Flashcards in Neda's typed out notes Deck (395)
What is the initial glaucomatous damage seen on VFT?
What conditions are contraindicated for PG drugs for glaucoma?
1. History of Uveitis
4. Complicated cataract surgery
What is the known ocular complication of a topical beta blocker?
Pt's who have a low BPM (Bradycardia), which ultimately should be avoided.
What are the 2 contraindications of CAI usage in glaucomatous pt's?
Corneal endothelial compromise (Fuch's dystrophy) and Sulfonamide allergy.
What are the 2 systemic side effect relative contraindication in patient taking what certain medications?
MAO inhibitors and Bradycardia
When should you assess the efficacy of a topical drop in a glaucomatous patients?
4 to 6 weeks
When should be the follow up for a pt who has achieved their target IOP?
3 to 6 months
Signs: Recurrent attacks of unilateral acute raised IOP (Usually 40 to 60mmHg) associated with mild anterior uveitis?
Posner Schlossman Syndrome
What is the "speculated" cause of Posner Schlossman syndrome?
Acute Trabeculitis ; possibly by CMV or H. Pylori
What is the treatment for Posner Schlossman syndrome?
1. IOP controlling meds (Timolol 0.5% BID
2. Short course (1 week) steroids (Prednisolone Acetate 1% QID)
3. If significantly high, use Oral CAI
True or False, synchiae are formed during Posner Schlossman syndrome?
False. Synechiae and optic nerve damage is not seen. However, corneal edema is.
Which two layers of the angle will you see black pigment with a pt who has Pseudo-exfoliation syndrome?
Trabecular meshwork and Anterior to Schwalbe's line (Sampaolesi line)
When is IOP the highest?
When is Aq humor production the lowest?
12am to 6 am
When Aq humor production the greatest?
In the morning
What is the fastest peak glaucoma drug?
When does a drance heme go away?
1 to 3 months
What is the most common location for a drance heme?
Which condition likely occurs due to elevated IOP following retinal vascular conditions?
What is the IOP target when to treat for precautionary measure to avoid CRVO?
30 mmHg and above
How long does it take for a "steroid" to cause an increase in IOP?
How would you taper steroids?
Start by prescribing QID x 5 days, then tapers to BID x 5 days and then qd x 5 days.
Note: Longer the treatment period or frequent dosage, the longer the taper will be.
What is the most commonly encountered form of infantile glaucoma?
Primary Congenital glaucoma
What are the signs of Primary congenital glaucoma?
Before 1st birthday
Abnormal angle (either flat iris insertion or a concave iris insertion)
No systemic condition
No inheritance pattern
What are the symptoms of Primary congenital glaucoma?
Photophobia, epiphora and blepharospasm
Note: Corneal appear cloudy due to corneal edema.
Which layer of the cornea will result in a tear when a pt has Primary congenital glaucoma?
If the glove enlarges and the structures stretch with a pt suffering from primary congenital glaucoma is called?
What are horizontal breaks called when associated with congenital glaucoma? Which layer does this occur?
Haab's striae and ruptures in Descemet's membrane
What is the preferred procdeure for Congenital glaucoma?
Goniotomy (TM is incised)
Note: Trabeculectomy is used as a last resort when the cornea is not transparent and Schlemm's canal cannot be located.