Optic nerve and nerve fibre layer in glaucoma

Question 1

why is the nerve head important to assess?

Answer 1

there can be alot of damage before e VF defect will show

Question 2

what % has 0.6>?

Answer 2

5%

Question 3

Who has larger discs?

Answer 3

afro-carbo

Question 4

when should we have attension?

Answer 4

0.6 CD – asym of 0.2 between each eye

Question 5

what is normal IOP?

Answer 5

10-21mmgh

Question 6

What are the risk factors for POAG?

Answer 6

1. Afro
2. Myopia
3. IOP
4. FH

Question 7

what are the risk factors for ntg?

Answer 7

1. optic disc heam
2. women
3. vf close to fixation (central)

Question 8

what are acg risks?

Answer 8

1. fhg
2. chinese
3. women
4. hyperopia - short axial length and small chamber

Question 9

what is pupil block with acg?

Answer 9

this is when the lens moves foward and the iris moves back

Question 10

when does pupil block nroamlly happen?

Answer 10

when the pupil is in mid dilated state –> not big enough for the ah to pass.

Question 11

What is iris bombe?

Answer 11

this sis when the ah is stilll produced by the cilliary body and pressure builds behind the iris. -> bows the iris and blocks trab meshwork

Question 12

what is acg withut pupil block?

Answer 12

this when the cilliary boyd is large / positioned more forward = iris = pushed forward = dilation = cloe of dilation

Question 13

optic disc suspicoions?

Answer 13

1. vertical elongation of the cup
2. thinning of the rim
3. notiching
4. heams
5. vasualr chnages
6. ppa
7. nfl defect

Question 14

what is notching ?

Answer 14

this is when there is a localized defect on the neuroretinal rim –> typically sup / inf

this is highly suggestive of glaucoma

Question 15

why does disc heam happen?

Answer 15

linear bleeds stress of the IOP

Question 16

what vascular chnages happen?

Answer 16

bayoneting / narrowing

Question 17

why does ppa occour?

Answer 17

this is when there s degeneration of the retina and the choroid - around the disc

Question 18

how many zones?

Answer 18

beta and alpha

bta = more liekly of glaucoma

Question 19

What does a nfl defect show us?

Answer 19

retinal ganglion cells can thin out due to gluacoma –> see on oct

Question 20

when looking at discs what should we see?

Answer 20

cups sym and the NRR sym?

Question 21

why is beta more suspicous then alpha?

Answer 21

alpha = hyper/hypo
beta = arophy of the rpe/ chorocoidal choriocapillaries –> thin nrr

Question 22

refferal

Answer 22

45+ - emergency
35-45 - urgent
35- routine
high iop then routine - no pathway

Question 23

small disc.

Answer 23

look for ppa chnages mainlyy lol,

Question 24

what drugs?

Answer 24

beta blockers
adrenergic agnoist
prostaglandin
carb anhydrase inhibitor
cholinergic - pilocarpine

Question 25

what are some surgical managements?

Answer 25

1. laser trab - argon laser to the trab meshwork –> increase outflow
2. Trans scleral photocoagulation -