Disorders of the Anterior Chamber Flashcards
What produces aqueous fluid?
The ciliary body
Where does the aqueous fluid drain?
into the anterior chamber through the pupil
What type of fluid is aqueous
watery fluid
What type of fluid is vitreous
gelatinous fluid
Where is aqueous fluid absorbed
Through the trabecular network and the canal of schlemm
What are the primary disorders of the anterior chamber
Glaucoma
Hyphema
Uveitis or Iritis
What is the normal cup to disc ratio
< 0.3
What is abnormal cup to disc ratio
> 0.3
What elevation is glaucomatous cupping
at 0.6 or >
Open Angle Glaucoma Etiology
imbalance between aqueous production and aqueous absorption
Open Angle Glaucoma Symptoms
- asymptomatic until late in the disease – screening is VERY important
- decreased vision is a late sign
Open Angle Glaucoma Signs
- elevated IOP
- Optic nerve cupping of 0.6 or > (glaucomatous cupping)
Open Angle Glaucoma Workup
- Eye specialist usually does routine screening since most pts are asymptomatic
- Eyes with a narrow chamber angle should not be dilated with drops – will increase risk of acute angle closure glaucoma
- Chamber depth can be checked with tangential lighting of anterior chamber (will teach in Pt Assessment)
- Marcus-Gunn pupil is late finding
Open Angle Glaucoma Tx
Medication – Timoptic gtts etc
If medical Tx fails – surgery laser or incisional
Acute Angle Closure Glaucoma Symptoms
Sudden onset Unilateral blurry vision *Haloes seen around lights* Intense ocular pain and photophobia *Nausea, vomiting, diaphoresis*
Acute Angle Closure Glaucoma Signs
Mid-dilated pupil
Conjunctival injection
Corneal edema
IOP usually > 60 or even 80
Acute Angle Closure Glaucoma Tx
Ophthalmological emergency – immediate referral
The 3 components of the Uveal Tract
The choroid
The lens & Ciliary body
The iris
What is hyphema
- blood in the anterior chamber
- collects in front of the iris and behind the cornea
- “layers out” falling to the lowest point in the anterior chamber
hyphema Etiology
often result of traumatic injury to anterior chamber
complication following intraocular surgery
bleeding from blood thinners
von Willebrand’s disease
hyphema Symptoms
(often a hx of ocular trauma), blurred vision, if large can cause ocular pain
hyphema Signs
pool of blood seen in anterior chamber – can often be seen w/naked eye or certainly w/slit lamp examination
- *8 ball sign *
hyphema Tx
urgent ophthalmology referral
