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33 Cards in this Set
- Front
- Back
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Why gonioscopy?
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- AC see
-Narrow Ac by Van-herrick 2degree -angle closure -classification of Gl -iris neovascularization -assess angle recession -neoplasm - hystory of trauma -perepherial antherior synechiae -retinal-macular assessment |
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3-mirror Goldman:
central lens |
macula
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3-mirror Goldman trapezoid lens
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posterior pole to equator
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3-mirror Goldman:
rectangular lens |
equator to begining of ora serrata
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3-mirror Goldman:
thambnail lens |
ora serrata(dilated)
AC undilated |
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gonioscopy stat datas
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2-5% population anatomicaly narrow angle
occludable angles-1.6% angle closure GL-0.09% |
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plateau iris
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rare
younge angle closure could be after dilatation, due to folding of iris on perephery on top of trabecular meshwork |
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pupilary block
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iris and lens
in process of recovering from dilatation |
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normal AC angle
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I can see the line
iris ciliary body scleral spur trabecular meshwork schwalbe line |
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risk of angle closure
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1/2 of trabecular meshwork visible
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angle wide open
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u can see ciliary body
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angle is closed
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no structures are visible
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widest angle
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inferior
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narrowest
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superior
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less than 180 anggle resession
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rare development of gl
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180 anggle resession
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4-9% resession
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240 anggle resession
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high risk of gl
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iridocorneal endothelial syndrom (ICE)
-cogan-rees syndrome |
hummered silver aperance of corneal endothelium+ corneal failure+gl+iris destuction
iris strached wt holes, nodules, angle closure wt membrane formation |
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Cogan-reese syndrome
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pigmented nodules+ICE
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Chandlers syndrome
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corneal edema
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Essential iris atrophy
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corectopia, stratch holes
melting holes |
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cyclodialysis
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ciliary muscle separated from scleral spur
trauma |
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Sampaolesi's line
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pigment in anterior wall in scalloped pigmented wave
-above Schwalbe's line usually inferior angle associated wt pigment dispersion or exfoliation syndrome |
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Axenfeld-Rieger Syndrome
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Iris tissue inserting into prominent Schwalbe's line
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Gonioscopy indications
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-see angle
-narrow Ac angle 2(van herrick) -risk to gl (IOP assymetry) -angle assymetry -evidence of angle closure -classification of gl -risk of iris neovascularis -assess angle ressesion -iris cysts or tumors -history of trauma or foreign body -perepherial anter synechiae |
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Gonioscopy cotraindication
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postoperative eye
trauma-hyphema corneal abrasions-erosions |
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direct goniolens
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koeppe
high+lens |
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corneal goniolenses
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4 mirrors
Posner Zeiss Sussman |
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Schwalbe's line
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Termination of cornea
DEscement, Sampaolesi's line is pigmented SL |
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Trabecular meshwork
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Anterior-unpigmented
Posterior-pigmented |
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Scleral spur
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Attachment of ciliary muscule
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ciliary body
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usually most pigmented-iris processes
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AC angle grading and recording
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- most posterior stucture
- angular approach - pigment - iris processes - angle recessions - synechiae - foreign body |
