Disorders Flashcards
sign in plateau iris
sine-wave sign
plateau iris - PAS formation
begins at Schwalbe line and extends posteriorly
ICE syndrome - features, glaucoma more severe in…
vessels cross TM, high PAS extend over Schwalbe line, uni, F 20-50, glaucoma more severe in essential iris atrophy and Cogan Reese
ICE syndrome - cornea
beaten bronze metal
Cogan-Reese syndrome
multiple, pedunculated iris nodules
Chandler syndrome
corneal edema
Essential iris atrophy
corectopia and hole formation
ICE syndrome - which variant is the most common
Chandler syndrome
angle recession - definition
tear in the ciliary body, typically between the longitudinal and circular muscle fibers
angle recession - features in gonioscopy
torn or absent iris processes, “glistening” scleral spur, depression in TM, PAS at the border of recession
Posner-Schlossman - uni or bi, sex, age, virus, features, what if steroids and lowering IOP does not help
uni, M, 20-30 yo, (pylori,HSC), CMV, diffuse iris atrophy, absent PAS, topical 2% ganciclovir, then oral Vanganciclovir
Where notches of optic disc in early glaucoma
inferior and superior temporal
What is NOT effective in CIE syndrome?
Miotics (pilocarpine), SLT
Juvenile glaucoma - gene
GLC1A = TIGR/MYOC (protein myocilin)
3% POAG - gene
GLC1A = TIGR/MYOC (protein myocilin)
Primary congenital glaucoma - gene
CYP1B1 (GLC3A)
Normal tension glaucoma - gene
OPTN, GLC1B
Iridoschisis - definition
separation of the anterior iris stroma from the posterior iris stroma
Signs of elevated episcleral venous pressure (EVP)
“corkscrew vessels”, blood in Schlemm’s canal, proptosis, wide ocular pulse amplitude->pulsations, orbital bruit
Normal tension glaucoma - sings
nerve fiber later hemorrhages (escpecially inferotemporally), peripapillary atrophy, disc notching, disc sloping, larger optic disc size, VF - defects depper and closer to fixation
Essential Iris Atrophy
severe progressive iris atrophy causing heterochromia, corectopia, extropion uveae, iris hole formation. glaucoma severe
Chandler syndrome
minimal iris changes. corneal and angle chamges predominate
Cogan-Reese syndrome
less iris atrophy. tan pedunculated nodules or diffuse pigmented lesions on the anterior iris surface glaucoma severe
Which population has the highest prevalence of primary angle closure glaucoma
Inuits
Pigment dispersion
mid-peripheral transillumination defects, Sampoelsi line, posterior bowing of the iris, reverse pupillary block, Scheie strip (pigment on capsule and zonules), Zentmayer line (pigment on equatorial lens)
Pigment dispersion - treatment
medications, SLT, LPI (controversial), trabeculectomy, tube shunts
Ectopia lentis - laser treatment
2 LPI situated 180 degrees apart. definitive -lens extraction
What is reversible after treatment of congenital glaucoma
increased axial length, increased cupping, corneal edema
What is irreversible after treatment of congenital glaucoma
increased horizontal corneal diameter
gonioscopy in PEX
slightly narrow with a (patchy) pigmented deposition anterior to Schwalbe line inferiorly
Amsler-Verrey sign
break of fragile vessels causing hyphema during intraocular surgery in Fuchs heterochromic iridocyclitis
primary closure glaucoma - how deep AC predisposes
<2.5mm
When greatest risk of rebleeding in AC after trauma
3-7 days after injury
Schwartz-Matsuo syndrome
IOP in chronic rRD. presence of photoreceptor outer segments
where are PAS from chronic uveitis typically concentrated?
inferior angle
where are PAS from primary angle closure typically concentrated?
superior angle
PAS in neovascular glaucoma
end at Schwalbe’s line
PEX gene
LOXL1
pigment dispersion - findings, features in treatment
mid peripheral spoke-like iris transillumination defects, concave iris in gonio, SLT like in PEX, higher risk of hypotony with filtering surgery
phacolytic
inflammatory, leakage, macrophages in TM, hypermature cataract, corneal edema, cell flare, NO KPs
lens particle
cortical material blocks TM, lens absent or post traums,
phacoantigenic
sensitized to lens proteins, inflammation + KPs, lens absent or post trauma
Glaucomatocyclitis crisis - other name
Posner-Schlossman syndrome
Posner-Schlossman syndrome - other name
Glaucomatocyclitis crisis
Posner-Schlossman syndrome - features
HSV, CMV?, recurrent low grade inflammation + IOP spikes, steroids do not help
Fuchs heterochromic - virus, vessels
rubella. fine vessels do not cross the TM, do not lead to PAS, angle remains open
ICE - vessels
cross the TM
increased EVP - conditions
AV fistula, orbital varix, Sturge-Weber, retrobulbar tumor, TED, superior vena cava syndrome
Hemolytic glaucoma
after VH, Hb laden macrophages block TM, red tingled cells in AC
Ghost cell glaucoma
after VH, degenerated RBC block TM, khaki coloured cells in AC
pupillary block PAS
extend anteriorly
iris plateau PAS
begin at Schwalbe line and extend posteriorly over the TM
iris plateau - mechanism
anteriorly positioned ciliary process pushes peripheral iris forward OR more antior junction of the iris dialtor muscle and ciliary epithelium
aqueous misdirection - treatment
intense cycloplegia, YAG anterior hyaloid, PPV with anterior hyaloido-zonulectomy
