Aging Changes In The AC/vitreous/lacrimal System

Question 1

An acute rise in EVP results in a _____ ratio of increase IOP

Answer 1

1:1

Question 2

Conventional pathway

Answer 2

• Cornrealscleral outflow
• TM and SC (main structures)
• IOP dependent

Question 3

Unconventional pathway

Answer 3

• uveoscleral outflow
• ciliary muscle bundle
• IOP independent

Question 4

Factors affecting IOP

Answer 4

Peak int he morning
Corneal thickness
Steroid

Question 5

Outflow obstruction

Answer 5

Occlusive angle
-diabetes, uveitis, hyphema, pseudoexfoliation glaucoma, pigment dispersion glaucoma

Injury to the TM
-Fuchs heterochromic iritis, glaucomatocyclitic crisis

Question 6

Classic Goldman equation

Answer 6

An acute ride in EVP results in a 1:1 ratio of increase in IOP

Question 7

Aging changes in anterior chamber

Answer 7

• reduced anterior chamber depth, cortical cataract has more effect on this change
• reduced uveoscleral outflow. Increase in amount of connective tissue in ciliary muscle
• accumulation of extracellualr matrix plaque in TM
• increased outflow resistance in the TM and SC

Question 8

Vitreous function

Answer 8

Support
Diffuse barrier
Metabolic barrier
Transparency

Question 9

Vitreous function: support

Answer 9

PVD; macular edema

Question 10

Vitreous function: metabolic buffer

Answer 10

Reduce neovascularixation in retina

• neovascular glaucoma
• NSC

Question 11

Vitreous function: transparency

Answer 11

• synchisis scintillations

- asteroid hyalosis

Question 12

Aging change of the vitreous

Answer 12

The gel structure becomes more liquefied with aging

Question 13

Breakdown of the vitreous gel and aggregation of collagen fibrils due to increase of liquid potion

Answer 13

Vitreous syneresis

Question 14

What is the most common cause of pVD

Answer 14

Vitreous syneresis

Question 15

Floaters

Answer 15

Aggregation of collagen fibrils

Question 16

Where is the change of the gel of the vitreous most likely to happen with age

Answer 16

In the center

Question 17

Mucus layer composition

Answer 17

Mucin

Question 18

Mucus layer functions

Answer 18

• provides medium for aqueous
• cover epithelium
• trap debris and bacteria

Question 19

Mucus layer sources

Answer 19

• goblet cells (primary)

- squamous cells of cornea and conj

Question 20

Lipid layer composition

Answer 20

Meibomian oil

Question 21

Functionsof lipid layer

Answer 21

Slow the evaporation of the awe opus layer

Question 22

Vitreous compositions

Answer 22

Water 
Collagen
HA
Vitreal cells 
Vitamin C

Question 23

Functions of lipid layer

Answer 23

Slow the evaporation of the aqueous layer

Question 24

Sources of the lipid layer

Answer 24

• meibomian gland (primary)

- Zeiss and Moll

Question 25

Composition of aqueous layer

Answer 25

- water - electrolytes - Na and CL (osmolarity) - K and Ca (cornea epeothelium health) - proteins

Question 26

Functions of the aqueous layer

Answer 26

- provide protection - buffering - regulation cornea epithelium proliferation’s

Question 27

Sources of the aqueous layer

Answer 27

Main lacrimal gland | Accessory lacrimal gland

Question 28

Clinical evaluation for tear secretion

Answer 28

Schirmer 1 Schirmer II Phenol red thread test Meinscometry

Question 29

Clinical evaluation of tear film stability

Answer 29

TBUT Ocular protection index Videokeratography Tear turnover

Question 30

Clinical evaluation of the tear film osmolarity

Answer 30

Tear film osmolarity Tear ferining Tear evaporation

Question 31

Clinical evaluation of the lipid layer

Answer 31

Inferometry | Meibomtery

Question 32

Ocular surface clinical evaluation

Answer 32

Fluorescein Rosa bengal Lissamine green

Question 33

Aginging changes of the lacrimal systems

Answer 33

- goblet cell population may decrease - reduced in tear reflex secretion - change in composition of the meibomian secretion - increase of plugged meibomian gland pores - reduced lacrimal drainage capacity

Question 34

Major components of the aqueous layer

Answer 34

Water

Question 35

What are the main contributor fir the osmolarity of the aqueous layer

Answer 35

Na And CL

Question 36

What are the K and Ca responsible for in the aqueous layer

Answer 36

Corneal epithelium health

Question 37

Which outflow system is reduced with age

Answer 37

Unconventional

Question 38

What helps the mucus layer stay stable on the corneal epithelium

Answer 38

Glycocalyx