Flashcards in Secondary Glaucoma Deck (26)
What is secondary open angle glaucoma?
angle is open, but he glaucoma develops as a consequence of another recognizable ocular or systemic disease
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
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
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
What is Scheie's stripe/line?
pigment deposition along the insertion of the zonular fibers to the lens
What is treatment of PDS?
What is Pseudoexfoliation syndrome?
white, flaky, dandruff like deposits of amyloid material
What are the signs of pseudoexfoliation syndrome?
Loss of pigment along iris frill
hyperpigmentation of the TM
Schwalbe's line is pigmented
What is exfoliative glaucoma?
Like pseudoexfoliation but is depositional in nature. exfolation of the LENS CAPSULE
What is the gene associated with pseudoexfoliation syndrome?
Need another factor to create true link
What is treatment for pseudoexfoliation syndrome?
Sunglasses as prevention
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
What is treatment for angle recession glaucoma?
aqueous blockers are popular (beta blockers, alpha agonists, carbonic anhydrase inhibitors)
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
What are the signs of low tension glaucoma?
Any signs of POAG
Splinter hemorrhages at disc (drance hemes)
How do prostaglandins work?
Increases aqueous outflow.
First line therapy usually
How do beta blockers work?
decreases aqueous production
second line therapy
Do not use with asthmatics, COPD, hypotension
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
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
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
What are risk factors for angle closure glaucoma?
1. Smaller corneal height
2. smaller corneal diameter
3. anteriorly placed lens
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
7. intermittent blurring of vision with halos
8. sudden dramatic sever and persistent pain
How long does angle closure glaucoma last?
What is laser iridotomy?
preferred surgical treatment, because it have high risk-benefit ratio. Releive pupil block and prevent the formation of PAS.
YAG laser is effective for what type of iris?
thin blue iris
not good with thick brown iris