Case 14: Glare or Halos Around Lights

Question 1

5 Ddx for glare/halos around lights

Answer 1

1. cataracts 2. acute angle-closure glaucoma 3. corneal edema and/or haze (often secondary to corneal endothelial disease) 4. systemic meds (digozin, chloroquine) 5. post-refractive surgery

Question 2

When should pts discont. Coumadin prior to cataract surgery?

Answer 2

96-115 hrs (4 doses) prior to surgery

Question 3

Why should Xalatan be discont. prior to cataract surgery?

Answer 3

exacerbate inflammation & increase the risk of post-op cystoid macular edema particularly in pts w/ hx of uveitis

Question 4

Digoxin SE

Answer 4

blue/yellow color defects, retrobulbar optic neuritis, entopic phenomenon

Question 5

A scan ultrasonography

Answer 5

Measures the axial length of the eye, which is used in calculation of IOL power

Question 6

Brightness acuity test (BAT)

Answer 6

Determines glare disability secondary to media opcaities including cataracts- should be performed prior to dilation

Question 7

Potential acuity meter (PAM)

Answer 7

Provides an estimate of the potential VA after cataracts or other media opacities are removed- allows the clinician to assess the risks & benefits of cataract surgery & helps to set appropriate post-surgical acuity expectation for the pt. Should be performed after dilation

Question 8

1 mm in axial length measurement corresponds to a ___ D error in teh calculated IOL power

Answer 8

3

Question 9

Alcohol, sedatives, anti-convulsants, and posterior fossa disease may induce _____ _____

Answer 9

Gaze-evoked nystagmus