D - Glaucoma Histopath 2 - Week 2

Question 1

How does lens cell death differ in angle-closure glaucoma compared to open angle? Explain why this occurs and how it presents visually

Answer 1

Angle closure results in an acute rise to very high IOP levels. This leads to necrosis of the lens epithelium, which appears as “Glaukomflecken” (grey-white lens epithelial and anterior cortical lens opacities; beneath anterior lens capsule)

(cf open angle, which is apoptosis)

Question 2

What percentage of aqueous drains through the uveoscleral route? What about via trabecular meshwork?

Answer 2

Uveoscleral: 85-95%
Trabecular: 5-15%

Question 3

What feature of the trabecular meshwork allows for fine control of aqueous outflow?

Answer 3

giant vacuoles on the endothelial surface of schlem’s canal

Question 4

What is the role of trabecular cells (2) and where are they found?

Answer 4

In the cribriform region of the trabecular meshwork, there are trabecular cells that:

• Produce a gel to fill in holes + stick to debris
• phagocytose debris to clean TM

Question 5

List 2 trabecular mechanisms for angle compromise

Answer 5

Congenital/juvenile (formation problems)
Mechanical blockage (e.g. pigment, debris, vacuole dysfunction)

Question 6

What does posterior trabecular dysfunction lead to? (2)

Answer 6

Reduced venous drainage

Increased venous backpressure

Question 7

List 2 anatomical causes for angle closure

Answer 7

Anterior membrane overgrowth (Irido Corneal Endothelial “ICE” syndrome)
Occlusion of PTM by iris (iris “push” or “pull”)

Question 8

continue later

Answer 8

yeah