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High Yield Glaucoma for Step 1 and 2

Title: High Yield Glaucoma for Step 1 and 2

Author: Abigail Jebaraj, MSIV

Date: 10/17/2018

CORE Category:

Medical Student Education Outline > III. Additional Resources > New line “2. High Yield Glaucoma Review for Steps 1 and 2”

Cupping: measurement of optic nerve cup diameter to optic disc diameter ratio to assess thickness of optic nerve head. More cupping (ratio greater than 0.5) = higher risk

Normal Cup to Disc Ratio

Abnormal Cup to Disc Ratio

 

Drug Class Examples Mechanism of Action Side effects
Beta adrenergic receptor antagonists Timolol, betaxolol, carteolol Decrease production of aqueous humor Irritation, dry eye, blurry vision potential exacerbation of bradycardia, asthma exacerbation, or hypotension
Carbonic anhydrase inhibitors Acetazolamide Decrease production of aqueous humor Dry eye, blurry vision if oral, dizziness, lightheadedness, dry mouth, drowsiness, allergic reaction with sulfa drug allergy
Prostaglandin analogues Bimatoprost and latanoprost Increase outflow of aqueous humor Irritation, darkening of the iris, hypertrichosis (increased eyelash growth)
Cholinomimetics Pilocarpine and carbachol (Direct)

Physostigmine and echothiophate (Indirect)

Increase outflow of aqueous humor Blurry vision, headache, miosis (constriction of pupil), and cyclospasm (contraction of ciliary muscle)
Alpha adrenergic agonists Epinephrine and brimonidine Decrease production and increase outflow of aqueous humor Irritation, allergy, pruritis, dry eye, blurry vision, mydriasis (dilation of pupil)

 

References:

Tae L, Bhushan V, Sochat M, Chavda Y, Zureick A. First Aid for the USMLE Step 1 2018, 28th Edition. New York: McGraw-Hill Medical, 2017. Pages 520 and 535.

Weinreb RN, Aung T, Medeiros FA. The Pathophysiology and Treatment of Glaucoma: A Review. JAMA. 2014;311(18):1901-1911. doi:10.1001/jama.2014.3192

Boyd K. Glaucoma. American Academy of Ophthalmology. Eye Health A-Z. Available at: https://www.aao.org/eye-health/diseases/what-is-glaucoma. Accessed: September 25, 2018.

Root T. Introduction to Glaucoma. OphthoBook. Available at: https://timroot.com/glaucoma/ Accessed September 25, 2018.

National Eye Institute. Facts About Glaucoma. Available at: https://nei.nih.gov/health/glaucoma/glaucoma_facts. Accessed: September 25, 2018.

Faculty Approval by: Griffin Jardine, MD
Identifier: Moran_CORE_26821
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