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40 Cards in this Set
- Front
- Back
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Name the 10 step progression of glaucoma.
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1- normal
2- accelerated apoptosis 3- ganglion cell loss 4- RNFL change (undetectable) 5- RNFL change (detectable) 6- short wavelength VF changes 7- Standard VF changes (automated perimetry) 8- VF change (moderate) 9- VF change (severe) 10- Blindness |
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How many americans are diagnosed with glaucoma? How many americans have glaucoma, but are undiagnosed.
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> 2 mill
estimated 1 mill |
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G is 2nd only to _____ as the leading cause of irreversible blindness in the US.
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AMD
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T or F: every myopic disk is glaucoma until proven otherwise.
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true
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What risk to americans have of becoming bilaterally blind 20 years follow their G diagnosis?
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<10%
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What % of all adult Glaucoma are due to POAG?
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70%!!
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What are 4 characteristics that might suggest glaucoma?
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1- larger C/D
2- Appearances of other abnormalities 3- asymmetry b/t ONH R/L 4- progression over time |
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Do changes in RHFL come before or after VF loss?
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before, by up to 10 years
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What % of the NFL may be loss before a VF defect is noticed?
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30%
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Iis the risk of developing POAG higher or lower in AA?
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slightly higher
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How does a thin corneal thickness relate to risk for glaucoma?
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the thinner the CT the higher the risk! (this suggests a weak lamina cribosa)
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Describe a very high risk person for getting glaucoma.
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old, black with a thin cornea
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As you increase IOP, the disparity in risk b/t whites and blacks _____. (increase or decreases)
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INcreases!!
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Define glaucoma.
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a group of diseases causing progressive optic neuropathy. (disk cupping, NFL loss)
-sometimes- VF loss and/or raised IOP |
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What is the #i risk factor for glaucoma?
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IOP
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What factor is most important for diagnosis of glaucoma?
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Optic disk examination
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Where is the most resistance to aqueous outflow?
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at the TM
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How much Vit. C would be required to be an affective way of treating Glaucoma?
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5 grams/ day
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What are some reasons to do gonio?
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1- high pressure--to assess the angles
2- diabetic patient 3- ischemic situation 4- inflammatory situation 5- past trauma |
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Name 5 general theories related to the etiology of glaucoma.
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1- apoptosis gone wild (ganglion cells)
2- glutamate and Ca infulx 3- vascular compromise 4- genetics 5- increased IOP |
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Where is the blood supply to the prelaminar and laminar areas of the ONH derived from?
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short post. ciliary artery
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T or F: nocturnal systemic hypotension is also a risk factor for the development of glaucoma.
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True, dont give B-blocker at night
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About 3% of patients with _______ also have a mutation in the GLC1A gene.
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adult-onset POAG
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What is the normal amount of diurnal fluctuation on IOP?
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3-5 mmHg
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When is IOP commonly the highest? ( time of day)
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in the very early morning (related to cortisol)
Actually this is related to sleep. not actual clock hour |
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The higher the IOP the ______ the progression of glaucoma.
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faster
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The more fluctuations a patient experiences, the ____ the risk of progression of glaucoma.
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higher
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For every 1mmHg increase in IOP, the odds of glaucoma progression _________ by 24%.
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increase
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Has there been suggestion of a link b/t migraines and NTG?
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yes, possibly related to vasospasm and ischemia
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A hemorrhage at the disk suggests ____.
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progression
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What % of glaucom patients do NOT have elevated IOP?
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20% NTG
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NTG is more common in ____? (M or F)
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females
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What test should you order if you see a glaucomatous nerve, but the patient has normal IOP?
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a CT scan... to rule out compression of ONH by tumor
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Describe the 2 types of NTG: progressive and non-progressive.
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progressive: due to chronic vascular insufficiency
non-progressive: transient vascular shock (bleed-out) |
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What type of glaucoma is more likely to have drance hemes?
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NTG
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What are 5 characteristics of NTG?
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1- hX of disease
2- IOP<22 3- large cup relative to field loss 4- drance hems 5- field loss closer to fixation and steeper |
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How would you treat NTG?
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1- treat systemic cause
2- LOWER THE PRESSURE into the single digits |
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Define ocular hypertension.
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IOP>22 where the optic disk and VF are normal
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What syndromes are associated with the developmental form of glaucoma?
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ICE snydromes (very rare)
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T or F: there is a relationship of risks b/t coronary artery disease and glaucoma?
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True
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