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Ala Shamasneh

on 11 October 2014

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Transcript of glaucoma

we have five classes of drug
1- beta blockers
2- alpha agonist (alpha 2 agonist and nonspecific agonist)
3- carbonic anhydrase inhibitors
4- parasympathomimetics
5- prostoglandin analogs

Drugs that decrease
aqueous humor production:

Drugs that increase the aqueous humor outflow:
Cholinergic (Miotic)
non specific adrenergic agonists
Prostaglandins analogs

Beta blockers
Alpha2- agonists
Carbonic anhydrase inhibitors

low BP, bradycardia; arrhythmia; heart failure; heart block.
shortness of breath
Rare side effects include reduced libido and depression.
selective adrenergic agonists
apraclonidine, brimonidine
prejunctional NE release, production and IOP

Side Effects
Ocular side effects include follicular conjunctivitis, burning, reactive hyperemia...
Systemically, they can cause headache, dry mouth, fatigue, bradycardia, and hypotension
Carbonic anhydrase inhibitors
side effects:
gradual change in eye color, due to an increased amount of brown pigment in the iris of the treated eye.
Other side effects can include stinging, blurred vision, eye redness, itching, and burning.

are taken as eye drops
have few systemic side effects.
increase uveoscleral outflowؤمثقشم
are effective at reducing intraocular pressure in people who have open-angle glaucoma

such as a beta blocker and alpha adrenergic agonist, or a beta blocker and carbonic anhydrase inhibitor.
Decreases production of intraocular fluid.
Combined medications can offer an alternative for patients who need more than one type of medication.

Combined medications
pharmacologiacl treatment
also it can be classified as:
action site of antiglaucoma drugs
1 & 2 mitotic (cholinergic)
3 beta blocker
4 prostaglandin analog
5 alpha agonist
1-beta blockers:

block beta receptors in the iris and ciliary body block the action of NE in the ciliary epithelium reduce production
classify into:
non-selective beta blockers:
timolol, levobunolol, metipranolol and carteolol
selective beta 1 blockers:
non-specific adrenergic agonists
alpha agonists
(acetazolamide, brinzolamide, dorzolamide, methazolamide)
reduce HCO3 so reduce formation of aqueous humour

1-topical 2-oraly 3-IV or IM
side effects:
systemic CAI: transient myopia; parasthesia of the fingers, toes, and perioral area; urinary frequency; metabolic acidosis; malaise; fatigue; weight
hepatic disease renal insufficiency
hyponatremia hypokalemia
electrolyte imbalance
pilocarpine, carbachol
their use has declined due to their side effect
It is a heterogenous group of diseases that cause optic neuropathy .
It is the most common disease of the eye
in most cases assosciated with elevated IOP.

• How does incresed IOP Cause Glaucoma?
• In the world ,glaucoma is the third leading cause of blindness.

• An estimated 13.5 million people may have glaucoma and 5.2 million of those may be blind.

• Glaucoma often is called the
"silent thief of sight"
• For this reason, glaucoma often progresses undetected until the optic nerve already has been irreversibly damaged.

Classification of glaucoma
acheived by :
• Medication
• Laser therapy
• Surgery

The goal of Glaucoma treatment:
• Preserve the visual field
• Prevent the loss of visual function

Open angle glaucoma
close angle glaucoma
common type
it is called
angle glaucoma
Drainage angle between iris and cornea is open
Rise in pressure is caused by resistance to outflow through trabecular meshwork
Vision loss is
Lifelong condition
open angle glaucoma
common type
it is called
Drainage angle closes off
Rise in pressure is caused by iris completely closing off drainage angle
Acute condition :
Symptoms are sudden severe pain, blurry vision and red eye (Nausea and vomiting are also possible)
Vision loss is irreversible,
treated early
immediate medical attention
, if treated within time
close angle glaucoma
angle closure glaucoma
open angle glaucoma

AL-Quds University
Glaucoma and drugs used for its management
Made by Ihdaa Adawi and Ala shamasneh

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