Ocular Disease 2

Front 1

Dellen

Back 1

-Depression; reversible
-Dehydration/thinning of cornea adjacent to raised corneal/limbal lesions (ptyrigium/bleb)

Front 2

Exposure Keratopathy

Back 2

-Eyelid issue that leads to K problem
-Incomplete lid closure
-Bell's palsy (CN7)
-Thyroid
-Lagophthalmos
-Floppy eyelid syndrome

Front 3

Filamentary Keratopathy

Back 3

Chronic inflammation (ie dry) of cornea leads to strands of epithelial cells in mucous form (like rubbing hands together)
-Filaments will stain

Front 4

Superficial Punctate Keratitis

Back 4

-Epithelial defects
-Most common causes: DES, BAK preservative (Travatan Z has no BAK), aminoglycosides (mean to K)

Front 5

Preservative: Thimerosal

Back 5

-Mercury
-Toxic
-Don't use more than 3 weeks
-In Viroptic

Front 6

Thygeson's superficial punctate keratopathy

Back 6

-U R a HERO if you dx this
-Recurrent episodes of foreign body sensation (6-12 yrs) with no inflam/redness
-Intraepith crumb-like opacities in central K

Front 7

Neurotropic Keratopathy

Back 7

-CN5v1 damage leads to desensitization and delayed corneal healing
-Corneal FINDINGS are worse than symtoms
-Hx: stroke, herpes, diabetes

Front 8

Recurrent Corneal Erosion

Back 8

-Past K abrasion (especially wood,fingernail) or ABMD (Cogan's) leads to poor adhesion

Front 9

Thermal/UV keratopathy

Back 9

-Welding, Skiing, Sunlamp
-Worse 6-12 hours after incident

Front 10

Dry eye dx (how much wetting?)

Back 10

PRT (phenol red thread) and Schirmer's: 10mm in 5 minutes
If unanesthetized, Schirmers = 15 mm

Front 11

Keratoconus

Back 11

-See it at puberty (eye now full-grown)
-Frequent eyeglass changes
-50% had topical allergies as kid
-Fleischer's ring
-Vogt's striae (stromal vertical lines)
-Munson's sign=downgaze, lower lid
-Hydrops=ruptured Descemet's

Front 12

Systemic causes of Keratoconus

Back 12

"TDOME"
Turner
Down's
Ostiogenesis imperfecta
Marfan's
Ehlers Danlos

Front 13

Iron deposits in cornea:
Fleischer's ring
Hudson Stahli lines
Stocker's line
Ferry's line
Kayser-fleischer ring

Back 13

Fleischer's -base of cone
Rust ring-foreign body
Hudson Stahli- benign line, lower K of elderly
Stocker's-ptergium
Ferry-Bleb
Kayser-fleischer- copper from **Wilson's disease (liver); causes cataracts at young age (hepatolenticular degen)

Front 14

Pellucid Marginal Degeneration

Back 14

-*Kissing doves,Crab claws
-Inferior corneal thinning
-Early adult-hood (not puberty like keratoconus)
-High ATR

Front 15

Which of the following can happen in pellucid and keratoconus:
Fleischer ring
Hydrops
Scarring
Vogts striae

Back 15

Pellucid: only hydrops
Keratoconus: everything

Front 16

Which K dystrophies are Autosomal Dominant and Autosomal Recessive?

Back 16

All are AD except Macular Dystrophy

Front 17

Anterior Basement Membrane Dystrophies (names)

Back 17

-Most common K dystrophy
-Weak/abnormal adhesion between epithelium and basement menbrane
-ABMD, Map-dot, EBMD, Cogan's
-50% of patients with K erosions have ABMD

Front 18

Meesman's Dystrophy

Back 18

-Ant K dystrophy (epithelium)
-1st year of life
-100's of cysts

Front 19

Reis-Buckler

Back 19

Anterior K dystrophy
Bowman's replaced with collagen

Front 20

Four types of Stromal dystrophies and respective substance

Back 20

Marilyn Monroe got high in Los Angeles Sniffing Fat
Macular-mucopolysaccaride
Granular-hyline
Lattice-Amyloid
Schnyder-Hyperlipedemia

Front 21

Macular dystrophy

Back 21

-Stromal K dystrophy
*Only autosomal recessive
(Mac Daddy=different from others)
-Most severe stromal dystrophy
-Mucopolysaccharide deposits within stroma (cloudy cornea)

Front 22

Granular Dystrophy

Back 22

-Most common stromal dystrophy (Gr = Greatest)
-Hyline deposits in central stroma

Front 23

Lattice Dystrophy

Back 23

-Stromal K dystrophy
-Lattice-like lines of amyloid deposits in stroma

Front 24

Schnyder's dystrophy

Back 24

-Stromal K dystrophy
-Ring of crystals in central stroma
-Associated with hyperlipidemia

Front 25

Fuchs Endothelial Dystrophy

Back 25

Older women
Endothelial guttata, edema
(Guttata in periph=Hassal-Henle)
Pleomorphism(shape), Polymegathism (size)
Increased Pachs
At birth: 3,000 endoth cells
Age 70: 2,000
Edema: 500

Front 26

Posterior Polymorphous Dystrophy

Back 26

-*Early in life
-Patches of vesicles
-Typically benign
-Can get secondary angle closure (15%) from metaplasia of endoth cells growing into angle

Front 27

Megalocornea

Back 27

-X-linked (males)
-Horizontal diameter of 13mm
(11.7 is normal)
-High myope
-Lens/glaucoma problems
-Connective tissue dz: Marfans, Ehlers-Danlos syndrome, osteogenesis imp

Front 28

Microcornea

Back 28

-Diameter less than 10mm
-Hyperope, glaucoma (shallow angle)

Front 29

Haab's Striae

Back 29

Horizontal cracks in Descemet's from increase IOP
-Congenital glaucoma

Front 30

Posterior Embryotoxin

Back 30

Anteror displaced Schwalbe's line
(glaucoma risk)

Front 31

Axenfeld's Anomaly/Syndrome

Back 31

Anomaly=posterior embryotoxin+prominent iris strands
50% develop glaucoma (syndrome)

Front 32

Rieger's anomaly

Back 32

Posterior embryotoxin + Axenfeld's + displaced pupil/iris atrophy
-50% develop glaucoma

Front 33

Reiger's Syndrome

Back 33

-Anomaly + Mental retardation and skeletal abnormalities
-50% develop glaucoma (Axenfeld syndrome)

Front 34

Progression of diseases for line/strands/glaucoma/iris/pupil?

Back 34

PARR
Post Embr = line
Axen anom = strand (syndr=glaucoma)
Rieger's anomaly = pupil/iris
Rieger's syndrome = body

Front 35

Peter's anomaly

Back 35

-Central corneal opacity with iris adhesions
-50% glaucoma

Front 36

Aniridia

Back 36

75% glaucoma
Foveal hypoplasia
Chorodial coloboma

Front 37

Limbal dermoid

Back 37

Dense connective tissue that is commonly located at inferotemporal limbus

Front 38

Bacterial Keratitis

Back 38

-Most common etiology of infectious keratitis (*aka ulcer)
-*Infiltrate w/ overlying epi defect (ulcer)

Front 39

Gram(+) bacteria

Back 39

Staph, Strep, Clostridium, Corny, antrax

Front 40

Bacteria that can penetrate intact epithelium

Back 40

"Canadian Professional National Hockey League" CPNHL
Corneybacterium diphtheriae
Pseudomonas aeruginosa
Neisseria gonorrhea
Haemopilis
Listeria

Front 41

Fungal Keratitis

Back 41

-Feathery edges
-Plate on Sabouraud's agar

Three main risk factors:
1-Trauma involving vegetable matter
2-Long-term steroids use
3-Chronic ocular surface dz (dry eye, neurotrophic keratopathy)

Front 42

What fungus is part of normal flora?
aspergillus
fusarium
candida
pneumocystis pneumonia

Back 42

Candida

Front 43

Acanthamoeba Keratitis

Back 43

-"I can't believe ya" (acanthamoeba) would do that w/your CLs
*-Pain is greater than signs suggest (looks like SPK but more pain)*
-CL hygiene (tap water, swiming)
-Ring ulcer (late finding, transplant time)
-Culture in heat killed e.coli plate

Front 44

HSV

Back 44

-Edges of ulcer stain well with rose
-Center stains w/fluorescein
-*Disciform keratitis (disc shaped stromal keratitis due to endothelitis and edema)
-Interstitial Keratitis
-Giemsa stain culture>giant cells
-If epithelium is intact>steroids
-Stromal scarring = decr acuity
-#2 cause of corneal blindness (#1=trauma)

Front 45

HZV

Back 45

-Reactivation of chicken-pox virus
-If young, think imunocomp.
-*Prodrome (fever, malaise, tingling)
-Post herpetic neuralgia BAD pain
-Hutchingson's sign=higher risk of ocular involvment (nasociliary nerve of CNV)
-*No terminal bulbs (stuck-on appearance)
-*The entire lesion stains with rose and poorly with NaFl (HSV stains edges with Rose, all with NaFl)

Front 46

Interstitial Keratitis

Back 46

Stromal swelling without primary involvment of epi or endo.
**Syphilis 90%**
-*Triad:Saddle nose, hutchinson's teeth, Frontal bossing (signs of congenital syphilis)

Front 47

3 disease that cause Peripheral Ulcerative Keratitis (PUK)

Back 47

Mooren's ulcer
Staphylococcal Marginal Keratitis
Collagen vascular disorders (RA, lupus, Wegener)

Front 48

Mooren's Ulcer

Back 48

-Vasculitis of Limbal vessels>necrosis>ulcers
-Independant of systemic disorder
-Mid-stage ulcer with overhanging edge
(think, Jared Moore cliff hanging)
-Unilateral, benign, older

Front 49

Staph marginal keratitis**

Back 49

-Immune-mediated result of under-treated chronic bleph (staph)
-Multiple stromal infiltrates with no epi staining
(Infiltrate is sign of immune system, NOT infection)

Front 50

Corneal signs of Collagen vascular disorders

Back 50

-RA, Lupus, polyarteritis nodosa, wegener granulomatosis)
-Peripheral corneal thinning (that's where the antibodies can access)
-Associated scleritis/episceritis
-K sicca

Front 51

Terrien's Marginal Degeneration

Back 51

-Men over 40
-Progressive thinning in periphery
-ATR astigmatism
-Only one that starts superiorly

Front 52

Salzmann's nodular Degeneration

Back 52

-Female predilection
-Blue-grey stromal opacities (nodule)
-Seen with K sicca

Front 53

Band K

Back 53

-Gout, hypercalcemia, JRA, iritis
-Calcium deposits like "swiss cheese" on anterior surface of bowmans

Front 54

Corneal Arcus

Back 54

-Lipid deposition on bowmans and decemet's
-Unilateral arcus *Carotid Disease*
-If under 40 lipid profile is warranted

Front 55

Corneal graft rejection

Back 55

Khodadoust line-endo (WBC; dd=endo)
Krachmer's spots-stroma
Type 4 hypersensitivity

Front 56

Absolute counterindications for refractive sx

Back 56

<21yo, refractive instability, keratoconus, contact lens warpage, immunosuppression (systemic steroids), active HSVeK, Connective tissue disease, unrealistic expectations

Front 57

Potential complications of LASIK (laser in situ keratomileusis)

Back 57

Ectasia (keratoconus), DLK (diffuse lamellar keratitis), higher incidence of dry eye

Front 58

Potential complications of PRK (photorefractive keratectomy)

Back 58

Regression, glaucoma (steroids), corneal haze

Front 59

Potential complications of RK (radial keratotomy )

Back 59

(radial incisions) Hyperopic shift, diurnal fluctuations

Front 60

NS
-Refractive error shift
-Etiology

Back 60

-Myopic shift, "second sight"
-Diffusion of glutathione from aqueous to nucleus of lens diminishes w/age

Front 61

Cortical
-Refractive error shift

Back 61

Hyperopic shift

Front 62

PSC

Back 62

Affect near vision more than distance
-systemic steroids
-X-rays

Front 63

Presenile Cataracts

Back 63

DM, myotonic dystrophy (PSC christmas tree), wilson's, hypocalcemia, *atopic dermatitis*

Get MAD about cataracts early in life

Front 64

Tramatic cataracts - clinical manifestation

Back 64

Vossius ring

Front 65

Toxic cataracts

Back 65

Chlorpromazine: stellate cataracts
Amiodarone: deposits
Miotics: vacuoles
Gold salts: gold deposits

Front 66

Disease that can cause lens subluxation

Back 66

Marfan's (up and out), Ehlers-danlos, homocystinuria

Front 67

Most serious complication of Marfan's

Back 67

RD
(also superotemporal lens sublux)

Front 68

When measuring axial length to determine IOL power for cataract surgery, 1mm represents how many diopters?

Back 68

3 D

Front 69

Drug C/I before sx

Back 69

Anticoagulents, Tamsulin (flowmax), prostaglandins

Front 70

Acute postoperative bacterial endophalmitis
-Prognosis
-Infecting agent

Back 70

1/1000, 50% go blind in that eye
-Staph epidermis
-Hypopyon
-Occurs within days

Front 71

PCO (after-cataract)

Back 71

-2-6 months after sx
-Elschnig pearls (type of PCO in children)

Front 72

Post Sx Cystoid Macular Edema

Back 72

-Called Irvine-Gass syndrome
-Happens in 6-10 weeks
-Can be prostaglandin-induced

Front 73

Asteroid hyalosis

Back 73

-Unilateral 75%
-Usually asymptomatic
-Calcium-phosphate soaps

Front 74

Synchysis Scintillans

Back 74

-Golden brown cholesterol crystals that often settle in inferior vitreous
-Occurs after chronic uveitis, vitreous heme, trauma

Front 75

PVD

Back 75

-Prevalence approximates age (50yo=50%, 75yo=75%)
-Acute onset of floaters, flashes of light, decreased VA
-Weiss ring
-Tobacco dust (Shafer's sign) w/retinal break
-10% have RD

Front 76

Vitreous Heme

Back 76

-Diabetes**
-Trauma, HTN, BRVO, PVD, ARMD, Sickle,
-Pre-retinal is boat-shaped

Front 77

What systemic conditions can cause tractional detachments?

Back 77

Diabetes, sickle cell ret, ROP, Ocular ischemic syndrome, vascular occlusion

Front 78

Does a CRVA or a CRVO release VEGF?
Ischemia vs hypoxia?

Back 78

CRVO: sick retina can release VEGF
CRAO: dead retina can't release VEGF

Ischemia is reduced blood flow, which results in hypoxia.
However, hypoxia can occur if blood has insufficient O2

Front 79

CRVO

Back 79

-All 4 quadrants
-Collateral veins can form over weeks-months and drain retina to choroid
-Usu involves artery compressing vein (due to HTN, DM)
-90-day glaucoma from NVI
-Ischemic=10DD of non-purfusion, 20/200 or worse
-Non-ischemic 20/40 or better
-Concern: Macular disease (isch, edema, ret heme), Neo (heme, glaucoma, RD, vitr heme)

Front 80

BRVO most common quadrant

Back 80

-Superior temporal
-Most common vasc occlusive dz
-Concern: same as CRVO
(macular ischemia/edema, neo)

Front 81

CRAO

Back 81

-White in all 4 quadrants
-HTN 67%
-Emboli are usually (1)*calcific from heart (2) Hollenhorst cholesterol from carotid
-CRAO more common than BRAO
-20/400 or worse unless cilioretinal artery is present (15-20% of population; from choroid)
-APD, cherry red spot
*Narrowed arteries may be only sign patient had CRAO
-Giant cell arteritis, collagen vascular disease, sickle

Front 82

BRAO

Back 82

90% involve temporal
-Mostly Hollenhorst
-Leave permanent VF defect when resolve

Front 83

Diabetic Ret

Back 83

-Leading cause of new cases of blindness in US in ages 20-74
**-NEO in DM is always pre-retinal
-Damage to pericytes
-Snowflake cataracts
-Worry about:
1-Macular edema/ischemia
2-Neo:pre ret hemes, tractional ret detatchmnt, NVI/glaucoma

Front 84

Rule of 4-2-1

Back 84

Patient is labeld severe NPDR (10-50% develop PDR in 1 year) if they have one or more:
4)severe hemes in 4 quadrants
2)venous beading in 2 quadrants
1)Irma in 1 quadrant

Front 85

Proliferative diabetic ret

Back 85

5% of diabetics have PDR (95% NPDR)
Vitreous or preret hemes, tractional RD, neo, glaucoma

Front 86

Treatment for PDR is delayed untill High Risk Characteristis (HRC)are shown, what are they?

Back 86

1)NVD greater than 1/4 DD
2)Any NVD/NVE with vitreous or pre-ret heme

Front 87

CSME criteria

Back 87

-Most common reason for legal blindnes in Diabetic Ret
-To be diagnosed with CSME, one of the following must be present:
1)Thickening within 1/3DD of foveal center
2)Exudate within 1/3DD
3)Thickening of at least 1DD within 1DD

Front 88

Hypertensive Ret

Back 88

-Vessels constrict (autoregulate) to decr flow
-Vision is usually unaffected unless macular edema (macular star - exudates) serous RD, vein occlusion, papilledema

Front 89

HTN Ret grading

Back 89

1) Increased light reflex, narrowing
2) Nicking
3) Hemes, CWS, exudates
4) Papilledema, macular star

Color shows at 3

Front 90

Retinal macroaneurysm

Back 90

-Circinate exudates
-60+ yo women
-HTN/atherosclerosis

Front 91

Ocular Ischemic Syndrome

Back 91

-65 yo man
-Gradual vision loss, pain, amaurosis fugax
-Unilat midperiph dot/blot
-NVD, NVI
-Atherosclerosis, Arteritis

Front 92

Amaurosis Fugax

Back 92

1) Monoc vision loss (seconds to minutes)
2) Carotid artery embolus

Front 93

Coats

Back 93

-8yo boy with unilateral leukocoria (ddx retinoblastoma, ROP), strab
-Tons of exudates (can lead to exudative RD)

Front 94

ROP

Back 94

-Born less than 36 weeks
**Temporal retina subject to neo and tractional RD
-Temporal retinal vessels develop around 9mo

Front 95

ARMD

Back 95

-Chief cause of vision loss in 50+ Caucasians
-Dry:asymptomatic or gradual VA loss, *drusen, mottling,
-Worst form of dry ARMD:
Geographic atrophy
-Wet:Sudden, distortion (amsler)

PED can happen w/dry or wet

Front 96

Pathophysiology of Dry and Wet AMD

Back 96

Dry: disease of RPE, Bruch's, and choriocapillaris
Wet: abnormal RPE and choriodal neovascular membrane (CNV) w/subret fluid

Front 97

4 types of leakage associated with wet ARMD

Back 97

1)Sub-RPE heme:grey-green
2)Sub-RPE detachment: plasma under RPE (also called **PED); can happen in dry or wet
3)Sub retinal heme
4)Sub retinal detachment (plasma-serous retinal detatchemt)

(2 fluids, 2 potential spaces)

Front 98

4 big risk factors for dry going wet?

Back 98

*multiple soft drusen
*focal hyperpigmentation
HTN
smoking

Front 99

Central Serous Choroidopathy

Back 99

-Type A middle aged men
-Sudden unilater vision loss/metamorphopsia
-Bruch's breakdown
-40% recurrence
-Macular serous detatchment
-Fluorescein angiography: gradual pooling or smokestack
-Self-resolve 1-3 months

Front 100

Histoplasmosis

Back 100

-Whites, Ohio/MS valley
-Fungus
-30% recurrence
-Chorioretinitis (no vitritis like toxo)
*Triad:
1) Peripapillary atrophy
2) Punched out lesions
3) Maculopathy (CNV)

Front 101

High myopia

Back 101

>6D
-Axial length> 26mm
-Oblique insertion of disc
1) Fuchs' spots (hyper pigmentation)
2) *Lacquer cracks (yellow streaks)
3) *Macular holes
4) Posterior staphyloma

Front 102

Lacquer cracks

Back 102

Fine yellow lines that represent large breaks in bruch's
-Neo can occur

Front 103

Epiretinal membrane

Back 103

-Glial cells from retina grow out a hole in ILM
-Contraction of membrane can wrinkle retina
-Mild=cellophane
-Severe=pucker
-Cause: PVD, RD, sx, trauma idiopathic

Front 104

Macular Hole

Back 104

-Women (...)
-Round red spot, vision 20/200
-Stages:1)yellow, 2)hole/pseudo operculum, 3)hole with operculum, 4)hole+detatchment
-PVD, if other eye already has PVD no risk

Front 105

Cystoid macular edema

Back 105

-Post cataract sx (Irvine-Gass)
-Prosaglandin induced

Front 106

Macular Photostress Test

Back 106

-Look at light for 10 sec
-Time to read 1 line less than BVA
-Should be <1min

Front 107

Retinitis Pigmentosa
(triad)

Back 107

-Dominates (*Autosom Dom) periph & central
-Usually heritable but also associated with Usher's syndrome (hearing loss) 5%
-*Most common retinal dystrophy
-Night blindness/tunnel vision
-By 30yo 75% are symptomatic
-Triad: bone-spicule pigment, arteriolar attenuation, waxy optic disc pallor

Front 108

Cause of RP?
Testing?
Retinal signs centrally?

Back 108

Cause: progressive loss of RPE
Test: ERG (scotopic reduced)
Signs: CME, ERM, mac holes, PSC

Front 109

Stargardt's

Back 109

-Typically diagnosed between age 6-20
*Vision loss out of proportion to fundus appearance.
-Most common hereditary macular dystrophy
-Fundus flavimaculatus (stargardt's without macula involvment)

Signs:
-Yellow flecks shape: pisciform (fish tail)
-*Beaten-bronze macular pattern
-Salt and pepper pigment changes (syphilis)
-Dark choroid

Front 110

Differentials for bull's eye maculopathy

Back 110

Stargardt's, cone dystrophy, chloroquine/hydroxychloroquine, thioridazine toxicity

Front 111

Best's Disease
(Vitelliform dystrophy)

Back 111

-"Best macular dystrophy to have until 50 yo"
-"Who has the best egg (eog)"
-Young 5-10yo
-Bilateral, Yellow round egg yolk lesion (lipofuscin in RPE) under fovea; scrambled egg = bad
-CNV
-Abnormal EOG. Normal ratio (light peak:dark trough ratio) is 1.8; Best is about 1

Front 112

Gyrate Atrophy

Back 112

-Young, by 10
-Night blindness (nyctalopia)
-Scalloped areas of periph chorioret atrophy
-Deficient in mitochondrial enzyme ornithine aminotransferase

Front 113

Rhegmatogenous Retinal Detatchments

Back 113

-RD caused by hole/tear
-Floater, flashes, curtain
-Demarcation line>chronic RD

Front 114

Signs and causes of Rhegmatogenous RD

Back 114

Signs: undulating retina, Shafer's sign (pigment cells; aka tobacco dust), low IOP

Causes: atrophic holes, vitreo-retinal traction tears (PVD), weaker connection between RPE and photoreceptors

Front 115

*LATTICE DEGEN*

Back 115

-*Found in 6-10% people
-Only 1% of people w/lattice will develop RD
-Bilateral, temporal, superior

Front 116

Non-Rhegmatogenous

Back 116

-Tractional from Proliferative DB ret
-Serous from ARMD

Front 117

Retinoschisis

Back 117

-Splitting of outer plexiform layer
-4-7% general population >40yo
-Dome shaped bullous elevation located inferior/temporal that doesn't move (not RD)
-Absolute VF defect
-May have retinal breaks (outer or inner)

Front 118

Angiod Streaks

Back 118

"PEPSI"
-Pseudoxanthoma elasticum is most common cause
-Streaks from the disc like spokes
-Elastic layer of Bruch's membrane

Front 119

Risk factors for POAG:

Back 119

-IOP: only one we can control
-Race: Afr Am 4-5x more likely
-Family history: 16%
-Age
-Thin corneas

Front 120

POAG

Back 120

-IOP >21 mm Hg
-If damage at lower IOP=normal tension gl
-Signs: focal vertical thinning, notching, NFL defect, C/D ratio, drance heme

Front 121

Port-Wine Stains

Back 121

Vascular birthmarks highly associated w/ipsilateral glaucoma (45%).

Rarely associated w/systemic disorders (Sturge-Weber Syndrome)

Front 122

Pseudoexfoliation Syndrome

Back 122

-Caucasians, Scandinavian decent, 60 yo
-White, flaky amyloid deposits on pupil margin, lens capsule, TM
-Sampaolesi's line: pigmentation on Schwalbe's line (also seen in pigment dispersion syndrome)
-Happens in older people (epithelial cells and BM get old and release stuff)

Front 123

Pigmentary Dispersion Glaucoma

Back 123

-Caucasians, 30 yo
-High ant chamber pressure causes iris to bow posteriorly, zonules scrape off pigment (50% develop glaucoma)
-Signs: transillumination defects, Krukenberg's spindle (vertical pigment line), TM pigment, Scheies line (pigment on lens)

Front 124

Normal Tension Glaucoma

Back 124

-NFL/VF damage at lower pressures (&lt;21)
-Before dx, take diurnal IOP readings
-Signs similar to POAG but drance heme (splinter heme) is more common
-Ddx: myocardial infarction, anemia, syphilis, vasculitis

Front 125

Primary Angle-Closure Glaucoma

Back 125

-Acute or subacute (intermitten)
-Periph iris pushes anteriorly, blocking TM
-Cause: lens growth w/age
-Cause: mid-dilated pupil, highest risk after dilation and pupil constricts to mid position
-2 causes: pupillary block (more common; hyperopes) and plateau iris syndrome
-Vomit, intense oc pain, HA, halos, nausea
-Lower IOP (50-100) and do PI
-Greatest threat: CRAO

Front 126

Glaucomflecken

Back 126

Type of cataract (anterior subcapsular opacities from lens epith ischemia) associated with previous primary angle-closure glaucoma

Front 127

Neovascular Glaucoma
(Secondary Angle-Closure Glaucoma)

Back 127

-Cause: CRVO, Diab, CRAO (ret ischemia)
-Sign of neovasc glaucoma: rubeosis of iris
-Examine pupil margin for neovasc tufts
-Neo in angle makes fibrovasc membrn, impedes aqueous outflow

Front 128

Uveitic Glaucoma
(Secondary Angle-Closure Glaucoma)

Back 128

-Cause: periph ant synechiae, post syn
-Iris inflammed & sticky (adheres to TM/lens)

Front 129

Glaucomatocyclitic Crisis

Back 129

A type of Inflammatory Glaucoma
(Secondary Angle-Closure Glaucoma)
-aka Posner-Schlossman syndrome
-Cause: acute trabeculitis
-40-60 IOP, angles open
-Recurrent unilat attacks

Front 130

Fuch's Heterochromic Iridocyclitis

Back 130

A type of Inflammatory Glaucoma
(Secondary Angle-Closure Glaucoma)
-Chronic non-granulomatous anterior uveitis
-Glaucoma & cataracts
-Unilat, iris different color