32 Glaucoma

  • aqueous humor in anterior chamber of eye before iris
  • posterior chamber behind iris, in front of lens
  • gives eye shape and nourishes the eye

  • ciliary secrete into posterior chamber, migrate to anterior, then to canal of schlemm

Intraocular Pressure

  • creates pressure in anterior chamber of eye

Glaucoma

  • angle formed by iris, ciliary muscle
  • left: open angle glaucoma
  • right: closed angle glaucoma

Closed Angle

  • rarer

  • muscle dilating causes iris muscle to contract, can close the angle more, cause more pain

  • eye surgery definitive
  • multiple drugs used while waiting surgery

Open Angle

  • far more common

  • elderly
  • steroid usage: remodel of trabecular meshwork, less drainage

  • most patients primary
  • uveitis: impaired drainage

  • disc cup: bright area 1/3 size of optic disc
  • glaucoma: optic cup very big

Glaucoma Drugs

Parasympathetics

  • closes iris, improves angle
  • contracts ciliary muscle

Alpha

B blockers

PGE

  • "F": PGF2a
  • LA tan sandals: latanoprost (PGF2a)
  • World traveler boots: travoprost (PGF2a)
  • Leaking eyeballs: latanoprost and travoprost treat glaucoma by increasing aqueous humor outflow (not production)
  • Brown sunglasses: latanoprost and travoprost can produce brown pigmentation in iris

Diuretics

Sympathetic

  • not used anymore