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Methods Block 10 > Gonioscopy > Flashcards

Gonioscopy Flashcards

1
Q

An examination of the eye to look at the anterior chamber from the anterior part of the iris to the posterior part of the cornea using the helps of a goniolens and a slit lamp

A

Gonioscopy

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2
Q

Order of the angle

A

CB
scleral spur
TM
Schwalbes line

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3
Q

All the emergent light is subjected to

A

The total internal reflection

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4
Q

Why is the angel hard to see without a gonio

A

Because the region is covered by a projecting shelf of sclera at the limbus

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5
Q

Why use gonioscopy

A
  • fundamental part of a comprehensive eye exam
  • most important factor in differential diagnosis (COAG vs angle closure glaucoma)
  • done on ALL glaucoma suspects
  • repeat periodically for narrow angle or angle closure glaucoma patients
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6
Q

What is the most important factor in differential diagnosis for glaucaom

A

Gonio

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7
Q

All four mirrors on the lens is an angle of ______

A

64 degrees

-eliminates the need for rotating the lens

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8
Q

Posterior curvature of the lenses of a goniolens (4 mirrors)

A

Posterior curvature of all these lenses are equal to that of the cornea which allows the patients own tear film to form the “fluid bridge” between the lens and the surface of the cornea

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9
Q

Purpose of 3 mirror gonio

A

Use this for more than gonioscopy. Can look at different parts of the retina too. Look at retina that us closest to ciliary body and the other two mirrors go a little further back into the peripheral retina

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10
Q

Apical mirror of 2 lens

A

D shaped

  • only one that you can use for gonioscopy
  • put it on the superior part of the cornea to see the inferior angle
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11
Q

Peripheral mirror in a 3 lens

A

Goes towards the periphery of the retina

-look at the anterior retina

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12
Q

Equatorial lens of the 3 mirror

A

Looking at the equator of the eye

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13
Q

From posterior to anterior, what structure should you see in the gonioprism

A

Ciliary body
Scleral spur
TM
Schwalbes line

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14
Q

How to remember the 3 differnt lenses on 3 lens

A

APE
Apical
Peripheral
Equatorial

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15
Q

How to remember gonio structures

A 
I CANT SEE THIS STUFF
I-iris 
C-ciliary 
S-scleral spur
TM
Schwalbes line
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16
Q

Deepest angle

A

Inferior angle

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17
Q

Most pigmented angle

A

Inferior angle

18
Q

Most important angle to look at during gonio

A

Inferior

19
Q

What mirror will you look at to view the inferior angle

A

The superior (12 0c lock) one

20
Q

Looking over the hill

A
  • iris is bowed, hard to see over it

- move the mirror over towards the angle you are looking at and it will take you up over the hil (over the iris)

21
Q

How to move the mirror to look over the hill

A

Towards the angle you are trying to view

22
Q

Difficult angles

A

Go to the other eye

-most patients have symmetrical eyes

23
Q

Doing a peripheral iridotomy in one eye

A

You will have to do the other eye

24
Q

A good screening tool before gonio

A

Von Herrick

Do it in all 4 meridians

25
Q

In van Herrick, the beam is offset ____ temporally to the slit lamp ocular

A

60 degrees

26
Q

If the anterior chamber depth is as deep as the cornea is thick,

A

Then the angle is presumed to be wide open

27
Q

Good screening tool before gonio

A

Von herrick

28
Q

If you cant see anything in one eye on gonio

A

Look at the other eye, also compare to van Herrick

29
Q

Van herrick grading

A

4 wide open

Can’t see any light- 1

30
Q

Normal vessels in the angle

A
  • radial orientation (not branching)
  • thick
  • non-breaching
  • do NOT cross the scleral spur
31
Q

Neovascularization in the angle

A
  • fine
  • arborising
  • crosses scleral spur
32
Q

Corneal wedge

A

When a thin slit of light hits the irido-corneal angle at an angle of 10-15 degrees

  • two light reflections are seen from the external and internal corneal surfaces which pipe down at the scleral corneal junction (schwalbes)
  • this marks the anterior border of the TM
33
Q

Indentation gonioscopy

A

Ver useful in patients where the iris covers the TM. When that happens, it is easy to mistake

  • no pigmented TM for scleral spur
  • pigmented schwalbes line for TM
  • apposition for synechiae
34
Q

Indentation gonioscopy in glaucoma

A

Push down on the cornea

Helps open the angle up a little bit so you can see down into there

35
Q

Indentation gonioscopy and synechiae

A

Won’t be abale to break synechiae with this. But you can see it

36
Q

Plateau iris

A

Need to use indentation gonioscopy to see the angle

37
Q

Scleral spur visible

A

Yes, grade angle, record findings

Open angle

38
Q

Scleral spur is not visible

A

-do indentation gonioscopy

39
Q

When doing indentation gonioscopy when you dont see the scalers spur, and you see synechiae

A

Grade angle
Record findings
Primary angle closure (synechiae)

40
Q

If you do not find synechiae upon indentation gonio

A

Check to see is IOPs are raise

  • yes: grade angle, record findings, primary angle closure, primary angle closure
  • no: grade angle, record findings, primary angle closure suspect

Methods Block 10 (5 decks)

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