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Flashcards in Glaucoma Deck (11):

What is Fuch's heterochromic iridocyclitis?

- chronic, non-granulomatous, low-grade anterior uveitis with stellate keratic precipitates
- iris heterochromia (due to chronic inflammation)
- iris/angle neovascularization in affected eye
- risk of glaucoma due to chronic TM damage
- cataracts due to chronic inflammation


Conditions associated with Fuch's heterochromic iridocyclitis?

- ocular toxoplasmosis
- Horner's CMV
- retinitis pigmentosa
- Herpes simplex
- ocular trauma
- rubella virus


Posner-Schlossman syndrome
(Glaucomatocyclitic crisis)

- acute trabeculitis
- open angle
- elevated IOP (40-60mmHg) resulted in blurred vision
- open angle on gonio
- few cells in anterior chamber
- young to middle-aged patients


Pseudoexfoliation syndrome

- age-related systemic condition found in elderly Scandinavian Caucasians
- most common cause of elevated IOP and secondary open angle glaucoma
- due to abnormalities of basement membrane
- accumulation of toxic flaky deposits in various connective tissues through the body (eg. lung, heart, skin)

Ocular signs:
- whitish flaky deposits on pupillary margin, anterior lens capsule, zonules, trabecular meshwork
- deposits on zonules may cause release of pigment from posterior iris = pigment deposit within TM
- zonules weaker = result in phacodonesis, poor dilation


Phacolytic glaucoma

- hypermature cataract leaks lens material into AC
- obstruction of outflow in TM
- cells,flare and lens particle present


Phacomorphic glaucoma

Crystalline lens thickens and pushes iris forward into angle resulting in angle-closure glaucoma


How much posterior synechiae is required for IOP elevation?



How much peripheral anterior synechiae is required for IOP elevation?

Most cases, 6 or more clock hours is associated.


Acute angle closure

- acute and symptomatic elevation in IOP
- usually hyperopes, Asian/ Eskimo, elderly

- blurred vision, halos around light, eye pain, nausea, and vomiting

Clinical signs:
- closed angle, IOP > 50 mmHg, corneal edema, mid-dilated pupil, cells in the anterior chamber, conj injection

Tx: peripheral iridotomy


Chronic angle closure

- asymptomatic mild elevations in IOP
- suspect in occludable angles and PAS
- pigment splotches on TM (aborted PAS)
- progressive optic nerve damage
- VF loss despite low IOP


According to OHTS, non-treated OHT patients after 5 years were ___% more likely to develop POAG.