Intraocular pressure elevated

Opatowsky I, Feldman RM, Gross R, Feldman ST. Intraocular pressure elevation associated with inhalation and nasal corticosteroids. Ophthalmology 1995 102(2) 177-9. 

N. Bodor, N. Bodor, and W.-M. Wu, A comparison of intraocular pressure elevating activity of loteprednol etabonate and dexamethasone in rabbits, Curr. Eye Res. 11 525 (1992). 

Measurement of amino acid levels in the vitreous humor of rats after chronic intraocular pressure elevation or optic nerve transection. Glaucoma 11, 396—405. 

Robin AL. Effect of topical apraclonidine on the frequency of intraocular pressure elevations after combined extracapsular cataract extraction and trabeculectomy. Ophthalmology 1993 100 628-633. 

Conservative treatment of zoster-associated conjunctivitis, including cold compresses, lubricants, and decongestants, carries the lowest risk of treatment-related complications. Treatment of the acute conjunctivitis with topical broad-spectrum antibiotics may help to prevent secondary bacterial infection. Increased patient comfort by reduction of conjunctival inflammation may be affected by the use of topical steroids. Often, a combination antibiotic-steroid is used to accomplish both of these goals. In contrast to herpes simplex infection in which steroids are specifically contraindicated, topical steroids do not exacerbate herpes zoster infection. If steroids are used, the patient should be carefully monitored for intraocular pressure elevation. 

If intraocular pressure elevated, topical antiglaucoma therapy avoid prostaglandin analogue... 

Packer AJ, Fraioli AJ, Epstein DL. The effect of timolol and acetazolamide on transient intraocular pressure elevation following cataract extraction with alpha-chymotrypsin. Ophthalmology 1981 88(3) 239-43. 

Indications Post-surgical intraocular pressure elevation Category Adrenergic alpha2-receptor agonist Half-life 8 hours... 

Sensory system Intravitreal CS therapy may be useful for a variety of retinal and ocular inflammatory conditions. In one editorial, the authors give their impression about that intravitreal CS therapy may be underutilised because of a fear of CS-associated intraocular pressure elevation or of its potentially attendant surgical interventions, a fear that is disproportionate to actual risk [KF]. They provide perspective on the risk-to-benefit ratio of intravitreal CS therapy with respect to CS-associated glaucoma. 

Loteprednol 1 drop in affected eye(s) four times daily Elevated intraocular pressure, cataracts, decreased wound healing, secondary ocular infections, systemic side effects possible... 

Glaucoma-To decrease elevated intraocular pressure (lOP) in glaucoma. 

Elevated intraocular pressure f/OPJ Treatment of elevated lOP in patients with ocular hypertension or open-angle glaucoma. 

Elevated intraocular pressure (lOP) For reduction of elevated lOP in patients with open-angle glaucoma and ocular hypertension who are intolerant of other lOP-lowering medications or insufficiently responsive to another lOP-lowering medication. 

The answer is B. LHON often has an onset in early adulthood. It is a mitochondrial disorder usually resulting from a mutation in one of the proteins of the electron transport chain, particularly complex I, encoded by the mitochondrial genome so there is no chance that the patient can pass the disorder to his children (see Chapter 13). Cataracts would have been detected as opacity in the lenses, and glaucoma would have been identified by an elevated intraocular pressure. Macular degeneration is also associated with central vision loss but is found mainly in patients over age 65. 

Topically applied /3-blockers are used to reduce elevated intraocular pressure in patients with open-angle glaucoma simplex. 

Other reported side effects include vomiting, salivation, lacrimation, shivering, skin rash, and an interaction with thyroid preparations that may lead to hypertension and tachycardia. Ketamine also may raise intracranial pressure and elevate pulmonary vascular resistance, especially in children with trauma or congenital heart disease. Increases in intraocular pressure also may occur, and vigilance is required if ketamine is used in ocular surgery. 

Succinylcholine produces muscle fasciculation, which may result in myoglobinuria and postoperative muscle pain. The amount produced depends on the level of physical fitness. Succinylcholine causes contractions of extraocular muscles, posing the danger of transient elevated intraocular pressure. Succinylcholine may produce hyperkalemia in patients with large masses of traumatized or denervated muscle (e.g., spinal cord injury). Denervated muscle is especially sensitive to depolarizing drugs because of the increased number of AChRs on the sarcolemma (denervation supersensitivity). Succinylcholine also causes prolonged contraction of the diseased muscles of patients with myotonia or amyotrophic lateral sclerosis. 

Serious adverse reactions may include proteinuria (80%), nephrotoxicity (53%), neutropenia (31%), elevated serum creatinine levels (29%), infection (24%), anemia (20%), ocular hypotony (a decrease in intraocular pressure 12%), and pneumonia... 

Ophthalmic Burning or stinging on instillation, keratitis, elevated intraocular pressure Rare (less than 3%)... 

The major acute toxicities of organic nitrates are direct extensions of therapeutic vasodilation orthostatic hypotension, tachycardia, and throbbing headache. Glaucoma, once thought to be a contraindication, does not worsen, and nitrates can be used safely in the presence of increased intraocular pressure. Nitrates are contraindicated, however, if intracranial pressure is elevated. 

Wingate RJ, Beaumont PE. Intravitreal triamcinolone and elevated intraocular pressure. Aust NZ J Ophthalmol 1999 27(6) 431-2. 

Rulo AH, Greve EL, Hoyng PF. Additive effect of lata-noprost, a prostaglandin F2 alpha analogue, and timolol in patients with elevated intraocular pressure. Br J Ophthalmol 1994 78(12) 899-902. 

Sherwood M, Brandt J. Bimatoprost Study Groups 1 and 2. Six-month comparison of bimatoprost once-daily and twice-daily with timolol twice-daily in patients with elevated intraocular pressure. Surv Ophthalmol 2001 45(Suppl 4) S361-8. 

Huang, Y., Li, Z., Wang, N., van Rooijen, N., and Cui, Q. (2008). Roles of PI3K andJAK pathways in viability of retinal ganglion cells after acute elevation of intraocular pressure in rats with different autoimmune backgrounds. BMCNeurosci. 9, 78. 

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