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eye assess 411 part

part 3

QuestionAnswer
Primary closed angle glaucoma (emergency)
 increased IOP - over 75mmHg
 Pathophysiology : due to complete blockage of filtering angle caused by a bunching up of iris.
 Maybe precipitated in by narrow anterior chamber angles of administering anticholinergic drugs (atropine, scopolamine)
 Sxs : Excruciating, throbbing pain around eyes to radiation to 5th CN region. Rapid loss of vision Nausea and vomiting (oculovagal reflex) Abdominal Pain, cornea - steamy, edema Blurred vision, haloes around light/rainbow around light Edematous eyelids during a
 If untreated, irreversible blindness
 Aqueous humor backing up because of Iris abnormality - fluid backing up to Retina - put pressure on Retina - need surgery right away.
 Keep IOP low to prevent further Optic Nerve damage.
 Cholinergic agonist(Miotics) : Constrict pupil - more room for draining off. (Pilocarpine, Carbachol - make pupil constriction)
 Prostaglandins - Reducing aqueous humor. Has no systemic effects. SE : It makes eye pigmentation. Xalatan(Latanoprost).
 Beta blockers : Decrease AH production.(does not affect pupil. Betagan, Ocupress) - Don't give nonselective B-blocker to COPD pts.(ex. Don’t give Inderal(nonseletive), since it knocks out lungs too)
 Selective Beta blockers – Betoptic (betaxolol – Selective B1 antagonist)
 Alpha2 adrenergic agonists(negative feedback-inhibitory) - enhance AH drainage. Closed angle glaucoma - never give adrenergic agonists.(give sympatholytic(cholinergic) drug – to constrict pupil).
 Carbonic Anhydrase inhibitors - Reduce AH production. Diamox.
 Osmotic diuretics - Mannitol, Urea, Glycerol, Osmoglyn. Pulling out fluid(AH), lessen the pressure.
Created by: holla
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