Chronic open-angle glaucoma: case study | Learning article

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In cases of open-angle glaucoma, the angle where the iris and cornea meet is as wide as it should be, but the drainage tubules are unable to drain the eye effectively. Intraocular pressure builds up and can permanently damage the optic nerve and nerve fibres in the retina, leading to blindness.

Learning outcomes

At the end of this case, you will be able to:

  • Outline the pathophysiology, diagnosis and monitoring of chronic open-angle glaucoma;
  • Describe the populations of patients who are at risk of developing glaucoma;
  • Describe the optimum use of topical preparations and the rationale for topical therapy in the case of ocular conditions;
  • Outline the chemistry and mechanism of action of latanoprost;
  • Outline methods for reducing or preventing side effects from ocular products.

Miss NG is 34 years old and African–Caribbean. She regularly comes to your community pharmacy to collect medication for her father, Mr HG, who is 56 years old. During today’s visit, she seems anxious and asks to speak to the pharmacist. She is concerned that her father has developed glaucoma and may go blind. The glaucoma was suspected by her father’s optometrist who performed air puff tonometry as part of routine screening when he went to buy a new pair of glasses. He was then followed up and given latanoprost eyedrops, which she is collecting today.

  • What is chronic open-angle glaucoma?
  • How is it diagnosed?
  • Which people are most likely to develop glaucoma?
  • Is the patient likely to go blind?
  • What class of drug is latanoprost and what is its mechanism of action?
  • How is it related structurally to the naturally occurring biomolecule that it mimics?

Miss NG comes back the next day because her father is having difficulty in using the eyedrops as his eyes seem to run with tears when he administers the drops. She asks if her father could have a tablet instead.

  • What are the common formulations used for eyedrops?
  • How should eyedrops be correctly administered to the eye?
  • Why are topical…

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