmacotherapy for chronic conjunctivitis |
|
Definition
PO doxycycline or tetracycline
PO erythromycin in pregnancy and children (avoid tetracyclines in children due to tooth discoloration) |
|
|
Term
| pharmacotherapy for allergic conjunctivitis (hay fever) |
|
Definition
avoid triggers
topical mast cell stabilizers:
Chromoyl 4% - instill in affected eye 4-6x/day
topical antihistamines:
epinastine (elestat)
emedasting (emadine)
topical combination products (antihistamine and mast cell stabilizer):
olopatadine (Patanol BID or Patadya QD)
keotifen (Zaditor)
Azelastine (Optivar) |
|
|
Term
| pharmacotherapy for keratoconjunctivitis sicca |
|
Definition
artificial tears - symptomatic relief
cyclosporine ophthalmic emulsion 0.05% (Restasis):
immunosuppressant
decreases ocular inflammation
DO NOT USE DURING AN ACTIVE EYE INFECTION <- EXAM |
|
|
Term
| pharmacotherapy for subconjunctival hemorrhage |
|
Definition
usually spontaneously resolved in 2-3 weeks
artificial tears - symptomatic relief of mild irriation
if recurrent, may need to see MD for evaluation of INR |
|
|
Term
| pharmacotherapy for episcleritis |
|
Definition
mild:
artificial tears
short term vasoconstrictor - naphazoline BID may result in rebound vasodilation after prolonged use
severe:
ocular NSAID - detorolac
ocular steroid - fluorometholone
oral NSAID |
|
|
Term
| pharmacotherapy for scleritis |
|
Definition
| oral NSAID +/- steroids, immunocuppressant |
|
|
Term
| pharmacotherapy for corneal infiltrate and ulcer |
|
Definition
refer to ophthalmologist for exam
FQ or tobramycin drops q2h while awake
cyanoacrylate tissue adhesive (Dermabond) - useful if perforation present
following surgery, fibrinogen glue (tisseel) may be used |
|
|
Term
| pharmacotherapy for herpes simplex virus |
|
Definition
trifluridine 1% drops (Viroptic) 9x/day x10-14d
severe:
PO acyclovir or other systemic antivirals
do NOT use topical steroid drops - may make infection worse |
|
|
Term
| pharmacotherapy for endophthalmitis |
|
Definition
intravitreal antibiotics - most cases warrant intravitreal antibiotics
intravenous medications are also commonly used
prognosis can be excellent or result in blindness; depends on timely diagnosis and treatment regimen |
|
|
Term
| pharmacotherapy for age related macular degeneration - dry |
|
Definition
|
|
Term
| pharmacotherapy for age related macular degeneration - wet |
|
Definition
angiogenesis inhibitors:
pegaptanib
ranibizumab
derivative of oncology drug bevacizumab (Avastin)
laser/phototherapy:
verteporfin |
|
|
Term
| the objective of drug therapy of open angle glaucoma is to: |
|
Definition
| halt progression of visual field loss |
|
|
Term
| aqueous humor is produced by the: |
|
Definition
|
|
Term
| drug therapies used in glaucoma reduce intraocular pressure by: |
|
Definition
reduction of aqueous production by ciliary body
increased outflow of aqueous humor through the trabecular meshwork and/or uveoscleral pathway |
|
|
Term
| first line agents for the treatment of open angle glaucoma include: |
|
Definition
|
|
Term
| use of nasolacrimal occlusion following application of topical glaucoma medications is potentially beneficial for: |
|
Definition
|
|
Term
| side effects associated with prostaglandin analogues include: |
|
Definition
| pigmentary changes of the iris |
|
|
Term
| appropriate therapeutic approaches to a 67 yo patient with an intraocular pressure of 26 mmHg in both eyes with normal visual fields and optic disc findings include: |
|
Definition
| monitor for signs of glaucoma only after assessing glaucoma risk factors |
|
|
Term
| side effects associated with ophthalmmic beta blockers include |
|
Definition
depression
bradycardia
dizziness
sexual dysfunction |
|
|
Term
| caution should be used when administering the following medications to patients being treated for open angle glaucoma: |
|
Definition
| ophthalmic topical corticosteroids |
|
|
