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opthalmology > glaucoma LGW > Flashcards

glaucoma LGW Flashcards

1
Q

what are the differential diagnosis of cloudy cornea in peds ?

A

birth trauma
rubella keratitis
metabolic disorders
Congenital hereditary endothelial dystrophy.
Sclerocornea

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2
Q

what are the differential diagnosis for large cornea in peds ?

A

megalo-cornea
high myopia

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3
Q

what are the differential diagnosis for epiphora in peds ?

A

nasolacrimal duct ectasia
lacrimation secondary to occular irritation
congenital glaucoma

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4
Q

what are the types of congenital glaucoma ?

A

primary
secondary ( due to systemic disease or occular disease)

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5
Q

what are the types of congenital primary glaucoma ?

A

true
juvenile
infantile

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6
Q

which primary congenital glaucoma type is the most common ?

A

infantile glaucoma

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7
Q

what aree the features of
true
infantile
juvenile

A

true - IOP raised in intra uterine life
infantile - manifests before the age of 3
juvenile - the rarest manifests betweeen thee age of 3 and 16

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8
Q

what is the cause of primary congenital glaucoma ?

A

trabeculodysgenesis

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9
Q

what is the presentation of congenital primary glaucoma ?

A

Axial myopia
Buphthalmous
Corneal haze
Diameter of cornea
Descement membrane breaks
Disc cupping
Epiphora

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10
Q

what is thee other term used to describe descement memb breaks ?

A

haat striae

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11
Q

what is thee normal IOP in children ?

A

10-12 mmhg

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12
Q

what does buphthalmous mean ?

A

large eyes as a result of stretching the sclera due to elevated IOP that happened in intra-uterine life
it appears blue due to underlying uvea

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13
Q

what investigations should be donee for cases of suspected congenital glaucoma ?

A

corneal diameter measurement
tonopen
gonioscopy

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14
Q

what corneal measurement raises suspicion for congenital glaucoma ?

A

more than 12 before the age of 1

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15
Q

what is the mode of inheritance of congenital glaucoma ?

A

usually sporadic
but can be autosomal recessive

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16
Q

what does the prognosis depend on ?

A

age of onset and seeverity

17
Q

what is the definitive treatment for congenital glaucoma ?

A

goniotomy
trabeculotomy
Amblyopia and refractive error should be corrected

18
Q

what if goniotomy cant be performed due to corneal haze ?

A

perform trabeculotomy

19
Q

what tools are used to measure IOP ?

A
  1. goldmann tonometry
  2. portable applanation -perkin - more portable
  3. electronic-indentation- tono-pen - can be used with soft contact lens and corneal oedema
  4. re-bound tonometry - uswd for screening
20
Q

whiich tool can be useed for screening purposes of measuring IOP ?

A

re bound tonometry

21
Q

what method does a gonioscopy use to visualize ?

A

total internal reflection to visualize the anterior chamber angle

22
Q

how can early stage glaucomatous damage be suspected or seen ?

A

using Ganglion cell complex (GCC) analysis

23
Q

what are the combination therapies for glaucoma ?

A

Xalacom, Cosopt, Combigan.

24
Q

what are the indications for a trabeculectomy ?

A

1- Failure of conservative therapy to achieve adequate
IOP control
2- Progressive deterioration despite seemingly
adequate IOP control (including poor adherence to
the recommended medical regimen)
3- Primary therapy. Advanced disease requiring a very
low target pressure may achieve a superior longterm outcome from early surgery, particularly in
younger patients.
4- Patient preference.

25
Q

what is the effect of anti-metabolites on filtration surgery ?

A

increase survival time of filtration surgeries by preventing bleb fibrosis and scarring.

26
Q

what are examples of anti-metabolites used in filtration surgery ?

A

mitomycin c
5- FU
a higher risk patient would use mitomycin rather than 5-FU

27
Q

why is the pupil fixed and mid-dilated in glaucoma ?

A

due to ischemia of the sphincter pupillae

28
Q

what are the contraindications to carbonic anhydrase inhibitors ?

A

sulfonamide allergy

29
Q

what type of drug is pilocarpine ?

A

miotic , increases uveoscleral flow and is used in the management of acute angle closure glaucoma

30
Q

what is the definitive treatment for angle closure glaucoma ?

A
  1. Peripheral Laser iridotomy
  2. Lens extraction
  3. Guarded filtration procedure
    (surgical trabeculectomy/iridectomy)
31
Q

in angle closure glaucoma - what to do with the fellow eye ?

A

bilateral peripheral laser iridotomy

opthalmology (14 decks)

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