Question

1. Which of the following is TRUE about glaucoma?
A. It affects White individuals more often than Black individuals
B. It is most commonly diagnosed in childhood
C. It is the leading cause of irreversible blindness in the United States (US)
D. Black individuals with glaucoma are more susceptible to blindness

2. Which of the following BEST describes open-angle glaucoma (OAG)?
A. The iris is pushed forward, blocking drainage of aqueous humor
B. Aqueous humor drains from the eye too quickly, elevating intraocular pressure (IOP)
C. Resistance within the trabecular meshwork reduces aqueous humor outflow
D. Optic nerve damage and visual field loss occur under normal IOP

3. Which patient scenario warrants urgent glaucoma evaluation based on risk factors and presentation?
A. A 32-year-old Hispanic patient with seasonal allergies and blurry vision
B. A 67-year-old Black patient with diabetes and gradual peripheral vision loss
C. A 45-year-old Black patient with conjunctivitis and eye redness for 1 day
D. A 70-year-old White patient with stable cataracts and no visual complaints

4. Which of the following is TRUE about OAG?
A. OAG onsets suddenly, causing blurry vision and eye pain
B. OAG onsets suddenly, causing immediate loss of peripheral vision
C. OAG onsets gradually, initially presenting with little or no symptoms
D. OAG onsets gradually, initially presenting with loss of central vision

5. Which of the following best describes IOP elevation caused by abnormal protein accumulation in the eyes' drainage system?
A. Exfoliative glaucoma
B. Normal-tension glaucoma
C. Neovascular glaucoma
D. Corticosteroid-induced glaucoma

6. Which of the following is an advantage of rho kinase (ROCK) inhibitors over traditional OAG treatments?
A. They maintain nutrient and oxygen delivery to anterior chamber tissues
B. They eliminate the need for regular ophthalmologic follow-up
C. They reverse optic nerve damage caused by IOP elevation
D. They increase aqueous humor production to restore IOP balance

7. Which of the following statements BEST summarizes the evidence supporting the netarsudil/latanoprost fixed-dose combination?
A. It was inferior to each monotherapy in the MERCURY studies
B. It was superior to each component alone in reducing IOP
C. It is approved only to treat angle-closure glaucoma
D. It is dosed twice daily to improve efficacy and safety

8. Daniel, age 72, comes to the pharmacy to refill his glaucoma eye drops. While chatting, he says, “My vision hasn't changed in months, so I think the glaucoma is gone. I might stop using the drops after this bottle.” Which of the following is the most appropriate response?
A. “That's a good idea; one less medication would alleviate your treatment burden.”
B. “The pharmacist can better explain why stopping your drops may cause vision loss.”
C. “That's great to hear, but you should only reduce use to every other day instead.”
D. “You can only safely stop all your glaucoma medications once your vision improves.”

9. Jackie, a new glaucoma patient, picks up netarsudil for the first time. She says she's never used eye drops and isn't sure how to keep the medicine from running down her cheek. Which of the following is the BEST counseling point to reinforce?
A. Close your eyes and gently press the inner corner for 1-2 minutes after using the drop
B. Use 2 drops in each eye, so more medicine is appropriately absorbed
C. Place the dropper directly up against the eye when administering
D. Tilt your head forward so the drop stays in the front of the eye instead of running down

10. Cynthia is late refilling her latanoprost prescription. When asked, she says she sometimes skips doses to make the bottle last longer because of the cost. Which of the following is the most appropriate action to take?
A. Recommend stopping the medication until his next eye exam to see if it is still needed
B. Suggest spacing out doses to every other night to save drops but remain consistent
C. Let the pharmacist know so they can discuss generic options or assistance programs
D. Tell her to squeeze the bottle more gently to use smaller drops, so the bottle lasts longer

Answer 1

1. D — Black individuals with glaucoma are more susceptible to blindness (higher prevalence, earlier onset, and greater risk of severe vision loss).

2. C — OAG is caused by increased resistance in the trabecular meshwork that reduces aqueous outflow.

3. B — A 67‑year‑old Black patient with gradual peripheral vision loss has classic risk factors and presentation for OAG and needs urgent evaluation.

4. C — OAG develops gradually and initially produces little or no symptoms (peripheral vision loss is often insidious).

5. A — Exfoliative (pseudoexfoliative) glaucoma is caused by abnormal extracellular material accumulating in the drainage structures.

6. A — ROCK inhibitors can improve conventional outflow and may help maintain nutrient/oxygen delivery to anterior segment tissues (they target the trabecular outflow pathway).

7. B — The netarsudil/latanoprost fixed‑dose combination was superior to each component alone in reducing IOP in the MERCURY studies.

8. B — The pharmacist should explain that stopping glaucoma drops can lead to progression and irreversible vision loss and counsel adherence/coordinate with the eye specialist.

9. A — Use punctal occlusion: close the eyes and gently press the inner corner (nasolacrimal area) for ~1–2 minutes after instilling a drop to reduce runoff and systemic absorption.

10. C — Notify the pharmacist so they can discuss lower‑cost generics, patient assistance, or other affordability options rather than skipping or altering doses.