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22 Cards in this Set
- Front
- Back
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Briefly explain the epidemiology of glaucoma. |
The leading cause of irreversible blindness globally. It is most prevalent for those of African descent. Increased incidence with age and family history. |
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What is glaucoma?
Is the onset painful?
What is the major risk factor and focus of treatments? |
A group of chronic progressive ocular diseases that lead to progressive damage to the optic never and corresponding progressive loss of visual field.
No, is typically painless.
Increased intraocular pressure. |
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What is normal IOP? |
10-21 mm HG. The bell curve is skewed towards the higher end. |
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What are the various types of glaucoma? |
Congenital/newborn - requires surgery
Primary open-angle - most frequent in US
Primary angle closure - acute is emergency, chronic has creeping IOP elevation
Secondary - many causes
Low-tension or normal pressure - vascular and other masquerading pathologies seen |
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How does open angle glaucoma differ from narrow angle physiologically? |
In open angle, the trabecular meshwork undergoes a change and no longer allows aqueous flow through the Canal of Schlemm.
In angle-closure, the ciliary body has gotten bigger and now blocks flow before it even reaches the trabecular meshwork. |
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What are the pertinent risk factors for developing glaucoma? |
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What is the best way to measure IOP? What is another way?
What is gonioscopy? |
Goldmann Applanation. Tonopen.
Evaluation of the anterior chamber angle. |
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What does the ISNT rule refer to? |
The distance between the border of the optic disc and position of blood vessel bending.
Inferior>Superior>Nasal>Temporal |
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Is rim thinning and notching indicative of glaucoma?
What does optic disc hemorrhage indicate?
What does a pallor greater than the cup indicate? |
Yes!
Glaucoma progression.
Non-glaucomatous neuropathy. |
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What are the symptoms associated with open angle glaucoma? |
There are usually no symptoms. Vision loss is seen in advanced cases.
It is identified on routine eye exams. Some may have decreased peripheral vision. |
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What are the symptoms of acute angle closure glaucoma? |
Headache, nausea, vomiting, halos around light, red eye. |
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What determines the prognosis of a patient with glaucoma? |
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Briefly explain chronic glaucoma management. |
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Briefly explain the two types of laser treatments of glaucoma. |
Laser trabeculoplasty - laser applied into or near trabecular meshwork to increase outflow
Laser iridotomy - used for angle closure |
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Briefly describe glaucoma surgery. |
MIGS - micro-invasive glaucoma surgery
Create opening from anterior chamber into the subconjunctival space or bypass primary tissue or resistance.
Antifibrotic agents are frequently used as failure is commonly due to fibrosis of filtering space. |
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What are the 3 symptoms seen with congenital glaucoma?
What other two things might be seen upon examination? |
Epiphora (tearing) Photophobia (light sensitivity) Blepharospasm (contraction or twitch of the eyelid)
Buphthalmos (enlargement of the eyeball) Haab's Striae |
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When should you absolutely refer to an Ophthalmologist for possible glaucoma? |
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Who is most likely to get cataracts?
What is it the most common cause of in the U.S. and the world? |
Older people. Present in 70% over 75 years of age.
Decreased vision. |
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What is discoloration or opacity of the lens an indication of?
What is a mature cataract? |
A cataract.
A totally opacified cortex. |
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What are the symptoms of cataracts? |
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What are some common risk factors for cataracts? |
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What are the indications for cataract surgery? |
It is almost always an elective surgery done when patient no meeting visual needs -- typically 20/40 or less when glare is utilized. |
