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Flashcards in Secondary Glaucoma Deck (26)
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1

What is secondary open angle glaucoma?

angle is open, but he glaucoma develops as a consequence of another recognizable ocular or systemic disease

2

What is pigmentary dispersion syndrome?

concave bowing of the peripheral iris causing physical contact of the posterior iris with the zonules and pigment is released

3

What are the associated findings of pigmentary dispersion syndrome?

1. iris transillumination
2. liberation of pigment from posterior iris
3. Krukenberg spindle
4. pigment on zonules/lens
5. large dirunal variation of IOP

4

What are krukenberg spindles?

spindle-shaped, vertical deposits of chocolate-brown coloured pigment in the cornea of the eye, created by flakes of pigment rubbed off the back of the iris

5

What is Scheie's stripe/line?

pigment deposition along the insertion of the zonular fibers to the lens

6

What is treatment of PDS?

Laser irodotomy
Glaucoma medication
ALT/SLT

7

What is Pseudoexfoliation syndrome?

white, flaky, dandruff like deposits of amyloid material

8

What are the signs of pseudoexfoliation syndrome?

Loss of pigment along iris frill
hyperpigmentation of the TM
Schwalbe's line is pigmented
Krukenberg spindles

9

What is exfoliative glaucoma?

Like pseudoexfoliation but is depositional in nature. exfolation of the LENS CAPSULE

10

What is the gene associated with pseudoexfoliation syndrome?

LOX 1
Need another factor to create true link

11

What is treatment for pseudoexfoliation syndrome?

Glaucoma meds
Sunglasses as prevention
ALT/SLT

12

What is angle recession glaucoma?

After blunt trauma to the eye. Results from contusion to the angle with tears inthe uveal meshwork causing a recessed insertion of the iris onto the ciliary body band. TM less efficient

13

What is treatment for angle recession glaucoma?

aqueous blockers are popular (beta blockers, alpha agonists, carbonic anhydrase inhibitors)

14

What is low tension glaucoma?

Signs of glaucomatous optic discs changes but IOp is less than 21. Multiple IOP readings needed to distinguish from POAG. Vasculature plays big role

15

What are the signs of low tension glaucoma?

Any signs of POAG
Splinter hemorrhages at disc (drance hemes)
Shallower cupping
PPA

16

How do prostaglandins work?

Increases aqueous outflow.
First line therapy usually

17

How do beta blockers work?

decreases aqueous production
second line therapy
Do not use with asthmatics, COPD, hypotension

18

What is the difference between SLT and ALT?

ALT - argon laser. 100 burns in two treatments. placed into anterior TM to increase aqueous drainage
SLT - works on cellular level. Laser applied to TM

19

What is angle closure glaucoma?

Aqueous outflow is decreased due to anatomically restricted angles. Peripheral iris covers TM, preventing outflow. Increase in resistance of flow b/w posterior iris and anterior lens is called relative pupil block and iris bows forward, potentially blocking the TM

20

How can dilation cause angle closure glaucoma?

Not due to dilation but reconstriction of the pupil when it sits on the lens and causes relative pupillary block

21

What are risk factors for angle closure glaucoma?

1. Smaller corneal height
2. smaller corneal diameter
3. anteriorly placed lens

22

What are the symptoms of an angle closure glaucoma attack?

1. high IOP (up to 100mgHg)
2. ciliary flush
3. corneal edema
4. mid-dilated pupil
5. ocular pain
6. naseua
7. intermittent blurring of vision with halos
8. sudden dramatic sever and persistent pain

23

How long does angle closure glaucoma last?

4-6 hours

24

What is laser iridotomy?

preferred surgical treatment, because it have high risk-benefit ratio. Releive pupil block and prevent the formation of PAS.

25

YAG laser is effective for what type of iris?

thin blue iris
not good with thick brown iris

26

Many in the US are treated with what type of laser, followed by what type of laser?

Argon laser followed by YAG