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Glaucoma Flashcards

1
Q

What % of pple are steroid responders and at what point does steroid induced glaucoma appear

A

42% and starts 2 weeks

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2
Q

whats swan syndrome?

A

hyphema from neo on the lip of an old corneal wound that bleeds

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3
Q

whats hemolytic glaucoma?

A

s/p VH, macrophages eat RBC–>clog tm

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4
Q

why do a PI in acute angle closure

A

treating the pupillary block component, make another channel for aq to flow from post chamber to ant chamber

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5
Q

what causes acute angle closure?

A

pupillary block–> causes iris to bow forward–>zips angle–>closed on gonio–>do PI to break pupillary block and

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6
Q

how does plateau iris cause angle closure

A

funny insertion of iris causes a roll of iris to block tm. On slit lamp ac will be deep centrally but will se “double hump” sign on gonio

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7
Q

how do you treat plateau iris?

A

1) peripheral pupilloplasty
2) ce
3) chronic miotics to keep iris out of angle

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8
Q

what causes pupillary block in an aphakic eye?

A

ant hyaloid face causing pupillary block

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9
Q

whats the unifying theme in ICE syndrome?

A

they all have abnormal K endo, with beaten bronze appearance and downgrowth into angle causing glaucoma

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10
Q

Is ICE unilateral or bilateral?

A

unilateral

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11
Q

Whats the difference between the ICE syndromes?

A

The appearance of the iris

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12
Q

Whats the other name for cogan reese syndrome?

A

IRIS NEVUS SYNDROME (cogan resse and iris nevus both 2 words)

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13
Q

Whats the exam in chandler syndrome

A

iris appears normal

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14
Q

should you do a trab in ICE?

A

no bc crap grows over the bleb

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15
Q

whats nanophthalmos?

A

small eye but normal structures

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16
Q

lens bowing forward causes what refractive shift?

A

myopic if lens bows forward
hyperopic if lens goes back
(its the opposite of glasses)

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17
Q

At what age is glaucoma considered JOAG?

A

if the glaucoma starts >3 yo

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18
Q

what are haabs striae?

A

horizontal lines in congenital glaucoma

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19
Q

whats the surgical sequence for congenital glaucoma?

A

1) goniotomy 2) trabeculotomy 3) trab w mmc 4) tube

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20
Q

is axenfeld reiger unilateral or bilateral?

A

bilateral

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21
Q

whats the inheritance pattern of axenfeld reiger?

A

AD

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22
Q

posterior embryotoxon, periumbilical skin folds, maxillary hypoplasia, microdontia, hypospadias

A

axenfeld reiger

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23
Q

whats Gillespie syndrome?

A

a syndrome that 2% of aniridia pts have.

Triad of aniridia, cerebellar ataxia and MR

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24
Q

WHat % of pts w peters have glaucoma?

A

50%

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25
Q

what % of the time is peters bilateral?

A

80%

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26
Q

When is there blunt pressure rise?

A

am

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27
Q

which beta blocker can cause heart block?

A

levobunolol

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28
Q

how does beta blocker effect cholesterol?

A

lowers HDL

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29
Q

Whats a drug that acts like ACH?

A

Pilocarpine

30
Q

Name an indirect acting parasympathomimetic drug (ie ach-ase inhibitor)

A

echothiphate

31
Q

name a drug that’s a combo of direct acting ach and also a ach-ase inhibitor

A

miostat (carbachol)

32
Q

whats the 2 SE of echothiophate?

A

1) systemic parasympathetic stimulation

2) iris cysts in children

33
Q

whats the best glaucoma med in pregnancy?

A

brimonidine (class B). Everything else is class C

34
Q

What % of pple have success at 6 mo with ALT?

A

80%

35
Q

Who is NOT good candidate for trab?

A

young
aphakic
black
previous failed trab

36
Q

Does treating a pt with OHTN delay onset of glaucoma?

A

OHTS showed IOP reduction reduced the development of glaucoma from 9.5% to 4.4%

37
Q

Does treating a pt with early glaucoma delay progression? Maybe we should just leave these pts alone?

A

Early manifest glaucoma trial (EMGT) showed pts treated with BETAXOLOL AND ALT has less and later progression vs. observed group (45% v 62%)

38
Q

When a pt is first diagnosed with glaucoma is there a “best” way to treat the pt?

A

Collaborative Initial glaucoma treatment trial (CIGTS) showed med vs trab has very similar outcome at 5 years.

39
Q

What did the glaucoma laser trial show? (GLT)

A

Timolol vs ALT as initial treatment showed ALT is just as good as timolol

40
Q

My pt is failing medical therapy, should I go to ALT or trab?

A

AGIS showed white pts did better w trab. Black pts did better w ALT

41
Q

Im doing a trab- anything I can do to increase chances for success?

A

5FU filtering surgery study- substantial improvement in IOP reduction with 5-FU

42
Q

Does lowering IOP in pt w NTG help?

A

Collab NTG study- lowering IOP by 30% reduced progression from 35% to 12%

43
Q

PXE gene

A

LOXL1

44
Q

PITX2 gene

A

Axenfeld Reiger

45
Q

TIGR-MYOC

A

JOAG

46
Q

FOXC1 gene

A

Axenfeld reiger (the foxy one gets reigers from being anorexic)

47
Q

whats phacoanaphylactic glaucoma?

A

trauma violates ant capsule–>lens proteins leak out–>glaucoma

48
Q

whats the significance if 2 isopters cross on a GVF?

A

functional vision loss

49
Q

why is 5FU a crappy choice during trabs?

A

causes K tox

50
Q

weird HVFs- whats does frequency doubling technology stimulate, what does SWAP hvf stimulate?

A

FDT- Magnocellular cells of rnfl
SWAP- koniocellular cells of rnfl

“frequenting mcdonalds seems krazy”

51
Q

how can you check if theres epi downgrowth on an iris?

A

argon laser to iris will turn white

52
Q

whats the best tolerated glaucoma med around the eye?

A

timolol

53
Q

whats GLC1A associated with

A

JUVENILLE glaucoma

54
Q

OPTN GENE

A

NTG

55
Q

how does GDX work?

A

scanning laser polarometer

measures birefrigence of the NRFL and compares it to itself in 4 quads (doesnt actually measure thickness)

56
Q

what systemic med might blunt the effect of timolol?

A

a systemic beta blocker like atenolol

57
Q

what % of pple >40 in the US have glaucoma?

A

2%

58
Q

who gets CPC?

A

poor visual potential and poor surgical candidtae

59
Q

what topical steroid gtts may cause iop rise?

A

PF and dex

60
Q

pt on tricyclic antidepressant, which glaucoma med do you have to avoid

A

alphagan

61
Q

pt w asthma and betaxolol not available, whats the next best choice?

A

carteolol

62
Q

how do pas in plateau iris look like?

A

start at schwalbes and go posterior

63
Q

sine wave sign

A

plateau iris

64
Q

what kind of epidemiologic distribution is IOP?

A

non-Gaussian with a skew toward higher pressures

65
Q

whats the deal with “matrix” visual field testing

A

using freq-doubling technology (tests magnocellular gang cells) and tests same number of points as standard 24-2

66
Q

what G needle is used to make the sclerostomy during a tube?

A

23G

67
Q

which glaucoma drop is most associated with dermatitis/red eye?

A

iopidne (apraclonidine)

68
Q

what % of the time do meds help aq misdirection?

A

50%

69
Q

which dz has lower than avg iop?

A

myotinic dystrophy

70
Q

why is it potentially bad to do a trab with a ce at the same surgery?

A

bc wound healing/inflamm from ce may decr the success of the trab

written boards (13 decks)

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