Glaucoma

Question 1

Define ocular HtN

Answer 1

IOP greater than 21
Per the OHTT study, iop greater than 24 in pt with open angle no ON damage

Question 2

Important risk factors for primary open angle glaucoma

Answer 2

Iop
Race
Family hx
Age
Thin corneas

Question 3

Patients with pachy > 555um are at ___ risk of POAG

Pt with pachy < 555um are at ____ risk of POAG

Pt with 555-588um pachy are are what risk

Answer 3

Patients with pachy > 555um are at less risk of POAG

Pt with pachy < 555um are at greater risk of POAG

Pt with 555-588um pachy , no change of risk based on CCT

Question 4

Most common visual field loss
Other relatively common

Answer 4

Nasal step
Others common:

Question 5

Port wine stain

Answer 5

Vascular birthmark (ant Seg) associated with ipsilateral glaucoma

Question 6

Pseudoexfoliation syndrome

Answer 6

• Systemic condition common in white
• high iop and resultant glaucoma
• abnormal white flaky deposits on pupil margin and lens capsule in bull’s eye pattern

Question 7

What does the gonio on a pt with pseudoexfoliation syndrome reveal

Answer 7

Sampaolesi’s line due to pigment accumulation that is released from deposits rubbing against posterior iris epithelium

Pigment anterior to Schwalbe’s line

Question 8

PXF, due to weak lens zonules, is associated with …

Answer 8

Poor pupil dilation

Increased risk of lens subluxation

Cataract surgery complication

Question 9

Risk of developing glaucoma is __% within 10 years

Answer 9

15%

Question 10

Pigmentary dispersion glaucoma is bilateral and usually impacts who

Answer 10

Myope
White people
Young patients (30-40)

Question 11

Describe pigmentary dispersion glaucoma

Answer 11

Bilateral
High pressure that causes bowing of iris posteriorly, creating contact between it and lens zonules

Pigment sheds off back of the iris

Question 12

Pigment dispersion glaucoma :Symptoms

Answer 12

Asymptomatic but pt can have
- blurry vision
- Halos around lights after exercising or pupil dilation

Question 13

Signs in SLE for pigment dispersion glaucoma

Answer 13

• transillumination defects
• krkenberg spindle- vertical pigm on endo
• pigment on anterior capsule
• TM hyperpigmentation

Question 14

What type of damage is being observed in pigment dispersion glaucoma

Answer 14

Damage to TM - hyperpigmentation
IOP will remain elevated

Question 15

Pigment dispersion glaucoma

Risk of developing glaucoma at 5 years is
Risk of developing glaucoma at 15 years

Answer 15

10%
15%

Question 16

Characterize angle recession glaucoma

Answer 16

Wide open angle with recessed iris and widened CB band.
TM is damaged resulting in glaucoma risk over time

Question 17

Normal tension glaucoma

Answer 17

NFL damage at lower pressures.
IOP is less than 21 with open angle on on gonio

Question 18

Who is at greater risk of normal tension glaucoma

Answer 18

Females
Highest prevalence among Japanese
Pt with vascular disorders: Raynaud phenomenon, low bp, sleep apnea, hypercoagulation, taking bp meds before bed time

may decrease ocular perfusion pressure

Question 19

The ocular hypertensive treatment study showed that 9.5% of untreated ocular hypertensives converted to glaucomatous damage or field loss. in how many years?

Of those who were treated to at least a 20% decrease in IOP during the same period, how many converted to glaucomatous damage?

Answer 19

5 years

Just 4.4%

Question 20

Lumigan is also referred to as

Answer 20

prostamide

has an amide group on the 1st carbon