Gluacoma

Question 1

How much coupling device should be used when filling the cup of the lens?

Answer 1

it should be no more than half full

Question 2

Where should the patient look when the goniolens is being inserted?

Answer 2

Ask the patient to look up and insert the inferior rim of the lens into the lower fornix

Question 3

What is important to remember about the image viewed in the Goldmann lens?

Answer 3

The image is vertically inverted (upside down

Question 4

Lesions located to the right of 12 o’clock will appear in the mirror……….

Answer 4

on the right hand side

Question 5

Where should the mirror be placed initially?

Answer 5

At 12 o’clock, visualize the inferior angle and then rotate the lens in a clockwise direction

Question 6

Name the angle structures from anterior to posterior.

Answer 6

Schwalbe’s line: represents the peripheral termination of Descemet’s membrane

The trabeculum extends from Schwalbe’s line to the scleral

• the anterior non-functional and non-pigmented part
• the positerior functional and pigmented part

The scleral spur: the site of attachment of the longitudinal muscle of the ciliary body

The ciliary body

Question 7

Name the causes of pathological trabecular hyperpigmentation.

Answer 7

@. Blunt ocular trauma
 @. Anterior uveitis
 @. Following acute angle closure glaucoma
 @  Pseudoexfoliation syndrome
 @  Pigment dispersion syndrome
@  Diabetes after cataract surgery
\:@. Naevus of Ota

Question 8

Where is the Canal of Schlemm situated?

Answer 8

A slightly darker line deep to the posterior trabeculum

Question 9

What are the causes of blood in Schlemm’s canal?

Answer 9

@. Compression of the episcleral veins by the goniolens and the episcleral venous pressure exceeds the IOP

@ Pathological causes of raised episcleral venous pressure:

         - Carotid-cavernous fistula or dural shunt
         - Sturge- Weber syndrome
        - Obstruction of the superior vena cava

Question 10

What is the Shaffer grading system?

Answer 10

@ Grade 4: 40 degrees (35-45 degrees): 4 structures visible
@. Grade 3: 30 degrees ( 25. -35 degrees): 3 structures visible
@. Grade 2; 20 degrees: 2 structures visible; angle closure possible
@. Grade 1: 10 degrees: 1 structure visible: angle closure possible

Question 11

What is the difference between iris processes and prripheral anterior synechiae?

Answer 11

@ Iris processes are slender; PAS broader

@. Iris processes attach to the scleral spur:; PAS attach to the trabecular structures