Glaucoma Mnemonics

Question 0

3 major types of RGCs

Answer 0

“FrequentingMcDonald’sSeemsKrazy!”

The three major RGC types in humans areM (magnocellular) cells, P (parvocellular) cells, and koniocellular neurons(bistratified cells).

M cellshavelarge-diameteraxons (think: “massive”), subserve motion vision, have thelargest perceptive field, and are sensitive to light inscotopicconditions. They are primarily responsible formotion vision.

P cellshavesmall-diameteraxons (think: “petite”),small perceptive fields, and are concentrated in the macula.P cells account for 80% (not 20%) of all RGCs. P cells are responsible for color and fine-detail vision.

Koniocellularneurons conduct information regardingblue-yellow colorand are preferentially activated by short-wavelength perimetry (SWAP).

Question 1

Risk factors for suprachoroidal hemorrhage

Answer 1

Too: tachycardia
Much: myopia
Alcohol: advanced age
Gives: glaucoma
A: aphakia
Heart: hypertension
Attack: atherosclerosis

Question 2

Gene association with PXE

Answer 2

Bagel (crumbs) with LOX. Pseudoexfoliation material is the crumbs.

Single-nucleotide polymorphisms, associated with the LOXL1 gene, have been associated with pseudoexfoliation glaucoma. The expressed protein of this gene catalyzes elastin fiber formation which is a major part of exfoliation material.

Briefly, a summary of the other major glaucoma genes:

Axenfeld-Rieger: PITX2 or FOXC1
Juvenile-onset glaucoma: GLC1A (aka TIGR/MYOC)
Normal tension glaucoma: OPTN

Question 4

Which lens has a direct view into the angle?

Answer 4

Mnemonic: A koeppe iris nodule @ pupil would have a direct view of the angle.

All gonioscopy lenses allow visualization of the anterior chamber angle by eliminating total internal reflection at the air-tear interface. Ex of indirect lenses are the Goldmann, Posner, and Zeiss goniolenses.

The Koeppe lens is a DIRECT goniolens that is often used during examination under anesthesia. Another example of a direct goniolens is the Barkan lens which has a blunted side that allows access for goniotomy. Other direct lenses include the Wurst, Swan-Jacob, and Richardson lenses.

On a side note, the critical angle at which total internal reflection occurs at the air-tear interface is approximately 46 degrees.

Question 4

Goldman VF

Answer 4

A helpful way to remember these questions is 4 to the power of (n-2).
(n = size of the target). Only starts working at size 3

And just remember that size 2 would be 1mm by 1mm (if it were a square), and 1+1=2

Easy: Think of the target as a square (who cares that it’s actually round, this makes the math easy) with doubling length of sides with every Roman numeral increase. Thus…
Size 0 = 0.25mm x 0.25mm square = 1/16th mm squared
Size 1 = 0.5mm x 0.5 mm square = 0.25mm squared
Size 2 = 1mm x 1mm square = 1mm square
Size 3 = 2mm x 2mm square = 4 mm squared.
Size 4 = 4 mm x 4mm square = 16 mm squared
Size 5 = 8mm x 8mm =64 mm squared.

Question 5

Drugs that raise IOP

Answer 5

Mnemonic: Alcohol, cannabis and heroin are all depressants –> decrease IOP

LSD and ketamine get you tripping –> increase pressure