Gonioscopy

Question 1

What are the advantages/disadvantages of using a more viscous solution?

(Air bubbles and irritation on cornea)

Answer 1

• Greater air bubbles

- Less irritating on cornea

Question 2

What are the slit lamp settings for gonioscopy?

Answer 2

• 10-16x, medium beam width, microscope arm position straight ahead

Question 3

What is the most posterior structure, angle width and closure risk for Grade 3 angle?

A. CB, 35-45 degrees, Impossible
B. SS, 20-35 degrees, Impossible
C. TM, 10-20 degrees, Possible
D. anterior TM, 10 degrees, Probable
E. none, 0, closed

Answer 3

B. SS, 20-35 degrees, Impossible

Question 4

What is the most posterior structure, angle width and closure risk for Grade 2 angle?

A. CB, 35-45 degrees, Impossible
B. SS, 20-35 degrees, Impossible
C. TM, 10-20 degrees, Possible
D. anterior TM, 10 degrees, Probable
E. none, 0, closed

Answer 4

C. TM, 10-20 degrees, Possible

Question 5

What is the most posterior structure, angle width and closure risk for Grade 1 angle?

A. CB, 35-45 degrees, Impossible
B. SS, 20-35 degrees, Impossible
C. TM, 10-20 degrees, Possible
D. anterior TM, 10 degrees, Probable
E. none, 0, closed

Answer 5

D. anterior TM, 10 degrees, Probable

Question 6

What are four things that can be evaluated for at the pupil margin?

Answer 6

• Iris cyst
• Iris atrophy
• Rubeosis
• Exfoliative material

Question 7

What type or refraction and associated risk is associated with a convex and concave iris surface curavature?

What can pupillary block result in?

Answer 7

• Convex: Hyperopia, increased risk of angle closure
• Concave: myopia, pigment dispersion
• Pupillary block may result in iris bombe

Question 8

What are three ocular characteristics of Plateau Iris Syndrome?

(Iris surface, chamber depth, Van Herick angles)

Answer 8

• flat iris surface
• Normal chamber depth
• Narrow van Herick angles

Question 9

List all the structures in a gonioscopic angle view from most posterior to anterior and a brief description of it.

(Start with Iris Root to Schwalbe’s Line)

Answer 9

• Iris Root (moveable anatomic landmark)
• Ciliary Body (brownish, attaches to scleral spur and TM)
• Scleral Spur (white color landmark)
• Trabecular Meshwork (Posterior is filtering, Anterior is non-filtering)
• Schlemm’s Canal (can not be detected unless filled with blood)
• Schwalbe’s Line (anterior limit of angle wall)

Question 10

What structure does the focal line technique fall on?

Answer 10

• Schwalbe’s line

Question 11

What is the Gonioscopy grading system at the IEI a combination of? (Pick 2)

A. Gorin & Posner
B. Schaffer
C. Scheie
D. Spaeth
E. Cockburn

Answer 11

B. Schaffer

C. Scheie

Question 12

What is the condition for it to be safe to dilate?

Answer 12

• 2 quadrants of posterior TM (Grade 2) must be visisble to dilate

Question 13

What do to when you have no/minimal view on the lens

Answer 13

-tilt towars observer