Glaucoma case study

Designed for students and instructors interested in clinical applications, the Clinical Companion is a rich compendium of medical case studies and clinical discussions. It contains numerous problems and references to the textbook. Such topics as glaucoma, cystic fibrosis, Tay-Sachs disease, and autoimmune diseases are covered from a biochemical perspective. 

Findings obtained from experimental studies suggest that induction of iNOS mediates inflammatory or ischemic brain damage and that excessively activated nNOS under excitotoxic or ischemic conditions produces NO that is toxic to surrounding neurons. Selective inhibition of iNOS or nNOS may be neuroprotec-tive. This is also the case in glaucoma and diabetic... 

Leopold and Comroe2 studied the use of 0 05, 01 and 0-2 per cent D.F.P. in arachis oil in glaucoma, and found that cases unrelieved by eserine responded readily to 01 per cent D.F.P. instilled into the conjunctival sac. However, the action of D.F.P. in the glaucomatous eye lasts for about 12 hr. compared to an action of about 12 days in the normal eye. The short-lived action of D.F.P. in cases of raised intra-ocular tension lends evidence to the suggestion that there may be an upset of the acetylcholine-cholinesterase mechanism in glaucoma. There are certain side effects such as ciliary spasm and headache which may prove troublesome during treatment. 

Zeese, Kevin B. Research Findings on Medicinal Properties ofMarijuana. Medical MJ Science.org. Available online. URL http //www.medmjscience. org/Pages/history/zeese.bhtml. Downloaded January 8, 2004. An attorney and advocate involved in federal marijuana rescheduling cases summarizes the history of medicinal use of marijuana and describes major research studies that have tended to confirm the medical value of marijuana for certain conditions such as anorexia, nausea, and glaucoma. 

It is recognized that many patients treated for glaucoma require a second concomitant medication to lower lOP. The appeal of a combination product stems from the belief that adherence to complex multiple medical regimens is improved with simplified dosing schedules. The two most common ocular hypotensive medications are in the prostaglandin and P-blocker classes. Several combination products are presently available worldwide that combine various prostaglandin analogues with a non-selective P-blocker.These products include a combination of latanoprost or travoprost with timolol. Studies have demonstrated comparable efficacy and in the case of the travoprost-timolol combination, a favorable lOP reduction between the combination product and the separate compounds administered concomitantly. At the present time, neither combination product is available in the United States. 

Band keratopathy was first described in 1848 and is a chronic degenerative condition characterized by the deposition of calcium carbonate salts in the superficial corneal layers, most frequently in the interpalpebral area. Although there are many reported cases of idiopathic band keratopathy, some of which seem to have a hereditary component, the most common causes are associated with chronic ocular inflammation and systemic conditions resulting in altered calcium metabolism. Band keratopathy is typically seen in eyes with chronic uveitis, severe superficial keratitis, corneal ulcers, chemical burns, interstitial keratitis (IK), trachoma, phthisis bulbi, and prolonged glaucoma. The chronic anterior uveitis of juvenile idiopathic arthritis is frequently associated with band keratopathy, with one study reporting its development in 66% of patients with juvenile idiopathic arthritis. 

Wilson MR, Hertzmai k E, Walker AM, Clrilds-Shaw K, Epstein DL (1987) A case-cond ol study of risk factors m open angle glaucoma. Ai ch Ophdialmol 105 1066-1071. 

Eyes Case-report studies have showed side effects of bilateral transient myopia and secondary ACG with choroidal detachment after use of oral methazolamide (100 mg) in a 51-year-old male with non-insulin-dependent diabetes mellitus (DM) used for refractory macular oedema after 10 days of treatment and a 70-year-old male with normoten-sive glaucoma after 1 day of treatment, which recovered with discontinuation of methazolamide [7],... 

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