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Glaucoma 1 Flashcards

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1
Q

If PAS is seen to extend anterior to the schwalbe line what condition should you suspect?

A

ICE syndrome

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2
Q

Preperimetric glaucoma

A

Glaucomatous changes in optic discs with normal visual fields

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3
Q

What portion of the TM has the most resistance to outflow?

A

juxtacanalicular TM (inner most that is adjacent to the Schlemn canal)

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4
Q

What is thought to be the age range for Juvinille open angle glaucoma (JOAG)?

A

4-35 yrs

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5
Q

Risk factors for open angle glaucoma

A
  • IOP * Age * AA * Family Hx * CCT * Female * CRVO * ?? HTN, DM, Myopia, Hypothyroidism, ??
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6
Q

Risk Factors for closed-angle glaucoma

A
  • Race (Inuits, Asian) * Female * Hyperopia (far sightedness) * Family history * Advanced age > 50
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7
Q

How many cililiary processes are there?

A

About 80

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8
Q

What is the arterial source for the ciliary processes?

A

branches of the major arterial circle of the iris

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9
Q

Aqueous humor is produced what what three mechanisms? What is the major contributing mechanism?

A
  • ACTIVE TRANSPORT * Ultrafiltration * simple diffusion
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10
Q

What ions in the aquous humor are in excess compared to plasma? Lower?

A
  • Chloride, H+, Vit C * Bicarbonate
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11
Q

What are the three major types of aqueous suppresants?

A
  • Beta blockers * Alpha 2 agonists * Carbonic anhydrase II inhibitors
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12
Q

What is the rate of aqueous turnover?

A

1% per min equaling full turnover every 1-2 hours

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13
Q

What is the pressure-independent aqueous outflow pathway?

A

uveoscleral pathway making up approx 10% of total outflow

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14
Q

What is normal diurnal variation and what would be suggestive of glaucoma?

A

2-6mmMg >10mmMg diurnal variation

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15
Q

What is a promising type of tonometry that is challenging goldmann tonometry?

A

Dynamic contour tonometry? (DCT)

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16
Q

What is the average rate of aqueous production?

A

2.0-2.5 ul/min

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17
Q

What is the method used to measure the rate of aqueous formation?

A

fluorophotometry

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18
Q

What is the method used to measure the rate of aqueous out-flow?

A

tonography

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19
Q

What is the normal variation in superior versus inferior visual fields?

A

Superior field in normally depressed 1-2 dB

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20
Q

What does a “cloverleaf” visual field suggest?

A

The patient stopped participating part way the the exam

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21
Q

False positives great than ____ percent suggest an unreliable test.

22
Q

False negatives greater than ___percent suggest unreliable test.

23
Q

What are two common causes of general decline in visual field sensitivities?

Study These Flashcards
A
  1. Miosis2. Cataract
24
Q

Does UBM or AS-OCT better visualize the cilliary body?

Study These Flashcards
A

UBM(umb is ultra sound biomicroscopy and as-oct is anterior segment oct)

25
IOP in general poplulation is not Gaussian but is rather...
skewed to the right
26
What is the average corneal thickness in adults?
530-545um
27
Are drance hemorrages more common in POAG or normotensive glaucoma?
Normo-tensive glaucoma
28
What is the usual goal IOP reduction in a normotensive glaucoma patient?
30%
29
What percentage of eyes w/ POAG may have a reading of less than 21mmHg on a single reading?
30-50%
30
What is the gene mutation found in exfoliation syndrome and what is the effect?
LOXL1, abnormal production of elastin (a fibrillar build-up ensues)
31
Sampaolesi line
At or anterior to schwalbes line often seen in PXT or PDS
32
Does lens extraction alleviate PXT?
No
33
What is "reverse pupillary block"
Sometimes seen in PDS in which peripheral iris bows posteriorly rubbing on zonules
34
What are the tree types of lens induced open angle glaucomas?
1. Phacolytic2. Phacoantigenic3. Lens particle
35
What is a distinguising differences on exam between phacolytic and phacoantigenic glaucoma?
KP's are seen in phacoantigenic
36
What time period followings surgery would you expect to see lens particle glaucoma?
usually within 1-2 weeks but can be months or years
37
TIGR/MYOC is most well known to be associated with what?
JOAG
38
What cells are thought to be the site of actual aqueous formation?
non-pigmented cells of the cilliary body
39
Would exercise increase or decrease IOP?
Decrease
40
Perkins tonometer is like what other tonometer and what is the major difference?
It is like the Goldmann tonometer; it is portable
41
Excess fluorescein would result in artificially high or low IOP reading?
High
42
Are fenestrations of laminar cribrosa larger superiorly/inferiorly or nasally/temporally?
superiorly/inferiorly
43
What is the ring of Elschnig?
rim of connective tissue between the optic nerve and adjacent choroidal and scleral tissue
44
The anterior optic nerve gets its blood supply entirely from what arterial source?
Short posterior ciliary arteries, not from the central retinal artery
45
What are the 4 regions of the anterior optic nerve called?
1. Nerve Fiber2. Prelaminar (at the level of choroid layer)3. Laminar (at the level of lamina cribrosa4. Retrolaminar (at the level posterior to lamina cribrosa
46
What number do you need to multiply the slit lamp beam to get the correct height of the optic nerve when using:1. 60D2. 78D3. 90 D
1. multiply by 12. Mulitply by 1.13. Mulitply by 1.3
47
What is the normal height of the optic nerve?
Conventionally 1.5 but normal ranges 1.5-2.2
48
What are the two types of peripaillary atrophy?
1. Alpha: represents hyper and hypo pigmentation that is often normal2. Beta: atrophy of RPE and choroid that is pathologic
49
What class of medication is not affective in ICE syndrome?
miotics (e.g. pilocarpine)
50
Hypotony maculopathy is most common in young myopic patients or in old hyperopic patients?
young myopic

Glaucoma (3 decks)

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