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Duke Elder > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

Glaucoma is a condition of the

A

optic nerve

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2
Q

pars pana and pars plicata are parts of the

A

ciliary body

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3
Q

parts of the ciliary body

A

pars plana and pars plicata

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4
Q

what produces aqueous humour

A

pars plicata of ciliary body

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5
Q

most humour drains through

A

trabecular outflow

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6
Q

traberular outflow involves

A

trabecular meshwork, schlemm’s canal, episcleral veins

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7
Q

minority of humour drains through

A

uveoscreal output

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8
Q

uveoscleral output involves

A

humour passes through the ciliary muscle to the suprachoroidal space, choroidal veins

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9
Q

what increses uveoscleral outflow

A

prostaglandin analogues

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10
Q

humour secretion controlled by

A

sympathetics

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11
Q

b2 receptos

A

increase secretion

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12
Q

a2 recepors

A

decrease secretion

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13
Q

normal IOP

A

> 10 >21 mmHg

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14
Q

ocular hypertension is

A

IOP >21 but no glaucomatous sign

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15
Q

proportion of people with ocular hypertension that g on to develop OAG

A

9.5%

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16
Q

risk factors for conversion from ocular hypertension into OAG

A

older age, higher IOP, large cup:disc ratio, thinner CCT, african-american origin, myopia, males, heart disease

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17
Q

fundoscopy findings in POAG

A

higher cup:disc ratio, neuroretinal rim thinning

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18
Q

pachymetry measures

A

CCT

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19
Q

why measure CCT with pachymetry

A

> CCT increases risk of POAG

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20
Q

perimetry

A

visual field testing

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21
Q

wiggly fingers

A

visual field with confrontation

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22
Q

flashing dots pt clicks when they see them (like at the opticians)

A

Humphrey analyser

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23
Q

POAG medical tx

A

IOP lowering agents eg a agonists, b blockers, CAIs

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24
Q

POAG laser tx

A

argon laser treatment

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25
Q

POAG surgical tx

A

trabeculotomy, MIGS

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26
Q

trabeculotomy

A

flap in sclera, humour sits in bleb. can scar

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27
Q

normal tension glaucoma assic

A

Japanese, raynauds, migraines, hypotension

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28
Q

normal tension glaucoma tx

A

monitor (50% dont develop visual field defects at 5 years). or prostaglandin analogues

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29
Q

adv of prostaglandin analogues

A

IOP control at night
b blockers cause hypotension
low SEs
once daily

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30
Q

primary angle closure glaucoma assoc

A

hypermetropics, short axial length, far eastern race, increasing age

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31
Q

primary angle closure suspect

A

small angle but no changes/synechiae

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32
Q

primary angle closure

A

synechiae +/- raised IOP

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33
Q

PACG

A

PAS + IOP + glaucomatous changes and visual field defects

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34
Q

relative pupillary block worst position

A

mid-dilated pupil

max contact between iris and lens

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35
Q

relaive pupillary block is..

A

humour cant pass through pupil, iris bends forwards under pressure bilaterally, closing angle

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36
Q

PACG features

A

blurring, pain, headache, vomiting, haloes, visual loss

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37
Q

PACG exacerbated by

A

dim light, reading

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38
Q

PACG acutte signs

A

mid-dilated pupil, corneal oedema, conjunctival hyperaemia

39
Q

PACG resolved signs

A

descemet membrane folds, glaukomflecken ant cataracts

40
Q

PACG mx acute

A

supine, systemic acetazolamide, b blockers, a agonists, prostaglandin analogues, mannitol, steroids

41
Q

mannitol moa

A

shrinks viterous

42
Q

PACG tx definitive

A

YAG laser peripheral iridotomy

43
Q

catarct extraction may…

A

lower IOP

44
Q

pseudoexfoliation syndrome

A

grey-white fibrillar deposts block ant chamber

45
Q

Pseudoex syndrome assoc

A

hearing loss, alz disease, high plasma homocysteine levels

46
Q

Pseudoex syndrome features

A

sampolesi line on gonioscopy

peripupillary defect on transillumination slit lamp

47
Q

HLA BW5

A

posner schlossman syndrome

48
Q

causes of 2˚ OAG

A

posner-schlossman, pseudoex syndrome, phacolytic, phacomorphic, red cell, angle-recession, pigment dispersion, neuvascular

49
Q

assoc with hearing loss, alz disease, high homocysteine levelsq

A

pseudoex syndrome

50
Q

glaukonflecken

A

PACG (acute)

51
Q

descemet membrane folds

A

PACG (resolved)

52
Q

conjunctival hyperaemia

A

PACG (resolved)

53
Q

sampaolesi line

A

pseudoex syndrome

54
Q

assoc raynauds, japanese, migraines, hypotension

A

normal tension glacoma

55
Q

recurrent unilateral acute attacks of raised IOP

A

posner-schlossman syndrome

56
Q

CMV, H pylori, HLA BW5

A

posner-schlossman

57
Q

Features of posner schlossman

A

discomfort, haloes, blurring, anterior chamber inflammation, mydriasis

58
Q

posner schlossman tx

A

topical b blockers or CAI

topical steroids

59
Q

phacolytic glaucoma

A

hypermature cataract denatues and lens leaks proteins causing TM obstruction

60
Q

phacolytic glaucoma tx

A

IOP lowering agents, cataract removal

61
Q

phacomorphic glaucoma

A

swelling of cataractous lens –> pupillary block

62
Q

red cell glaucoma

A

trauma causing red blood cell build up in ant chamber leading to blockage

63
Q

red cell glaucoma signs

A

visible blood in ant chamber on slit lamp exam

64
Q

what can happen 3-7 days post-injury in red cell glaucoma

A

secondary bleed

65
Q

angle recession glaucoma

A

rupture of ciliary body by trauma

66
Q

what is the risk of glaucoma after rupture of ciliary body

A

10%

67
Q

irregular widening of the face of the ciliar body on gonioscopy

A

angle recession glaucoma

68
Q

pigment dispersion syndrome

A

excessive shedding of pigmented material of iris deposited throughout the ant segment

69
Q

inheritance of pigment dispersion syndrome

A

AD

70
Q

risk factors for pigment dispersion syndrome

A

myopia and males

71
Q

blurred vision and haloes on eertion

A

pigment dispersion

72
Q

mid-peripheral spoke-like defects of the iris on transillumination

A

pigment dispersion

73
Q

vertical spindle shaped pigments on corneal epithelium (krukenberg spindles)

A

pigment dispersion syndrome

74
Q

signs of pigment dispersion syndrome

A

mid-peripheral spoke-like defects of the iris

vertical spindle shaped pigments on corneal epithelium

75
Q

trabecular meshwork pigmentation

A

pigment dispersion syndrome

76
Q

neuvascular glaucoma occurs due to…

A

proliferation of fibrovascular tissue in the ant angle due to rubeosis iridis

77
Q

glaucoma typically occurs 3 months after occlusive event (100 day glaucoma)

A

neovascular glaucoma

78
Q

causes: ischaemic CRVO, CRAO, diabetes (proliferative)

A

neovascular glaucoma

79
Q

PRP

A

neovascular glaucoma

80
Q

YAG laser iridotomy

A

ACG

81
Q

avoid pilocarpine and prosta analogues

A

neovascular glaucoma

82
Q

TM blockage by RBC shells typically 2-4 weeks after vitreous haemorrhage

A

ghost cell glaucoma

83
Q

ant uveitis + raised IOP with open angle

A

schwartz-matsuo syndrome

84
Q

results from rhegmatogenous retinal detachment

A

schwartz-matsuo syndrome

85
Q

sturge weber syndrome

A

congenital neuro-oculocutaneous disorder causing secondary OAG

86
Q

port int stain

A

sturge weber

87
Q

seizues, glaucoma, choroidal haemangiomas

A

sturge weber

88
Q

normal IOP

A

> 10 <21

89
Q

normal IOP in newborn

A

10-12 mmHg

90
Q

normal corneal diameter

A

10-10.5 mm

91
Q

primary congenital glaucoma tx

A

goniotomy or trabeculotomy

92
Q

if cornea is clear (in primary congenical glaucoma) which surgery do you do

A

goniotomy

93
Q

if cornea is cloudy (congenital glaucoma) , which surgery

A

trabeculotomy

Duke Elder (2 decks)

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