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PPO 4 - Final Exam > Lecture 8 - Tonometry 1 > Flashcards

Lecture 8 - Tonometry 1 Flashcards

1
Q

When do you perform Tono?

A

After the SLEx

Note: If you do Gonio first, it will give you different result

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2
Q

What type of focus and movement must be made by using the joystick for tono?

A

Fine focus and movement

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3
Q

What is Tonometry?

A

The clinical technique that measures the IOP

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4
Q

Where is the Aqueous humor produced by?

A

Epithelium of the Ciliary Body

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5
Q

What is the flow of the Aqueous Humor?

A

Pupil into the Anterior Chamber

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6
Q

What are the 2 routes for Aqueous Humor?

A
  1. “Conventional Route”: passes thru the trabecular meshwork into Schlemm’s canal. Exiting via collector channels into venous system
  2. “Unconventional Route”: passes thru the uvealscleral pathway. Passes thru the iris root uveal meshwork and the anterior face of cilary muscle à thru suprachoroidal space and on out thru sclera (Prostoglandins can be used)
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7
Q

What is the outflow percentage of Aqueous Humor Outflow?

A

Trabecular outflow 70% or more

Uveoscleral outflow 30% or less

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8
Q

What is the 3 IOP purposes?

A
  1. Maintains integrity of globe
  2. Maintains retina and choroid in place
  3. Nourishes the lens, endo of cornea, vitreous and TM
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9
Q

What is the normal range for IOP?

A

10 to 21

Note: Avg tends to be around 15 mmHg

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10
Q

What is another scientific name when the outflow rate is normal?

A

Dynamic Equilbrium

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11
Q

What are 2 abnormal changes of IOP?

A
  1. Rare is overproduction in presence of normal outflow cause of increased IOP
  2. Interference with aqueous outflow is the most significant factor in the etiology of increased IOP (MOST COMMON)
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12
Q

What is the main focus of glaucoma therapy in regards to outflow?

A

Increase outflow and inhibition of production

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13
Q

What drugs focus on outflow of aqueous humor and aqueous production?

A

Prostaglandin = outflow

Carbonic Anhydrase Inhibitor = production

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14
Q

When you have completed multiple readings, what happens to the aqueous outflow and to IOP?

A

Increased aqueous outflow

Decrease IOP

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15
Q

What is the diameter of the circular zone of applanation?

A

3.06 mm

Note: Area is 7.3542

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16
Q

In regards to the GAT, what does 2 grams equal to in mmHg?

A

20 mmHg

17
Q

What is the first thing you must do prior to GAT procedures?

A

Pt. education

18
Q

Why is it important to remind your pt. that they must not rub their eyes ?

A

This is so why there is more of an effect on the eyes

19
Q

What parts do you puntcal occlude?

A

Nasolacrimal sac and medial palpebral ligament

20
Q

What are the three chemical components of fluress?

A

Fluorescein, Benoxinate and Chlorobutanol

21
Q

What is the wetting agent and stabilizer?

A

15% Povidone

22
Q

What do you ask your pts. prior to distilling dyes or anesthetics?

A

Are you allergic to any dyes or anesthetics

23
Q

When inserting a tono probe, what markers must be aligned with one another?

A

Holder = white line

Tono probe = zero axis

24
Q

When do you align on the red line of the holder?

A

3D or more of CORNEAL ASTIGMATISM

25
Q

What is the separation degree between the red and white line on the holder?

A

43 degrees

26
Q

Why do we not start the drum set too high?

A

Since the avg is close to 15 mmHg.

27
Q

How many degrees and in what direction is the viewing system arm away from the GAT reference point?

A

5 to 10 degrees away and temporally

Note: GAT must be perpendicular patient’s corneal plane

28
Q

What is the magnification you use when scanning the cornea after probing?

A

10x

29
Q

While looking externally and pushing the slit lamp close to the pts. eye, when is it your indication to start looking through the eye piece of the slit lamp?

A

Limbal glow

30
Q

If the mires are too thick, how will that impact the IOP?

A

Artifically higher IOP

Note: The opposite is true for thin mires

31
Q

What type of motion occurs when there is venous pulsation?

A

Lateral motion of the mires

32
Q

True or False. Mires that come and go means they are pulsating mires?

A

False. This means that there is not proper applanation

33
Q

What is the most common type of virus that can occur when you do NOT clean the tono probe?

A

Adenovirus Keratoconjunctivitis

34
Q

What type of wash removes all types of viruses available, even HepB virus of the DNA?

A

Water Wash

35
Q

What does the AOA recommend when cleaning the tono probe?

A

70% isopropyl alcohol swab

PPO 4 - Final Exam (4 decks)

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