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Opthalmology midterm > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

Visual field loss

A

Retinal ganglion cell loss
Optic nerve head changes
Visual field changes

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2
Q

Why is glaucoma important

A

Potentially blinding
Causes irreversible optic nerve damage
Largely manageable when caught early

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3
Q

Changes in glaucoma

Cup disk ratio

A

Normal 0.3

Glaucoma 0.7

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4
Q

Changes in glaucoma

Retinal nerve fiber layer

A

N- makapal

G- numinipis

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5
Q

Changes in glaucoma

Visual field

A

N- manipis

G- dark part ibig sabihin nyan decreased sensitivity, hindi na nakakita yung part na yan

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6
Q

Classical glaucoma visual field change

A

Superior arcuate defect

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7
Q

Normal range of IOP

A

10-21mmHg

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8
Q

Produces the pressure inside eyeball

A

Aqueous humor

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9
Q

Aqueous humour produce via

A

Active transport in non-pigmented epithelium of the ciliary processes.

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10
Q

Aqueous humour lalabas sya sa ________ and then mag de drain sa _________. Rate of ______per minute 24/7

A

Pupil
Irido-corneal angle
2 microliter

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11
Q

Major pathway of aqueous humor

A

Trabecular

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12
Q

Minor pathway of aqueous humor

A

Uveoscleral

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13
Q

This is the major classification of family diseases of glaucoma

A

Elevated IOP

Open and closed angle

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14
Q

Apoptosis

A

Programmed cell death
Cell shrinkage
Chromatin clumping

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15
Q

Apoptosis kaya na mamatay yung mga

A

Retinal ganglion cells

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16
Q

Role of IOP

A

Direct effect on retoganglion cell
Mechanical effect on optic nerve cell
Effect on blood flow

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17
Q

Direct effect of reto ganglion cells

A

Somatic shrinkage
Dendritic changes
Heat shock response

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18
Q

Mechanical effects on optic nerve head

Don’t forget that the optic nerve is the

A

Weakest point in eye

Greatest stress

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19
Q

Mechanical effects on optic nerve head

Astrocyte remodeling and migration

A

Elastin deposition

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20
Q

Mechanical effects on optic nerve head

A

Optic nerve is the weakest point
Astrocyte remodeling and migration
Posterior bowing and thinning of cribriform plate or lamina crib isa.

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21
Q

Effects on blood flow of IOP

Formula

A

PP= MAP-IOP

Perfusion pressure
Mean arterial pressure
Intraocular pressure

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22
Q

Effects on blood flow of IOP

PP dependent Axonal transport of BDNF

A

Decrease PP in glaucoma

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23
Q

Mechanism of elevated IOP

Formula

A

IOP= F/C +Pe

F- aqueous flow (uL/min)
C- outflow facility (uL/mmHg)
Pe- episcleral venous pressure (mmHg)

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24
Q

Mechanism of elevated IOP

A

Increased Aqueous production
Impaired aqueous outflow
Elevated episcleral venous pressure

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25
Q

More common mechanism of elevated IOP

A

Impaired aqueous outflow

26
Q

Primary open angle glaucoma

Decreased number of pores in TM
Decreased Cellularity of TM (trabecular meshwork)

A

Senescent

27
Q

Primary open angle glaucoma

88% in POAG
Treatment associated with + response

A

Helicobacter pylori

28
Q

Primary open angle glaucoma

Vasoregulation
Apoptosis

A

Optineurin

29
Q

As we age the ______ which is the filtering portion of your angle has decreased that leads to slow of aqueous humor tumataas yung eye pressure

A

Trabecular meshwork

30
Q

Secondary open angle glaucoma

A

May antecedent cause

31
Q

Secondary open angle glaucoma

Steroid induced glaucoma

A

Myocillin/Tigr protein expression
Increased aqueous viscosity
Triggered by Myoc/ Tigr gene

32
Q

Secondary open angle glaucoma

Basement membrane disease
Exfoliated material obstruct TM

A

Pseudoexfoliate glaucoma

33
Q

Secondary open angle glaucoma

Pigmentary glaucoma

Reverse

A

Pupillary block

34
Q

Secondary open angle glaucoma

Pigmentary glaucoma

Posterior bowing of

A

Iris (concave)

35
Q

Secondary open angle glaucoma

Pigmentary glaucoma

Pigments

A

Epithelium contact with lens
Released causing Krukenburg spindles
Phagocytosed by TM causing decreased TM function

36
Q

Secondary open angle glaucoma

Increased episcleral resistance

Uncommon non familial disease recognizable at birth by a characteristic nevus flammeus on one side of the face.

A

Sturge-Weber syndrome

37
Q

Secondary open angle glaucoma

Increased episcleral resistance

Trauma

A

AV fistula

38
Q

Secondary open angle glaucoma

Increased episcleral resistance

May cause angle neovascularazation due to widespread ocular ischemia

A

Carotid cavernous fistula

39
Q

Medical treatment cannot reduced the intraocular pressure below.
Surgery is associated with high risk complication.

A

Increased episcleral resistance

40
Q

Angle closure glaucoma

A

Surgical

Sumasakit talaga, unlike sa open na incidental lang

41
Q

Angle closure glaucoma

Acute symptomatic

A 
Pain
Redness
Blurred vision
Haloes
Nausea/vomiting
42
Q

Angle closure glaucoma

Maybe asymptomatic
MC wrong mngt

A

Chronic

43
Q

Resistance of Irido-lenticular interface
Pressure bows iris anteriorly
Dilation causes angle to close
May be lens/ cataract induced

A

Pupillary block glaucoma

44
Q

Iris is convex

A

Pupillary block glaucoma

45
Q

Central iris flat centrally and convex peripherally

Angle closes on dilation

A

Plateau iris

46
Q

Akala mo open sya, flat yung central iris pero sa likod pala convex. On dilation, the angle closes the iris

A

Plateau iris

47
Q

There is anterior ciliary rotation. Yung ciliary body mo is anteriorly rotated so yung flow ng aqueous mo baliktad.

A

Supraciliary effusions

48
Q 
Uveitis
Malignant glaucoma (pero hindi cancer)
A

Supra ciliary effusions

49
Q

Super ciliary effusions

Drug effect

A

Sulfa

Topiramate

50
Q

Misdirection of aqueous flow

A

Malignant glaucoma

51
Q

Aka ciliary block glaucoma

A

Malignant glaucoma

52
Q

Following surgery upon open eye with marked increased IOP and a closed or narrow angle
Post operativel, the IOP is higher than expected and the lens is pushed forward as a result of the collection of aqueous in and behind the vitreous body.

A

Malignant glaucoma

53
Q

Blurred distance vision but improved hear vision. This is followed by pain and inflammation

A

Malignant glaucoma

54
Q

Role of ocular blood flow and oxygenation

Triggers glutamate cascade
May impair Axonal transport

A

Ischemia

55
Q

Role of ocular blood flow and oxygenation

Impaired compensation on

A

Open angle glaucoma

56
Q

Role of ocular blood flow and oxygenation

Dysautoregualtion in

A

Normal tension glaucoma

57
Q

Role of ocular blood flow and oxygenation

Others

A

Nocturnal hypotension and NTG
Sleep apnea and NTG
Migraine and NTG

58
Q

Aka low tension glaucoma

Normal yung pressure

A

Normal tension glaucoma

59
Q

Purely vascular disease

Chr 10

A

Normal tension glaucoma

60
Q

Conclusion

A

Glaucoma is a multi- faceted and multi factorial disease
Can occur at any intraocular pressure
Misdiagnosis can be visually devastating
A high index of suspicion is necessary

61
Q

A family diseases having a common characteristic progressive optic neuropathy and associated visual field loss.

A

Glaucoma

Opthalmology midterm (1 decks)

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