Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/91

Click to flip

91 Cards in this Set

  • Front
  • Back
what are you examining with gonio?
the anterior chamber
The ant. chamber angle is the filter and exit point for what?
aqueous humor
what physiological process affects the risk for glaucoma? What is the state of the angle which causes concern?
dilation, the narrowness of the angle.
Would you perform gonio after noticing a small angle when doing the Van Herrick technique?
of course!
Would you do gonio if the patient has a history of angle closure?
yes
Would you do gonio to rule out ischemic NVI? What could you rule out?
yes, rule out uncontrolled diabetes and vein occlusion
Would you do gonio to assess a peripheral anterior synechia?
yes
Name 5 others reasons to perform gonio.
1-suspect glaucoma
2- evidence of NVI
3- evidence of neoplasms in AC or on iris behind limbus
4- evidence of inflammation or trauma
5- evidence of degenerative conditions of the anterior segment.
What structure of the eye prevents you from seeing the angle with just using the slit lamp?
the opaque white nature of the limbal cornea.
What quantifies the anterior chamber angle?
anatomical zone b/t the iris root and descemet's membrane.
What is the critical angle of total reflection dependent on?
the refractive indices on either side of the interface.
How does the design of the gonio lens enable you to view the angle. (long answer)
the gonio lens involves placing a concave surface against the cornea-- this eliminates the cornea as a refracting surface. The obliquely inclined mirrors allow observation of the anterior chamber structures.
What amazing and super talented man designed the gonio lens we use today?
Goldmann
any small difference in curvature b/t the lens and the cornea is minimized by a ______ b/t the 2 surfaces.
fluid
What distinguishes the various gonio lenses?
the diameter of their contact surface.
Small gonio lenses have a diameter of___? Large is____?
<10 mm, >13 mm
What do large lenses require?
require an interface solution (used to mask the air/cornea interface difference)
(Large=Liquid)
What is the name of the 3-mirror?
Goldmann
What are 3 names of 4-mirror lenses?
1- Posner
2- Zeiss
3- Sussman
What is the name of a single high plus lens?
Koeppe
Describe a direct lens system.
this uses a high convex lens to view the AC. (no mirrors)
Describe an indirect lens system.
this uses mirrors + a slit lamp for AC evaluation.
Goldmann contains 3 ______mirrors and is thus
a(n) ________ system?
internal mirrors, indirect
A D-shaped mirror is used to view the______?
AC angle
The trapezoid mirror is used to view the _____?
mid-peripheral retina
The cylindrical mirror is used to view the ____?
ora seratta
Goldmann 3-mirror requires the use of____?
a viscous gel
How many of the 3 mirrors is used to evaluated the angle?
only 1
The center lens may be used to get a _____ view of the post. pole.
magnified
Does the Koeppe gonio lens have mirrors?
No!!
The Koeppe is a ____ view of the angle?
direct
How many diopters is the koeppe gonio lens?
50D
Compare the mag of the koeppe to the mag of ziess and goldmann.
The koeppe gives a Lower mag.(~1/2) As a result the field of view is doubled and has less distortion.
When using the koeppe, do you need a slit lamp?
No, patient lies down, face up.
Does the koeppe lens require a viscous solution?
yes
When using the koeppe lens the clincian views the angle _____ of where he is located.
opposite
What are 2 gonio lens that require a viscous solution?
1-goldmann
2-koeppe
(any lens that has a large corneal contact area)
What are 2 choices of viscous solutions?
1- goniosol
2- celluvisc
what is an advantage of using goniosol? a disadvantage?
advantage= better view, less bubble formation
disadvantage= allergic RXN to the preservative BAK
What is an advantage of using celluvisc? disadvantage?
advantage= less corneal disruption
disadvantage= greater frequency of bubble formation.
What are the needed supplies when performing goldmann 3-mirror? (5)
1- lens
2- soap, water, saline, and 2% glutaraldehyde
3-anesthetic
4-methylcellulose sol'n
5-slit lamp
What will you use to numb the patient while doing gonio?
0.5% proparacaine
what mag do you use for goldmann gonio?
16X
What size beam for goldmann gonio? ______wide and ____ tall?
wide parallelopiped, ~4mm wide, and maximum height.
What angle should your light housing be when doing goldmann gonio?
0 degrees
The Koeppe is a ____ view of the angle?
direct
How many diopters is the koeppe gonio lens?
50D
Compare the mag of the koeppe to the mag of ziess and goldmann.
The koeppe gives a Lower mag.(~1/2) As a result the field of view is doubled and has less distortion.
When using the koeppe, do you need a slit lamp?
No, patient lies down, face up.
Does the koeppe lens require a viscous solution?
yes
When using the koeppe lens the clincian views the angle _____ of where he is located.
opposite
What are 2 gonio lens that require a viscous solution?
1-goldmann
2-koeppe
(any lens that has a large corneal contact area)
What are 2 choices of viscous solutions?
1- goniosol
2- celluvisc
what is an advantage of using goniosol? a disadvantage?
advantage= better view, less bubble formation
disadvantage= allergic RXN to the preservative BAK
What is an advantage of using celluvisc? disadvantage?
advantage= less corneal disruption
disadvantage= greater frequency of bubble formation.
What are the needed supplies when performing goldmann 3-mirror? (5)
1- lens
2- soap, water, saline, and 2% glutaraldehyde
3-anesthetic
4-methylcellulose sol'n
5-slit lamp
What will you use to numb the patient while doing gonio?
0.5% proparacaine
what mag do you use for goldmann gonio?
16X
What size beam for goldmann gonio? ______wide and ____ tall?
wide parallelopiped, ~4mm wide, and maximum height.
What angle should your light housing be when doing goldmann gonio?
0 degrees
What solution do you use to soak the gonio lens?
2% glutaraldehyde
The D-shaped mirror will be located ______ when on the eye.
superiorly
The angle is viewed ____ from the mirror.
180 degrees
If the mirror is at the 12:00 position, the angle viewed is at _____?
6:00
With the gonio lens in place, in which direction will you push the slit lamp(in, or out?) to bring the structures into focus?
push in towards the patient.
You must _____ the lens to view all of the angles.
rotate
The light beam must be ______ to the flat surface of the "D".
perpendicular
To view lateral angles, the slit beam should be rotated to the ______ position.
horizontal
T or F: It is best to forcefully pull the lens off of the cornea when you are done.
False--this will cause corneal trauma!
T or F: There is no need to perform a parallelopiped scan of the cornea after gonio.
False! You must do this, and you may need to use a FL strip.
What has happened if you see stippling over the entire cornea when you are scanning?
Patient had a reaction to goniosol
What has happened if you see patchy puntate staining?
patient RXN to proparacaine.
Describe the procedure for cleaning the gonio lens.
1- 2% glutaraldehyde soak for 20 minutes
2- sterile saline rinse
3- dry with a lint free tissue or cotton towel
4- replace in lens container
What is the best choice for performing gonio if you have to take fundus photos?
use celluvisc (instead of goniosol), this will prevent the possibility of corneal rxns. Better yet, use a 4 mirror lens (b/c it does not require a solution)
To get deeper into the angle, have the patient _____?
look toward the mirror slightly.
T or F: Always check IOP BEFORE gonio.
true
What are the 3 things a clinician needs to examine when doing gonio?
1- the openness of the angle
2- are the structures healthy?
3- anything unusual?
What is the last iris roll?
Fuchs roll
What is the most posterior AC angle structure?
the CBB ( ciliary body band )
What color is the CBB?
grayish brown-white
What does the CBB play a role in?
aqueous production
The CBB is broader ___ and ____?
inferiorly, temporally
What structure comes after the CBB?
the SS (scleral spur)
What color is the SS?
thin whitish band
What does the SS represent?
the continuation of the sclera into the anterior chamber
where is the SS?
b/t the ciliary body and the TM
What structure comes after the SS?
The TM!
The TM is like a ____? What does it do?
sieve, it drains the aqueous from the anterior chamber.
What color is the TM? What might you see in here?
translucent gray. pigment
Where will most of the pigment be within the TM? why?
the posterior portion, b/c it is the filtering point
T or F: darker eyes will have more pigment in the TM than lighter eyes.
true