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Flashcards in Glaucoma Deck (70):
1

What % of pple are steroid responders and at what point does steroid induced glaucoma appear

42% and starts 2 weeks

2

whats swan syndrome?

hyphema from neo on the lip of an old corneal wound that bleeds

3

whats hemolytic glaucoma?

s/p VH, macrophages eat RBC-->clog tm

4

why do a PI in acute angle closure

treating the pupillary block component, make another channel for aq to flow from post chamber to ant chamber

5

what causes acute angle closure?

pupillary block--> causes iris to bow forward-->zips angle-->closed on gonio-->do PI to break pupillary block and

6

how does plateau iris cause angle closure

funny insertion of iris causes a roll of iris to block tm. On slit lamp ac will be deep centrally but will se "double hump" sign on gonio

7

how do you treat plateau iris?

1) peripheral pupilloplasty
2) ce
3) chronic miotics to keep iris out of angle

8

what causes pupillary block in an aphakic eye?

ant hyaloid face causing pupillary block

9

whats the unifying theme in ICE syndrome?

they all have abnormal K endo, with beaten bronze appearance and downgrowth into angle causing glaucoma

10

Is ICE unilateral or bilateral?

unilateral

11

Whats the difference between the ICE syndromes?

The appearance of the iris

12

Whats the other name for cogan reese syndrome?

IRIS NEVUS SYNDROME (cogan resse and iris nevus both 2 words)

13

Whats the exam in chandler syndrome

iris appears normal

14

should you do a trab in ICE?

no bc crap grows over the bleb

15

whats nanophthalmos?

small eye but normal structures

16

lens bowing forward causes what refractive shift?

myopic if lens bows forward
hyperopic if lens goes back
(its the opposite of glasses)

17

At what age is glaucoma considered JOAG?

if the glaucoma starts >3 yo

18

what are haabs striae?

horizontal lines in congenital glaucoma

19

whats the surgical sequence for congenital glaucoma?

1) goniotomy 2) trabeculotomy 3) trab w mmc 4) tube

20

is axenfeld reiger unilateral or bilateral?

bilateral

21

whats the inheritance pattern of axenfeld reiger?

AD

22

posterior embryotoxon, periumbilical skin folds, maxillary hypoplasia, microdontia, hypospadias

axenfeld reiger

23

whats Gillespie syndrome?

a syndrome that 2% of aniridia pts have.
Triad of aniridia, cerebellar ataxia and MR

24

WHat % of pts w peters have glaucoma?

50%

25

what % of the time is peters bilateral?

80%

26

When is there blunt pressure rise?

am

27

which beta blocker can cause heart block?

levobunolol

28

how does beta blocker effect cholesterol?

lowers HDL

29

Whats a drug that acts like ACH?

Pilocarpine

30

Name an indirect acting parasympathomimetic drug (ie ach-ase inhibitor)

echothiphate

31

name a drug that's a combo of direct acting ach and also a ach-ase inhibitor

miostat (carbachol)

32

whats the 2 SE of echothiophate?

1) systemic parasympathetic stimulation
2) iris cysts in children

33

whats the best glaucoma med in pregnancy?

brimonidine (class B). Everything else is class C

34

What % of pple have success at 6 mo with ALT?

80%

35

Who is NOT good candidate for trab?

young
aphakic
black
previous failed trab

36

Does treating a pt with OHTN delay onset of glaucoma?

OHTS showed IOP reduction reduced the development of glaucoma from 9.5% to 4.4%

37

Does treating a pt with early glaucoma delay progression? Maybe we should just leave these pts alone?

Early manifest glaucoma trial (EMGT) showed pts treated with BETAXOLOL AND ALT has less and later progression vs. observed group (45% v 62%)

38

When a pt is first diagnosed with glaucoma is there a "best" way to treat the pt?

Collaborative Initial glaucoma treatment trial (CIGTS) showed med vs trab has very similar outcome at 5 years.

39

What did the glaucoma laser trial show? (GLT)

Timolol vs ALT as initial treatment showed ALT is just as good as timolol

40

My pt is failing medical therapy, should I go to ALT or trab?

AGIS showed white pts did better w trab. Black pts did better w ALT

41

Im doing a trab- anything I can do to increase chances for success?

5FU filtering surgery study- substantial improvement in IOP reduction with 5-FU

42

Does lowering IOP in pt w NTG help?

Collab NTG study- lowering IOP by 30% reduced progression from 35% to 12%

43

PXE gene

LOXL1

44

PITX2 gene

Axenfeld Reiger

45

TIGR-MYOC

JOAG

46

FOXC1 gene

Axenfeld reiger (the foxy one gets reigers from being anorexic)

47

whats phacoanaphylactic glaucoma?

trauma violates ant capsule-->lens proteins leak out-->glaucoma

48

whats the significance if 2 isopters cross on a GVF?

functional vision loss

49

why is 5FU a crappy choice during trabs?

causes K tox

50

weird HVFs- whats does frequency doubling technology stimulate, what does SWAP hvf stimulate?

FDT- Magnocellular cells of rnfl
SWAP- koniocellular cells of rnfl

"frequenting mcdonalds seems krazy"

51

how can you check if theres epi downgrowth on an iris?

argon laser to iris will turn white

52

whats the best tolerated glaucoma med around the eye?

timolol

53

whats GLC1A associated with

JUVENILLE glaucoma

54

OPTN GENE

NTG

55

how does GDX work?

scanning laser polarometer
measures birefrigence of the NRFL and compares it to itself in 4 quads (doesnt actually measure thickness)

56

what systemic med might blunt the effect of timolol?

a systemic beta blocker like atenolol

57

what % of pple >40 in the US have glaucoma?

2%

58

who gets CPC?

poor visual potential and poor surgical candidtae

59

what topical steroid gtts may cause iop rise?

PF and dex

60

pt on tricyclic antidepressant, which glaucoma med do you have to avoid

alphagan

61

pt w asthma and betaxolol not available, whats the next best choice?

carteolol

62

how do pas in plateau iris look like?

start at schwalbes and go posterior

63

sine wave sign

plateau iris

64

what kind of epidemiologic distribution is IOP?

non-Gaussian with a skew toward higher pressures

65

whats the deal with "matrix" visual field testing

using freq-doubling technology (tests magnocellular gang cells) and tests same number of points as standard 24-2

66

what G needle is used to make the sclerostomy during a tube?

23G

67

which glaucoma drop is most associated with dermatitis/red eye?

iopidne (apraclonidine)

68

what % of the time do meds help aq misdirection?

50%

69

which dz has lower than avg iop?

myotinic dystrophy

70

why is it potentially bad to do a trab with a ce at the same surgery?

bc wound healing/inflamm from ce may decr the success of the trab