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Ophthalmology > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

Glaucoma: Definition

A
  • Neurodegenerative disease
  • Progressive death of retinal ganglion cells & their axons
  • In hypertensive or normotensive eyes
  • With complete loss of vision
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2
Q

What is shown?

A

The iridocorneal angle

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3
Q

List the diagnostic procedures of glaucoma

A
  • Tonometry
  • Tonography
  • Gonioscopy
  • US
  • Ophthalmoscopy
  • Electroretinography
  • Provocative tests
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4
Q

Glaucoma: Aetiology

A

A developmental anomaly of the iridocorneal angle → Obstruction

Disturbance in the drainage of aqueous → ↑ IOP

  • Hereditary
  • Episcleral venous engorgement
  • Anterior lens luxation
  • Synechia after uveitis - Posterior & anterior
  • Scar after foreign body
  • Mass
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5
Q

What is shown?

A

Anterior lens luxation

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6
Q

What is shown?

A

Posterior synechia

Where the iris adheres to the lens

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7
Q

Glaucoma: Pathogenesis

A

↑ IOP destroys all intraocular structures:

  • Cornea: Oedema & vascularisation
  • Sclera: Stretching (buphthalmos-lagophthalmos-corneal ulcer)
  • Anterior uvea: Atrophy
  • Lens: Opacity; Displacement
  • Vitreous: Syneresis (loss of liquid from a gel)
  • Retina: ONH (optic nerve hypoplasia)
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8
Q

Optic nerve hypoplasia: Pathogenesis

A
  • Impaired microcirculation
  • Ischaemia → Atrophy of the optic nerve head & body

Leads to vision loss

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9
Q

Acute glaucoma: CSx

A
  • Impaired habit
  • Vision disturbance & pain
  • Conjunctival hyperemia
  • Episcleral congenstion
  • Corneal oedema
  • Fixated, wide pupil; Ø response to light
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10
Q

Acute glaucoma: Recorded pressure

A

> 25mmHg

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11
Q

Chronic glaucoma: CSx

A
  • Vision disturbance
  • Episcleral congestion
  • Corneal oedema; Vascularisation; Pigmentation; Descemet’s streaks
  • Fixated, wide pupil; Ø Response to light
  • Iris & optic disc atrophy
  • IOP may be ↑ or normal
  • Buphthalmus
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12
Q

Glaucoma: Treatment (medical management)

A
  • Carbonic anhydrase inhibitors (Acetasolamide)
  • Hyperosmotics (Mannitol)
  • Prostaglandins (Latanoprost)
  • Beta-blockers (Timolol)
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13
Q

Glaucoma: Treatment (Surgery)

A

Either:

  1. Improve drainage of aqueous
  2. Decrease aqueous production
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14
Q

Glaucoma treatment: Improvement of aqueous drainage

A

Intraocular surgery

  • Cyclodialysis
  • Corneoscleral trepanation (make a hole)
  • Drainage implants
  • ICE of luxated lens
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15
Q

Glaucoma treatment: Decrease aqueous production

A

Cyclodestructive methods

  • Cyclodiathermy (TSCP)
  • Cyclocryotherapy
  • Cyclophotocoagulation
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16
Q

TSCP

A

Transscleral laser cyclophotocoagulation

  • Used in the treatment of glaucoma
  • Decreases the aqueous production
  • Iris-oculight diode laser
  • 35 sites
  • 3mm behind the eye

Ophthalmology (9 decks)

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