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Basics Flashcards

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1
Q

What are 3 things that cause ciliary body anterior rotation?

A
  1. PRP
  2. Scleral buckling
  3. CRVO
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2
Q

Which cells are the actual site of aqueous production?

A

Inner NONpigmented epithelial cells of the ciliary processes.

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3
Q

What accounts for the majority of aqueous production?

A

Active secretion - consumes energy (independant of pressure)

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4
Q

What is the average rate of aqueous production?

A

2.0 uL/min

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5
Q

What forms the inner wall of the Schelmm’s canal?

A

Juxtacanalicular meshwork.; lined by endothelial cells

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6
Q

Trabecular outlflow is what type?

A

Pressure DEPENDENT

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7
Q

What drop decreases Uveoscleral outflow?

A

Miotics

increased by cycloplegics, adrenergic agents, PGA

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8
Q

Which type of AC outflow is pressure-independent?

A

Uveoscleral

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9
Q

What are 2 causes of increased episcleral venous pressure?

A
  1. Facial hemangiomas

2. Thyroid ophthalmopathy.

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10
Q

Which study found that thinner corneas have a strong predictive factor to develop GL?

A

OHTS - decreasing IOP by 20%!! decreased POAG by 50% (9.5% –> 4.4%) at 5 yrs

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11
Q

What are the 3 cleaning agents for a tonometer?

A
  1. 3% hydrogen peroxide
  2. 1:10 sodium hypochlorite solution (bleach)
  3. 70% isopropyl alcohol for 5 mins
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12
Q

What are the 3 causes of GL in tuberous sclerosis?

A
  1. VH
  2. RD
  3. Ant segment NV
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13
Q

What percentage of retinal ganglion cells are M cells?

A

10%

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14
Q

What percentage of RCCs are P cells?

A

90%

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15
Q

Frequency doubling technology perimetry test what type of cells and is used for what?

A

M cells and may be more sensitive in the detection of early GL loss.

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16
Q

What are the 2 parts of the VF that are retained until late in the course of GL optic nerve damage?

A
  1. Central Island

2. Inferior temporal VF

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17
Q

A white scotoma on VF is what error?

A

High false-positive rate

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18
Q

What size does the pupil have to be to avoid artifact on HVF?

A

3 cm or greater.

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19
Q

What type of perimetry is Goldman vf?

A

Combines a kinetic exam of the peripheral isopters with a suprathreshold static examination of the central field.

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20
Q

Miotics causes what type of shift of the lens-iris diaphragm?

A

Forward shift

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21
Q

Blindness is what by definition?

A
  1. <20 degrees
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22
Q

GL is the WHAT leading cause of blindness in the world?

A

3rd

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23
Q

Who has the highest population of PACG in the world?

24
Q

The TIGR/MYOC gene causes what type of GL and is on what locus?

25
CYP1B1 gene causes what type of GL and is on what locus?
Congenital; GLC3A/B
26
The TIGR/MYOC gene is located in what 5 places?
1. TM 2. retina 3. retinoblastoma 4. Skeletal muscle 5. fetal heart
27
GLC3A gene is a/w what mutation?
Cytochrome P450
28
The Aqueous humor has an excess of what and is deficient in what?
Excess - hydrogen and chloride, ascorbate, lactate | Deficit - bicarbonate, protein, Ca, glucose
29
The CNTG study showed what?
Lowering IOP 30% (THIRTY) reduced progression from 35% to 12%
30
The OHTS studied ocular hypertensives tx with medication vs observation showed what?
``` IOP reduction (by 20%) reduced rate of GL development from 9.5% to 4.4% ALSO: were a/w the development of GL 1. Greater age 2. Greater C:D ratio 3. Greater IOP 4. Reduced CCT ```
31
African americans have what greater chance of developing GL compared to whites?
4 to 5 times greater
32
The Early Manifest GL trial had what 2 arms and showed what?
Observation vs betaxolol and ALT | Progression risk decreased by about 10% with each mm of Hg of IOP reduction from baseline to the first f/u visit.
33
FKHL7 gene is for what?
Iridodysgenesis, AD, chr 6
34
PITX2 gene for what?
Reiger's, AD, chr 4
35
What % of outflow is non-trabecular (uveoscleral)?
5-15% (up to 50% in young); pressure INDEPENDENT; (Increased by cycloplegics, cyclodylaisis, PGA, adernergic agonist) (decreased by miotics)
36
Edematous cornea and a contact lens causes what type of IOP reading?
Falsely low
37
Corneal scar causes what type of IOP reading?
Falsely high
38
In gonioscopy where is light reflected from a direct vs indirect lens?
Direct - angle | Indirect - mirror
39
M or P cells are affected earlier in GL?
M cells
40
What is the volume of the AC?
0.2 ml
41
Uveoscleral outflow occurs through what?
Ciliary body
42
What is the most common adnergic receptors in the ciliary epithelium ?
BETA 2!!
43
Measuring IOP with high astigmatism which cylinder axis do you line it up with?
MINUS cylinder is lined up with the red line
44
HVF testing test how many degrees apart in the central field?
6 degrees!! 3 above and 3 below
45
LSD causes what to IOP?
INCREASES IOP
46
Heroin causes what to IOP?
decreases IOP
47
Scleral Buckle does what to IOP?
Falsely low (decreases ocular rigidity)
48
Atropine increases what?
Uveoscleral outflow
49
What is the most common systemic side effect of brimonide?
dry mouth
50
When you have a convex iris and you are doing gonio, how do u see the angle better?
Have patient look opposite to the angle and push lens towards the angle you are trying to look at.
51
What drug has a high incidence of periocular blepaharitis / dermatitis?
Apraclonidine (40%)
52
Brimonidine real name is what and what class?
Alphagan, selective alpha 2 agonist
53
Glaucoma probability anyalisis for HVF is based on which study?
Early Manifest Glaucoma Trial
54
What is MATRIX perimetry?
1. FDT | 2. Test a similar size and number areas as standard automated perimetry
55
The Early Manifest Glaucoma Trial concluded what 3 things?
1. Treatment with ALT or meds decreased POAG by 50% 2. For every 1mmHg drop of IOP decrease chance of POAG by 10% 3. increased cataract formation with meds
56
The OHTS study did not include which risk factors?
FHx!!

Glaucoma (6 decks)

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