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finals > opthalmology > Flashcards

opthalmology Flashcards

1
Q

where is aqueous humour produced?

A

ciliary body

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2
Q

what is the purpose of aqueous humour?

A

supply nutrients to the cornea and lens

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3
Q

explain the course of aqueous humour

A

travels from the posterior chamber through the pupil into the anterior chamber then drains out of the anterior chamber through 2 independent pathways

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4
Q

what are the 2 pathways that aqueous humour drains out of the anterior chamber?

A

trabecular meshwork into canal of Schlemm

uveoscleral pathway

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5
Q

what causes primary open angle glaucoma?

A

resistance to outflow of aqueous humour through trabecular meshwork, causing IOP to rise

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6
Q

give 5 risk factors for open angle glaucoma

A

myopia (short sighted)
elderly
ocular hypertension
T2DM
cardiovascular disease

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7
Q

how does open angle glaucoma present?

A

slow and chronic course
usually affecting both eyes

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8
Q

what is the pattern of vision loss in open angle glaucoma?

A

initially loss of peripheral vision usually in superior visual field before inferior visual field

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9
Q

what are the clinical findings of open angle glaucoma?

A

increased IOP
visual field defects
cupped discs on fundoscopy

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10
Q

what is the gold standard investigation to measure IOP?

A

goldmann applanation tonometer

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11
Q

when is treatment for open angle glaucoma started?

A

when IOP is >24mmHg

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12
Q

what are the 3 management options for open angle glaucoma?

A

laser management
medical management
surgical management

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13
Q

what is the first line medical management for open angle glaucoma?

A

prostaglandin analogues e.g. latanoprost

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14
Q

what are the 2 side effects of prostaglandin analogues used in the treatment of open angle glaucoma?

A

eyelash growth
eyelid and iris pigmentation

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15
Q

aside from prostaglandin analogues, what other medications are used in the treatment of open angle glaucoma?

A

beta blockers (timolol)
parasympathetics (pilocarpine)
carbonic anhydrase inhibitors (acetazolamide)

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16
Q

what is the surgical management of open angle glaucoma?

A

trabeculectomy w/ pharmacological augmentation w/ mitomycin C

17
Q

what is acute angle close glaucoma?

A

an acute rise in IOP assoc w/ narrowing of anterior chamber angle causing optic nerve damage and sight loss

18
Q

what is the anterior chamber angle?

A

the angle between the iris and cornea

19
Q

what causes acute angle closure glaucoma?

A

reduced drainage of aqueous humour due to anterior chamber angle narrowing

20
Q

what are the risk factors for acute angle closure glaucoma?

A

hypermetropia (long sighted)
age
female (3x more likely than males)
FHx

21
Q

what is the timeline of acute angle closure glaucoma?

A

symptoms develop over hours to days

22
Q

what are the typical symptoms of acute angle closure glaucoma?

A

unilateral severe eye pain or headache that may cause nausea and vomiting

profound reduction in visual acuity or vision loss

rainbow coloured haloes around bright lights

23
Q

what are the clinical examination findings of acute angle closure glaucoma?

A

painful red eye
hazy cornea
fixed, non reactive, mid dilated pupil
v high IOP causing eye to be hard on palpation

24
Q

what are the 2 investigations for acute angle closure glaucoma?

A

gonioscopy
tonometry

25
Q

what is gonioscopy?

A

the gold standard for investigating the angle between the iris and cornea

mandatory in establishing diagnosis of angle closure glaucoma

26
Q

what is the gold standard way to measure IOP?

A

Goldmann applanation tonometry

27
Q

why is acute angle closure glaucoma an ophthalmic emergency?

A

because it is sight threatening

28
Q

what are the conservative measures in the management of acute angle closure glaucoma?

A

anti emetics
analgesic
lie the pt flat

29
Q

what are the specialist measures in the management of acute angle closure glaucoma?

A

systemic pressure reducing agents - acetazolamide

topical pressure reducing agents - beta blockers

topical steroids

peripheral iridotomy

30
Q

what is a peripheral iridotomy?

A

a laser hole through the iris to allow a separate route for aqueous drainage

done in the management of acute angle closure glaucoma

31
Q
A

finals (25 decks)

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