OD2 > OD week4 > Flashcards

OD week4 Flashcards

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1
Q

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A

Back

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2
Q

Glaucoma – What is it?

A

A progressive optic neuropathy characterised by optic nerve damage and corresponding visual field loss, often associated with raised intraocular pressure (IOP).

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3
Q

Glaucoma – Mechanism?

A

Damage occurs due to mechanical compression of lamina cribrosa or vascular insufficiency to the optic nerve head.

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4
Q

Glaucoma – Hallmark sign?

A

Excavation (cupping) of the optic disc with corresponding visual field defects.

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5
Q

Glaucoma – Symptoms?

A

Usually asymptomatic until late; peripheral field loss leading to tunnel vision; may cause pain in acute cases.

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6
Q

Glaucoma – Diagnosis?

A

Based on optic disc appearance, elevated IOP, visual field testing, RNFL analysis, and anterior chamber angle assessment.

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7
Q

Glaucoma – Risk factors?

A

Age >40, family history, myopia/hyperopia, race (African/Asian), corticosteroid use, vascular disease, thin CCT.

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8
Q

Primary Open-Angle Glaucoma (POAG) – What is it?

A

Chronic, progressive optic neuropathy with open anterior chamber angles and raised IOP.

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9
Q

POAG – Mechanism?

A

Reduced aqueous outflow through the trabecular meshwork despite open angle.

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10
Q

POAG – Hallmark sign?

A

Open angle on gonioscopy, IOP >21 mmHg, optic disc cupping, arcuate or nasal step VF defects.

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11
Q

POAG – Management?

A

Topical hypotensive agents (prostaglandin analogues, beta-blockers, CAIs, alpha-agonists); laser trabeculoplasty; surgery if uncontrolled.

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12
Q

Normal-Tension Glaucoma (NTG) – What is it?

A

Subtype of POAG with glaucomatous damage despite normal IOP.

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13
Q

NTG – Mechanism?

A

Vascular insufficiency to optic nerve (e.g. migraine, hypotension).

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14
Q

NTG – Hallmark sign?

A

Cupping and VF loss with IOP ≤21 mmHg; more focal notching and disc haemorrhages.

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15
Q

NTG – Management?

A

Lower IOP 30% below baseline, control systemic vascular risk; same drops as POAG.

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16
Q

Ocular Hypertension (OHT) – What is it?

A

Elevated IOP (>21 mmHg) without optic nerve or VF damage.

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17
Q

OHT – Management?

A

Monitor unless high-risk (thin CCT, family history, large cup); treat with topical hypotensives if progressive.

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18
Q

Primary Angle-Closure Glaucoma (PACG) – What is it?

A

Appositional or synechial closure of the angle causing elevated IOP and optic neuropathy.

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19
Q

PACG – Mechanism?

A

Pupillary block from iris–lens contact or plateau iris configuration leading to obstruction of aqueous outflow.

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20
Q

PACG – Symptoms?

A

Intermittent blurring, halos, pain, headache, nausea, vomiting; acute attack = red painful eye.

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21
Q

PACG – Hallmark signs?

A

Shallow anterior chamber, mid-dilated pupil, corneal oedema, high IOP, closed angles on gonioscopy.

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22
Q

PACG – Management?

A

Acute: IV acetazolamide + topical beta-blocker + pilocarpine; definitive: laser iridotomy/iridoplasty.

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23
Q

Pseudoexfoliative (PXF) Glaucoma – What is it?

A

Secondary open-angle glaucoma due to deposition of fibrillar material on lens and trabecular meshwork.

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24
Q

PXF – Hallmark signs?

A

Grey-white material on anterior lens capsule and pupillary margin, transillumination defects, high IOP spikes.

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25
PXF – Management?
Topical hypotensives; may need surgery; often resistant to medical therapy.
26
Pigment Dispersion Syndrome (PDS) – What is it?
Iris pigment granule dispersion blocking trabecular meshwork causing secondary glaucoma.
27
PDS – Hallmark sign?
Krukenberg spindle on corneal endothelium, mid-peripheral iris transillumination defects, pigment in angle.
28
PDS – Management?
Topical hypotensives; laser peripheral iridotomy to prevent iris concavity; avoid vigorous exercise.
29
Neovascular Glaucoma – What is it?
Secondary angle-closure glaucoma due to new vessels obstructing trabecular meshwork and angle.
30
Neovascular Glaucoma – Causes?
Commonly from diabetic retinopathy, CRVO, ocular ischaemic syndrome.
31
Neovascular Glaucoma – Management?
Control underlying disease, anti-VEGF injection, PRP, cyclodestructive laser if painful end-stage eye.
32
Uveitic Glaucoma – What is it?
Secondary glaucoma from inflammation or steroid response causing trabeculitis or angle synechiae.
33
Uveitic Glaucoma – Management?
Topical hypotensives (avoid prostaglandins if active inflammation); control uveitis; avoid long-term steroids.
34
Phacolytic Glaucoma – What is it?
Leakage of lens proteins through hypermature cataract causing trabecular blockage.
35
Phacomorphic Glaucoma – What is it?
Lens swelling causing pupillary block and angle closure.
36
Phacolytic/Phacomorphic – Management?
Control IOP, manage inflammation, definitive cataract extraction.
37
Steroid-Induced Glaucoma – What is it?
IOP elevation due to reduced aqueous outflow from steroid use (topical, systemic, inhaled).
38
Steroid-Induced Glaucoma – Management?
Discontinue or reduce steroid; switch to non-steroidal alternative; topical hypotensives.
39
Traumatic Glaucoma – What is it?
Post-trauma glaucoma due to angle recession or ghost cell obstruction.
40
Traumatic Glaucoma – Management?
Monitor for angle recession; treat with standard hypotensives; surgery if uncontrolled.
41
Iridocorneal Endothelial (ICE) Syndrome – What is it?
Proliferation of abnormal corneal endothelium causing PAS, iris atrophy, and secondary glaucoma.
42
ICE Syndrome – Hallmark signs?
Unilateral, corneal endothelial abnormalities, iris holes, corectopia, PAS.
43
ICE Syndrome – Management?
Control IOP; glaucoma surgery often required; avoid laser trabeculoplasty.
44
Sturge-Weber Syndrome – What is it?
Congenital neurocutaneous disorder with facial port-wine stain, leptomeningeal angioma, and glaucoma.
45
Sturge-Weber – Mechanism?
Elevated episcleral venous pressure or angle anomalies.
46
Sturge-Weber – Management?
IOP-lowering meds; filtering surgery if unresponsive; manage seizures and vascular malformations.
47
Carotid-Cavernous Fistula – What is it?
Abnormal connection between carotid artery and cavernous sinus causing venous congestion and secondary glaucoma.
48
Carotid-Cavernous Fistula – Signs?
Pulsatile exophthalmos, conjunctival congestion, bruit, raised IOP.
49
Carotid-Cavernous Fistula – Management?
Treat underlying vascular fistula; IOP control with drops; neurosurgical repair.
50
Intraocular Tumour–Related Glaucoma – What is it?
Raised IOP secondary to tumour infiltration or angle obstruction (e.g., melanoma).
51
Intraocular Tumour–Management?
Treat underlying tumour; avoid filtration surgery; consider radiotherapy or enucleation.
52
Congenital Glaucoma – What is it?
Developmental anomaly of anterior chamber angle causing elevated IOP in infants.
53
Congenital Glaucoma – Symptoms?
Photophobia, epiphora, blepharospasm; enlarged cornea (buphthalmos).
54
Congenital Glaucoma – Hallmark signs?
Haab’s striae, corneal oedema, large optic cup, increased axial length.
55
Congenital Glaucoma – Management?
Surgical (goniotomy, trabeculotomy, trabeculectomy).
56
Juvenile Glaucoma – What is it?
Inherited open-angle glaucoma presenting in childhood or adolescence.
57
Juvenile Glaucoma – Management?
Topical hypotensives; surgical if refractory.
58
Aniridia – What is it?
Congenital absence of iris associated with glaucoma and foveal hypoplasia.
59
Aniridia – Management?
Monitor for glaucoma and corneal opacity; use tinted lenses.
60
Axenfeld–Rieger Syndrome – What is it?
Autosomal dominant anterior segment dysgenesis with iris strands, corectopia, and angle anomalies.
61
Axenfeld–Rieger – Management?
Monitor for glaucoma; manage with topical hypotensives or surgery.
62
Glaucoma – Medical treatment?
Prostaglandin analogues (increase uveoscleral outflow), beta-blockers (reduce production), alpha-agonists, CAIs, miotics.
63
Glaucoma – Laser treatment?
Laser trabeculoplasty (open-angle), iridotomy/iridoplasty (angle-closure), cyclophotocoagulation (refractory).
64
Glaucoma – Surgical treatment?
Trabeculectomy, tube shunts, MIGS, cyclodiode laser in refractory or neovascular cases.
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