Glaucoma Flashcards

Latanoprost lowers IOP primarily by which mechanism?

Answer: Increasing uveoscleral outflow

Prostaglandin F2-alpha analogs remodel ciliary muscle extracellular matrix to increase uveoscleral outflow.

Which glaucoma medication is a Rho kinase inhibitor commonly associated with conjunctival hyperemia and corneal verticillata?

Answer: Netarsudil

Netarsudil inhibits Rho kinase to increase trabecular outflow and also lowers episcleral venous pressure; verticillata are a known side effect.

Why is brimonidine contraindicated in infants and young children under 2 years?

Answer: Risk of CNS depression and apnea

Brimonidine crosses the immature blood-brain barrier and can cause somnolence, hypotension, and apnea in infants.

Which medical history is the strongest contraindication to topical timolol?

Answer: Asthma or second-degree heart block

Nonselective beta-blockade can precipitate bronchospasm and worsen bradyarrhythmias or heart block.

A patient on oral acetazolamide reports tingling in the fingers and fatigue. Which other adverse effect is classically associated with this drug?

Answer: Calcium phosphate kidney stones

Carbonic anhydrase inhibitors cause metabolic acidosis, hypokalemia, paresthesias, and calcium phosphate nephrolithiasis, and rarely aplastic anemia.

Latanoprostene bunod differs from latanoprost because it also releases which molecule that increases trabecular outflow?

Answer: Nitric oxide

Latanoprostene bunod is metabolized to latanoprost acid and a nitric oxide-donating moiety that relaxes the trabecular meshwork.

Before starting pilocarpine in a highly myopic patient, which risk should be specifically discussed and screened for with a dilated peripheral retinal exam?

Answer: Retinal detachment

Pilocarpine-induced ciliary muscle contraction can exert vitreoretinal traction and precipitate retinal tears and detachment, especially in myopes.