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  #1  
Old 07-22-2011
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Eye African american man with vision problems

A 55 y/o African American man with hypertension and diabetes presents to the ophtalmologist clinic for routine examination. The patient has no visual complaints. Visual acuity is 20/20 in both eyes. Funduscopic examination reveals enlarged optic nerve head cupping with significant rim pallor in both eyes. Gonioscopy reveals open angles, and aplanation tonometry reveals borderline intraocular pressures. Which of the following could be used to treat this patient?

A. Corticosteroids
B. Intravenous Mannitol
C. Isoproterenol
D. Phenoxybenzamine
E. Pilocarpine
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  #2  
Old 07-22-2011
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I think it is A....Steroids
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Old 07-22-2011
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Quote:
Originally Posted by confident View Post
I think it is A....Steroids
Steroids increase intraocular pressure.
I think is B.
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Old 07-23-2011
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E although not the first choice is the best answer. The patient has open angle glaucoma and no symptoms and IV treatment is not indicated. Treatment of choice are beta blcokers and prostaglandins
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Old 07-23-2011
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Quote:
Originally Posted by Sadalssud View Post
Steroids increase intraocular pressure.
I think is B.

Yes but it depends on route of administration i think...on systemic administration it has very little effect on IOP but local administration may directly have effect on iop....moreover steroids stops inflammatory response and pramotes healing so if it treats inital condition then IOP which happened subsequently will be taken care by itself.......thats what i was thinking but lets see what is the answer......
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Old 07-23-2011
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The correct answer is E. This patient has open angle glaucoma. (OAG) . This condition is dx by increased intraoccular pressure, abnormal optic disk findings and typical field loss. The eye is not red or painful, the pupil and cornea appear normal and it commonly affects both eyes. OAG can be treated with a variety of meds. Pilocarpine is a muscarinic agonist that produces rapid miosis and contraction of the ciliary muscles. This can be used in the acute treatment of OAG or closed angle glaucoma to open the trabecular meshwork around Schlemm's canal increasing drainage of humor and decreasing intraocular pressure.
OAG can also be treated with agents that decrease secretion like beta-blockers (timolol), carbonic anhydrase inhibitor, and alpha 2 agonist (brimonidine).
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  #7  
Old 07-25-2011
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E. Pilocarpine
open angle glucoma
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