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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
what % of the time is peters bilateral?
80%
26
When is there blunt pressure rise?
am
27
which beta blocker can cause heart block?
levobunolol
28
how does beta blocker effect cholesterol?
lowers HDL
29
Whats a drug that acts like ACH?
Pilocarpine
30
Name an indirect acting parasympathomimetic drug (ie ach-ase inhibitor)
echothiphate
31
name a drug that's a combo of direct acting ach and also a ach-ase inhibitor
miostat (carbachol)
32
whats the 2 SE of echothiophate?
1) systemic parasympathetic stimulation | 2) iris cysts in children
33
whats the best glaucoma med in pregnancy?
brimonidine (class B). Everything else is class C
34
What % of pple have success at 6 mo with ALT?
80%
35
Who is NOT good candidate for trab?
young aphakic black previous failed trab
36
Does treating a pt with OHTN delay onset of glaucoma?
OHTS showed IOP reduction reduced the development of glaucoma from 9.5% to 4.4%
37
Does treating a pt with early glaucoma delay progression? Maybe we should just leave these pts alone?
Early manifest glaucoma trial (EMGT) showed pts treated with BETAXOLOL AND ALT has less and later progression vs. observed group (45% v 62%)
38
When a pt is first diagnosed with glaucoma is there a "best" way to treat the pt?
Collaborative Initial glaucoma treatment trial (CIGTS) showed med vs trab has very similar outcome at 5 years.
39
What did the glaucoma laser trial show? (GLT)
Timolol vs ALT as initial treatment showed ALT is just as good as timolol
40
My pt is failing medical therapy, should I go to ALT or trab?
AGIS showed white pts did better w trab. Black pts did better w ALT
41
Im doing a trab- anything I can do to increase chances for success?
5FU filtering surgery study- substantial improvement in IOP reduction with 5-FU
42
Does lowering IOP in pt w NTG help?
Collab NTG study- lowering IOP by 30% reduced progression from 35% to 12%
43
PXE gene
LOXL1
44
PITX2 gene
Axenfeld Reiger
45
TIGR-MYOC
JOAG
46
FOXC1 gene
Axenfeld reiger (the foxy one gets reigers from being anorexic)
47
whats phacoanaphylactic glaucoma?
trauma violates ant capsule-->lens proteins leak out-->glaucoma
48
whats the significance if 2 isopters cross on a GVF?
functional vision loss
49
why is 5FU a crappy choice during trabs?
causes K tox
50
weird HVFs- whats does frequency doubling technology stimulate, what does SWAP hvf stimulate?
FDT- Magnocellular cells of rnfl SWAP- koniocellular cells of rnfl "frequenting mcdonalds seems krazy"
51
how can you check if theres epi downgrowth on an iris?
argon laser to iris will turn white
52
whats the best tolerated glaucoma med around the eye?
timolol
53
whats GLC1A associated with
JUVENILLE glaucoma
54
OPTN GENE
NTG
55
how does GDX work?
scanning laser polarometer | measures birefrigence of the NRFL and compares it to itself in 4 quads (doesnt actually measure thickness)
56
what systemic med might blunt the effect of timolol?
a systemic beta blocker like atenolol
57
what % of pple >40 in the US have glaucoma?
2%
58
who gets CPC?
poor visual potential and poor surgical candidtae
59
what topical steroid gtts may cause iop rise?
PF and dex
60
pt on tricyclic antidepressant, which glaucoma med do you have to avoid
alphagan
61
pt w asthma and betaxolol not available, whats the next best choice?
carteolol
62
how do pas in plateau iris look like?
start at schwalbes and go posterior
63
sine wave sign
plateau iris
64
what kind of epidemiologic distribution is IOP?
non-Gaussian with a skew toward higher pressures
65
whats the deal with "matrix" visual field testing
using freq-doubling technology (tests magnocellular gang cells) and tests same number of points as standard 24-2
66
what G needle is used to make the sclerostomy during a tube?
23G
67
which glaucoma drop is most associated with dermatitis/red eye?
iopidne (apraclonidine)
68
what % of the time do meds help aq misdirection?
50%
69
which dz has lower than avg iop?
myotinic dystrophy
70
why is it potentially bad to do a trab with a ce at the same surgery?
bc wound healing/inflamm from ce may decr the success of the trab

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