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Glaucoma > Glaucoma 2 > Flashcards

Glaucoma 2 Flashcards

1
Q

What glaucoma medication class should be avoided in a patient with HSV, CME, or uveitis?

A

Prostaglandins

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2
Q

What is the most common stimulus size in automated perimetry?

A

4mm squared (size III)

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3
Q

How much does SITA standard (not fast) reduce test taking time compared to full thresholding strategy?

A

50%

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4
Q

According to OHTS, how much of an increased risk for glaucomatous field progression do you have for each millimeter mmercury above baseline IOP?

A

10% for each millimeter mercury

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5
Q

What are some characteristics of glaucomatocyclitic crisis (Posner-Schlossman syndrome)?

A

NAME?

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6
Q

What are some characteristics of Fuchs heterochromic iridocylitis?

A

NAME?

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7
Q

What class of glaucoma medications should be avoided in someone with PACG?

A

Non-selective alpha agonists or alpha 1 agonist as they may cause decreased blood flow (worsen ischemia) and may dilate

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8
Q

Why are 2 laser iridotomies indicated in a patient with ectopia lentis (prior to lensectomy)?

A

To relieve/prevent pupillary block. The lens loose lens can block a single iridotomy but not two iridotomies 180 degrees apart

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9
Q

What is the most common cause of ectopia lentis?

A

PDX is followed by trauma. Weil-Marchesani, Marfans, and homocystinuria are actually lower on the list.

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10
Q

What is the most common ICE variant?

A

Chandlers

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11
Q

PAS superiorly is more suspicious for chronic angle closure glaucoma or inflammatory glaucoma?

A

chronic angle closure glaucoma

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12
Q

What distinguishes acute angle glaucoma from aqueous misdirection syndrome on exam?

A

AC is flat peripherally and centrally in aqueous misdirection syndrome; in acute angle glaucoma the AC is flat peripherally but not centrally

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13
Q

What is the inheritance pattern of most cases of JOAG?

A

AD

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14
Q

What is the inheritance pattern of aniridia?

A

2/3 AD, 1/3 sporadic

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15
Q

The prognosis of primary congenital glaucoma diagnosed between what time frame?

A

3 months and 1 year

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16
Q

Axenfeld-Rieger is what type of inheritance pattern?

A

AD, some sporadic

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17
Q

Work-up for renal cell carcinoma should be obtained in aniridia inherited AD or sporadically?

A

sporadically

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18
Q

What glaucoma drug can cause apnea, hypotension, bradycardia, hypotonia, hypothermia and somnolence in children less than 3 and is thus contraindicated?

A

Alpha 2 agonist such as alphagan

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19
Q

What prostaglandin analogs are pro-drugs?

A

Latanoprost (XALATAN) and Travoprost (TRAVATAN). They are activated by corneal esterase and need only once daily dosing

20
Q

A scleral buckle with cause IOP’s to be artificially high or low with goldmann applanation?

A

Artificially low

21
Q

Which of the classes of glaucoma medications has the strongest IOP lower effects?

A

Prostaglandins

22
Q

What would be the most common advantage for using methazolamide over acetozolamide?

A

If someone has kidney failure. Acetazolamide is metabolized by the kidneys and methazolamide by the liver

23
Q

What is an advantage of brinzolamide (azopt) compared to dorsolamide (trusopt) as far as side effect profile is concerned?

A

brinzolamide does not sting as much as dorzolamide

24
Q

What is the benefit to a gel form of timolol?

A

It reduces systemic absorption

25
Q

Which glaucoma medication has the most alpha 1 agonist activity?

A

apraclonidine although it has more alpha 2 function. It is used for Horner’s testing

26
Q

Both apraclonidine and brimonidine lower IOP by decreasing aqueous outflow. Each have an additional way that they lower IOP, what are they?

A
  1. Apraclonidine: decrease EVP2. Brimonidine: Increase uveoscleral outflow
27
Q

How does LTP (including ALT and SLT work)?

A

thermal energy causes release of local chemical mediators that increase facility outflow

28
Q

How much is laser trabeculoplasty thought to lower IOP?

A

About the same as a glaucoma med…20-25%

29
Q

the 50 micron spot size in ALT is applied where?

A

The Anterior TM posterior TM junction

30
Q

How many spots are generally applied in ALT and over how much of the angle?

A

40-50 over 180 degrees (can do 360 too)

31
Q

What is the spot size for SLT?

A

400 microns

32
Q

What is the 10 year success rate of laser trabeculoplasty?

A

30%

33
Q

Young patients with myopia undergoing trabeculectomy have an increased risk of hypotony maculopathy when what adjuvant medication is used during surgery?

A

MMC or 5FU

34
Q

How does 5FU work?

A

It interferes with DNA synthesis with its action on thymidylate synthetase

35
Q

How is 5FU applied?

A

Like MMC. Postoperatively it can also be injected subconj away from the scleral flap so that it does not get in the eye.

36
Q

How does MMC work?

A

It is a DNA alkylating agent causing DNA crosslinking

37
Q

What type of laser is used for laser suture lysis?

A

Argon green or red

38
Q

Does antifibrotic agents increase the risk of endophthalmitis?

A

yes

39
Q

A patient needs glaucoma surgery which is progressing causing vision loss. They also need cataract surgery, although no risk for permanent vision loss from that. Should the surgeon do a combined glaucoma/CE or just glaucoma surgery?

A

Just glaucoma, combined has poorer outcomes.

40
Q

Which glaucoma draining device is valved?

A

Ahmed valve; molteno and baerveldt are non-valved

41
Q

In the tube vs trab study, which did better?

A

tube

42
Q

In the study comparing Baerveldt vs Ahmed, which had lower post-op complications? Which had better decrease in IOP?

A

Ahmed and fewer complications but high slightly higher IOP

43
Q

Indications for glaucoma drainage device include failed trab with antifibrotics, active uveitis, NVG, and inadequate conj. What are two other indications that may not be as intuitive?

A

Aphakia (trab success rate is late in aphkia) and need to wear contact lens (bleb will not interfere with corneal/scleral surface)

44
Q

How many degrees of cyclophotocoagulation is normally performed?

A

270 degrees

45
Q

What mechanism might a patient with tuberous sclerosis get glaucoma?

A

NAME?

46
Q

What is the laser setting for ALT?

A

50um spot size; 0.1 sec duration; 300-1000mW

47
Q

What is the laser setting for SLT?

A

Uses Nd:YAG; 400um spot size; 3 ns duration and 0.4-1.0mj energy

Glaucoma (3 decks)

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