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Glaucoma > Glaucoma Vol. 1 > Flashcards

Glaucoma Vol. 1 Flashcards

1
Q

Name the 3 anatomical factors that determine lOP.

A
  1. Rate of aqueous humor production 2. Resistance to aqueous outflow 3. Level of episcleral venous pressure
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2
Q

What is preperimetric glaucoma?

A

Glaucomatous changes of optic disc in patients without visual field defects

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3
Q

What is the the specific site of aqueous outflow resistance generally considered to cause primary open-angle glaucoma?

A

Juxtacanalicular meshwork

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4
Q

What is the most common cause of non-reversible cause of blindness in blacks?

A

Glaucoma

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5
Q

Name 3 anatomical characteristics that may make African-Americans more susceptible to glaucoma.

A
  1. Larger optic discs 2. More nerve fibers 3. Thinner central corneas
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6
Q

What ethnic group has the highest prevelance of PACG?

A

Inuit populations of the Artic

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7
Q

What gender is at higher risk for PACG?

A

Women

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8
Q

How does the anterior chamber change with age?

A

Anterior chambers decreases in depth and volume with age

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9
Q

What is the most common age associated with acute angle-closure glaucoma?

A

Age 55 to 65

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10
Q

What type of refractive error is at increased risk of PACG?

A

Hyperopia (due to decreased anterior chamber depth)

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11
Q

What protein produced by trabecular meshwork cells has bean linked to genetic studies of POAG?

A

Myocilin (TIGR protein)

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12
Q

What gene was the first to be associated with POAG?

A

GLC1A

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13
Q

What protein is produced by the GLC1A gene?

A

TIGR/MYOC

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14
Q

What type of glaucoma has been associated with GLC1B and GLC1E gene?

A

Low-tension glaucoma

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15
Q

On what chromosome is GLC1A gene found?

A

Chromosome 11

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16
Q

On what chromosome is GLC1C gene found?

A

Chromosome 3

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17
Q

What structure creates the aqueous humor?

A

Ciliary processes

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18
Q

What chromosome has been associated with nanopthalmos associated glaucoma?

A

Chromosome 11

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19
Q

What specific cells of the ciliary processes are the actual site of aqueous humor production?

A

Inner, nonpigmented epithelial cells

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20
Q

What type of transport mechanism accounts for the majority of aqeuous humor production?

A

Active transport

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21
Q

What is the average production rate of aqueous humor?

A

2.0 to 2.5 uL/min

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22
Q

What is the most common method used to measure rate of aqueous formation?

A

Fluorophotometry

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23
Q

What gene is associated with aniridia and glaucoma?

A

PAX-6 gene

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24
Q

What is the average rate of outflow of aqueous humor?

A

0.2 to 0.3 uL/min/mmHg

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25
Q

How are aqueous humor production and outflow change with age?

A

Both are decreased

26
Q

What artery supplies the ciliary processes?

A

Major arterial circle of the iris

27
Q

What is the average turnover rate of aqueous humor?

A

Approx. 1% per minute

28
Q

Nama the 3 layers of the trabecular meshwork.

A
  1. Uveal 2. Corneoscleral 3. Juxtacanalicular
29
Q

Name 3 classes of glaucoma drugs that cause decreased aqueous formation.

A
  1. alpha-2 agonists 2. Beta-blockers 3. Carbonic anhyrdase inhibitors (Think “ABC”)
30
Q

What is the average diameter of Schlemm’s canal?

A

370 um

31
Q

What two veins does Schlemm’s canal drain into?

A

Anterior ciliary and superior ophthalmic veins

32
Q

What vessel do the anterior ciliary and superior ophthalmic veins drain into?

A

Cavernous sinus

33
Q

What is the average value of episcleral venous pressure?

A

8 to 10 mmHg

34
Q

Name 2 systemic diseases associated with increased episcleral venous pressure.

A
  1. Facial hemangioma (age. Sturga-Wabar) 2. Thyroid-associated orbitopathy
35
Q

How does alcohol consumtption affect lOP?

A

EtOH causes transient decrease in lOP

36
Q

How does acidosis affect lOP?

A

Metabolic or respiratory acidosis causes decreased lOP (decreases aqueous humor production}

37
Q

How does pregnancy affect lOP?

A

Pregnancy generally causes decreased lOP

38
Q

How does heroin and marijuana affect lOP?

A

Heroin and marijuana cause decreased lOP

39
Q

On average, how much does lOP fluctuate of an individual within a 24-hour period?

A

2 to 6 mmHg

40
Q

During what time of the day does peak IOP tend to occur in the average person?

A

In the early morning hours

41
Q

What is the size of area of the cornea flattened by Goldmann applanation tonometry?

A

3.06 mm (Think Fick principle)

42
Q

How is lOP affected by body position?

A

lOP is higher in recumbent pressure (due to increased episcleral pressure)

43
Q

What does an elliptical fluorescein pattern during Goldmann tonometry typically indicate?

A

Corneal astigmatism

44
Q

What are the two ways lOP can be measured with an elliptical fluorescein pattern?

A
  1. Red mark set at the least curved meridian of the cornea 2. Two averaged pressure readings taken 90
45
Q

How is lOP affected by body temperature?

A

Elevated body temperature causes increased lOP (due to increased aqueous humor production)

46
Q

How is lOP affected by hypothyroidism?

A

Hypothyroidism causes increased lOP

47
Q

How does aerobic exercise affect lOP?

A

Aerobic exercise causes decreased lOP

48
Q

How do soft contact lenses affect lOP measurement?

A

Soft contact lens causes falsely low lOP measurement

49
Q

At what corneal thickness is Goldmann tonometry most accurate?

A

520 um

50
Q

How does central corneal thickness affect lOP measurement?

A

Increased CCT causes falsely high lOP measurement (and vice versa)

51
Q

How do depolarizing muscle relaxants, such as succinylcholine affect lOP?

A

Depolarizing agents cause decreased lOP

52
Q

What is the population mean CCT?

A

542 um

53
Q

How does the amount of fluorescein affect lOP readings?

A

Too much fluorescein causes falsely elevated lOP (and vice versa)

54
Q

How does corneal edema affect lOP measurement?

A

Corneal edema causes falsely low lOP measurement

55
Q

Is IOP typically under or overestimated with air-puff tonometer?

A

Air-puff tonometer typically overestimates lOP

56
Q

How does corneal scarring affect lOP measurments?

A

Corneal scarring causes falsely high lOP measurement

57
Q

How does scleral buckle procedures affect lOP measurment?

A

Post-surgery lOP measurement after scleral buckle may cause falsely low measurement

58
Q

By how much does lOP measurement differ from actual lOP for each 10 urn difference in CCT?

A

Measurement differs from actual lOP by 0.5 mmHg with each 10 urn change in CCT from the average

59
Q

According to the OHTS, how does CCT affect an individual’s risk of developing POAG?

A

Individuals with CCT of 555 um or less have three-fold greater risk of devoloping POAG

60
Q

When is the use of Tono-Pen particularly useful?

A

In individuals with corneal scars or edema

Glaucoma (3 decks)

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