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Mnemonics in Ophthalmology > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

Strong RF for Glaucoma

A

SHIBA

S - Steroids
H - Heritage
I - IOP
B - Blacks
A - Age (+40)
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2
Q

Weak RF for Glaucoma

A

My Sweet Hyp!
My - Myopia
Sweet - DM
Hyp - HTN

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3
Q

Primary Open-angle glaucoma appears in _____% of the population above the age of 45.

A

0.5-1%

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4
Q

Ocular HTN w/o glaucoma appears in _____% of the population above the age of 45.

A

10%

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5
Q

RF for transition from Ocular w/o glaucoma HTN to Glaucoma are:

A

PIRAT

P - PSD increase (Pattern of standard deviation)
I - IOP (the higher the riskier)
R - Ratio (cup to dick ratio - CDR, normal is 0/3)
A - Age
T - Thin CCT (Central corneal thickness)

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6
Q

Thick cornea - IOP pressure recorded is ____than the truth

Thin cornea - IOP pressure recorded is ____than the truth

A

Thick cornea -> IOP pressure recorded is lower than the truth
Thin cornea -> IOP pressure recorded is higher than the truth

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7
Q

When treating a glaucoma patient we have to determine his individual_______.

A

Target pressure.

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8
Q

Target pressure is ______

A

20% below the pressure known to cause damage.

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9
Q

___% of glaucoma patients will have a normal exam on their first doctor’s appointment

A

30%

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10
Q

An increase in IOP causes cupping on the ____ aspect of the disc.

A

inferior

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11
Q

What are the mechanisms (or theories) of high IOP causing glaucoma?

A

Mechanical and Avascular.

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12
Q

Mechanisms (or theories) of high IOP causing glaucoma - elaborate on the mechanical mechanism.

A

Increase IOP presses on nerve fibers passing through the scleral canal (exit point out of the eye) -> disrupts axoplasmic flow -> atrophy

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13
Q

Mechanisms (or theories) of high IOP causing glaucoma - elaborate on the avascular mechanism.

A

Increase IOP harms ocular perfusion -> ischemia and atrophy.

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14
Q

Blood pressure issues may cause _____ that may lead to retinal ganglion cell death.

A

nocturnal BP dip and ischemia

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15
Q

Every glaucoma patient goes through _____

A

Visual field testing (for potential damage assessment)

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16
Q

When examining a with a Goldman goniolens we pay attention to____

A

Pigmented trabecular meshwork.

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17
Q

Explain the grading system of the proximity of the iris to the Pigmented trabecular meshwork.

A

0-4
0 = no filtering (completely blocked)
1 = partily blocked

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18
Q

Explain the grading system of the proximity of the iris to the Pigmented trabecular meshwork.

A

0-4
0 = no filtering (completely blocked - angle closure)
1 = partially blocked

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19
Q

______ are cells that clean the Pigmented trabecular meshwork.

A

Goniocytes.

20
Q

Classification of glaucoma:

A

CaPSiD

Ca - Closed-angle
P -Primary open-angle
i
S - Secondary
D - Developmental
21
Q

Classification of glaucoma - subdivide Primary open-angle glaucoma:

A

PEN:
P - Pigment
E - Exfoliation
N - Normal tension

22
Q

Normal tension glaucoma pathophysiology:

A

Oversensitivity to tension and/or malperfusion.

23
Q

Pigmentary glaucoma finding:

A

Transillumination in mid-periphery iris.

24
Q

Closed-angle glaucoma pathophysiology:

A

Pupillary block combined with a narrow-angle, to begin with.

25
Q

______ are seen on chronic closed-angle glaucoma

A

Anterior synechia

26
Q

Classification of glaucoma - subdivide Developmental glaucoma:

A

Primary developmental - seen at birth (0-3 months)
Infantile - 3 months to 3 years.
Juvenile - 3 to 35 years.

27
Q

Classification of glaucoma - subdivide Secondary glaucoma:

A

HD PAINT

H - Hemorrhage (clots)
D - Drugs (steroids)

P - Phacogenic
A - Absolute
I - Inflammatory
N - Neovascular
T - Trauma (and scars)
28
Q

Subdivide phacogenic glaucoma:

A

Mature cataract (pushes iris forword) or subluxation of the lens (pupillary block -> iris moved forward).

29
Q

What is absolute glaucoma?

A

condition of complete atrophy and blindness due to uncontrollable IOP from an unknown reason.

30
Q

IOP of ____ can cause closure of the retinal artery.

A

60-70

31
Q

sign of acute angle closer glaucoma:

A

Fixed PHoNER
Fixed - Fixed mid dilated pupil

P - Pain (eyes and head)
H - Halos
o
N - Nausea/vomiting
E - Endothelial pump dysfunction (blurry vision)
R - Redness
32
Q

Fixed mid dilated pupil in acute angle closer glaucoma is due to

A

sphincter papillae unreactive due to ischemia

33
Q

Treatment of acute angle closer glaucoma:

A

CHeaP Laser!
C - CAI (Aqueous production decrease)
H - Hyperosmotics (IV mannitol - if vomiting, PO glycerol)
P - Pilocarpine (Miosis - sphincter papillae)

Day after - Yag laser.

All thee CHeaP drugs are given at the same time!

34
Q

Pilocarpine usage:

A

3-4 times every 10 minutes, may not react immediately because of ischemic sphincter papillae. As IOP starts to drop, the drug will take effect.

35
Q

Describe Goniodysgenesis

A

Dysgenesis trabecular meshwork. - looks open but the function is impared.

36
Q

Congenital glaucoma epidemiology:
Incidence?
M: F?
Bilateral?

A

Congenital glaucoma epidemiology:
Incidence - 1:10,000 (90% sporadic)
M: F - 65% Boys
Bilateral in 75%

37
Q

Congenital glaucoma signs:

A 
BiSHoPED:
Buphthalmos
i
S - Spasm (Blepharospasm)
H - Hazy large cornea
o
P - Photophobia
E - Epiphora
D - Decrement tears
38
Q

Congenital glaucoma treatment:

A

Surgical!
Trabeculectomy or Goniotomy

watch shot animation!

39
Q

Common scotoma in glaucoma is _____

A

Paracentral

40
Q

Paracentral scotomas can develop into

A

Archoid

41
Q

Contraindications of BB therapy?

A

ABC
A - Asthma/ AV block
B - Bradycardia
C - COPD

42
Q

BB therapy drug commonly used? and characteristics?

A

Timolol - rule of 0.5:
usually 0.5 %
Begins to work after 0.5 hour for 0.5 a day

The peak is at 2 hours. decease IOP by 25%

43
Q

Lasers used in glaucoma therapy?

A

Yag, ALT. SLT

44
Q

Drug of choice for open-angle glaucoma?

A

Prostaglandins.

45
Q

Lasers used in glaucoma therapy characteristics?

A

The effect lasts for 2 years, with maximum effect after 2 months.
IOP decrease is about 9 mm
angle has to be open to perform procedure

46
Q

Surgeries used in glaucoma therapy?

A

TIC!
T - trabeculectomy (filtration)
I - Implant
C - ciliary body ablation

watch shot animation!

Mnemonics in Ophthalmology (16 decks)

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