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ophthalmology > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

What produces aqueous humour

A

Non-pigmented epithelium of the pars plicats

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2
Q

What are the 3 main processes for the production of aqueous humour

A
  1. Diffusion
  2. Ultrafiltration
  3. Active secretion
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3
Q

What makes the aqueous humour optically clear

A

Ultrafiltration phase where the soluble substance is fenestrated across the ciliary capillary resulting in it becoming protein free

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4
Q

What affect does B2 have on aqueous humour

A

Increases aqueous secretion

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5
Q

What affect does a2 stimulation have on aqueous humour

A

Decreases aqueous secretion

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6
Q

What are the 2 routes of aqueous outflow

A
  • trabecular outflow
  • uveoscleral drainage
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7
Q

What is the conventional route of aqueous outflow

A

Aka trabecular outflow
- 90% of outflow

Through the trabeculum, through the canal of Schlemm and into episcleral veins

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8
Q

What is uveoscleral drainage

A

Across ciliary body into suprachoroidal space and is drained by venous circulation

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9
Q

What affect will increasing IOP have on outflow of aqueous humour

A

Increase outflow

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10
Q

What is the normal range of IOP

A

11-21 mmHg

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11
Q

How is IOP measure

A

To nome try

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12
Q

Neuroretinal rim thickness

A

ISNT
- inferior
- superior
- nasal
- temporal

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13
Q

What is a normal cup to disc ratio

A

0.3

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14
Q

What is disc cupping

A

When disc ratio is larger than 0.3

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15
Q

Risk factors of primary open angle glaucoma

A
  • age
  • fh
  • African
  • myopia
  • diabetes
  • raised IOP
  • hypertension
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16
Q

Where is aqueous humour produced

A

Posterior chamber

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17
Q

What is another name for the anterior chamber angle

A

Iridocorneal angle

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18
Q

What time is IOP highest

A

In the morning

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19
Q

Is central corneal thickness higher in POAG

A

Yea

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20
Q

What endocrine disorder is associated with normal tension glaucoma

A

Thyroid disease

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21
Q

Risk factors for acute angle closure glaucoma

A
  • age
  • Asian
  • female
  • hyperopia
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22
Q

Symptoms of acute angle closure glaucoma

A

Painful red eye
Blurry vision
Halos
Headache
Vomiting

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23
Q

Pupil in acute angle closure glaucoma

A

Fixed mid dilated

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24
Q

Management of acute angle closure glaucoma

A

Acetazolamide - carbonic anhydrase inhibitor
Pilocarpine - miotic agent
Timolol

2nd line
Mannitol
Brimonidine

Definitive
Laser iridotomy - done for both eyes

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25
Q

What are the 3 classes of secondary open angle glaucoma

A

Pre-trabecular
Trabecular
Post trabecular

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26
Q

What type of glaucoma is pseudoexfoliative

A

Secondary open angle

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27
Q

What mutation is seen in pseudoexfolaition glaucoma

A

LOXL1

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28
Q

Features of pseudoexfoliation

A

Krukenberg spindles
Aqueous flare

29
Q

What glaucoma is being described
Posterior layer of the iris rubs against the zonule as a result of excessive bowing of the mid-peripheral portion

A

Pigment dispersion syndrome

30
Q

What is the pigment deposited like in pigment dispersion syndrome

A

Krukenberg spindles

31
Q

What has the following features
Blurred vision on exertion

A

Pigment dispersion syndrome

32
Q

What does neovascular glaucoma occur as a result of

A

Rubeosis iridis

33
Q

What does retinal ischaemia cause the release of

A

VEGF
Interleukin 6

34
Q

Causes of neovascular glaucoma

A

CRVO - most common
Diabetes
Retinal detachment

35
Q

Can you use miotics in neovascular glaucoma

A

No

36
Q

Cause of uveitic glaucoma

A

Fuchs uveitis

37
Q

1st line for uveitic glaucoma

A

Beta blocker

38
Q

What is posner-schlossman syndrome

A

Recurrent attacks of unilateral raised IOP{

39
Q

Causes of posner schlossman syndrome

A

H pylori
CMV
HLA BW5

40
Q

Phacolytic glaucoma

A

Occurs due to hyper mature cataract

41
Q

When does red cell glaucoma occur

A

Acutely after hyphema and blunt trauma

42
Q

When does ghost cell glaucoma occur

A

Few weeks after vitreous haemorrhage

43
Q

What does iridocorneal endothelial syndrome include

A

Chandler
Cogan-reese
Iris atrophy

44
Q

SECONDARY CLSOED ANGLE

A

SECONDARY CLOSED ANGLE

45
Q

Phacomorphic glaucoma features

A

Same as primary closed angle but with cataract

46
Q

What size of lens has a greater risk of dislocation

A

Small lens

47
Q

What is an iris bombé seen in

A

Uveitic glaucoma

48
Q

What gene is implicated for congenital glaucomas

A

CYP1B1

49
Q

What is another gene that is implicated in congenital glaucomas

A

MYOC

50
Q

What is the triad of primary congenital glaucoma

A

Photophobia
Epiphora
Blepharospasm

51
Q

What tonometer is used in children

A

Perkins

52
Q

What is average IOP in newborn

A

10-12

53
Q

What is seen on slip lamp of congenital glaucoma

A

Haab striae

54
Q

How do prostaglandins work

A

Increase uveoscleral aqueous outflow

55
Q

Example of prostaglandin

A

Latanoprost

56
Q

Side effect of prostaglandin

A
  • hyperaemia
  • eyelash thickening, lengthening
  • iris hyperpigmentation
  • increased risk of cystoid macular oedema
57
Q

MoA of beta blocker

A

Decrease aqueous production

58
Q

When should beta blockers not be applied

A

At bedtime as they exacerbate hypotension during sleep

59
Q

MoA of a2 agonist

A

Decrease aqueous production and increase uveoscleral outflow

60
Q

Example of a2 agonist

A

Apraclonidine

61
Q

Side effect of brimonidine

A

Allergic conjunctivitis

62
Q

MoA of carbonic anhydrase inhibitor

A

Inhibit aqueous secretion

63
Q

When are carbonic anhydrase inhibitors contraindicated

A

Sulfonamdie alert

64
Q

Example of carbonic anhydrase inhibitor

A

Brinzolamide

65
Q

What is laser iridotomy mainly used for

A

Primary angle closure glaucoma

66
Q

What laser is used for laser iridotomy

A

Nd:YAG laser

67
Q

What is given to prevent bleb failure post trabeculotoym

A

5-fluorouracil
Mitomycin c

68
Q

When is laser trabeculoplasty used

A

Open angle glaucomas

ophthalmology (11 decks)

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