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Medical Management of Glaucoma – as seen in Chapter 7 BCSC

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Medical Management of Glaucoma – as seen in Chapter 7 BCSC by Dr. Honkanen

Here we’re going to have chapter 7 port 2 again the same rules apply outlined image of colors we’re first going to go over the prostaglandins here the prostaglandin analogs consists of xalatan and travatan andy’s increase evo squirrel l flow typically by about fifty percent by causing adjustment in the ciliary body face there are also similar medications called

A hypotensive lipids these include lumigan and rescue ‘la over my depressed and and the effect of these prostaglandin the effect of these medications on the prostaglandin f receptor remains somewhat controversial lumigan can increase the uv ll fly up to fifty percent and it also increases trabecular alpha by twenty-five to thirty percent mundo prosto nor rescue

Which is no longer available just increases the trabecular outflow on xalatan and travatan now it’s private entity or basically prodrugs that become available after hydrolysis by the cornea lester races they can reduce iop by twenty-five to thirty percent lumigan is not a pro drug that can be crees iop by 27 to 33 percent rescue ‘la again is not a prodrug and

It decreases pressure thirteen to eighteen percent the side effects of all the prostaglandin analogues are generally similar you can get darkening of the periocular skin this is due to increased numbers of mallanna psalms within the melanocytes it’s not due to increase in the numbers of melanocytes due to increase in the number of mallanna somes it occurs more

Commonly in eyes with some pigmentation at baseline so generally if you have some pigment like hazel of green color eyes you can have this increased pigmentation up to sixty percent of cases in blue eyed is probably ten to twenty percent you can also get conjunctival hyperemia thickening and lengthening of the eyelashes you can also develop other side effects such

As cma that happens most common in patients with open posterior capsules uveitis or exacerbation of hsv keratitis and here we should see images very nicely a little bit of periocular darkening on this side compared to the other darker pupil compared to the other side or darker iris and that’s more evident in photos down below see the discrepancy in the color as

Well as the counting title hyperemia typically associated with the prostaglandin analog and here you have a nice example of prostaglandin eyelashes where the drug is made where the drug medication is used on the we also have combined medications on the market now these include co soft and come began close-up is a combination of timolol and dorzolamide come again

Is a combination of timolol and ramana dean the benefits of these drugs are basically improved compliance sometimes an improvement in cost and can but typically you generally don’t start with a double agent like this you usually still begin treatment with single agents or single medications with monocular trials to make sure that each medication is effective in

Leveling okay when patients are on two of these medications frequently the combination drops off alone hyperosmotic agents are typically used to acutely control or lower marc died

Transcribed from video
Medical Management of Glaucoma – as seen in Chapter 7 BCSC By SB Eye Videos