24. Secondary Glaucoma

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Author:
sookylala
ID:
241161
Filename:
24. Secondary Glaucoma
Updated:
2013-11-12 04:58:48
Tags:
secondary glaucoma
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Description:
secondary glaucoma
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  1. Whats characteristic pigment deposition of PXF?
    • ring like deposit on the ant lens capsule
    • might not see it without dilation
    • also on iris
  2. Diff PXF and PDS iris transillumination?
    • PXF: seen at pupillary border
    • PDS: see more periphery
  3. Race prevalence PXF?
    northern european
  4. PXF associations?
    • reduced dilation
    • IOP spike
    • weaker zonules: subluxation
  5. DDX of PXF?
    • PDS
    • POAG
    • PACG
    • Uveitis
  6. PXF and glaucoma?
    • PXF + glaucoma: yes once optic neuropathy occurs
    • PXF w/o: yes 10-50% conversion
  7. What type of glaucoma is assoc with PXF?
    POAG
  8. PXF management considerations?
    • POAG
    • weakend zonules: cataract surgery
    • IOP spikes
    • no tx required if no POAG
  9. What is PDS?
    abnormal loss of pigment form post iris and redistributed across ant eye
  10. What causes PDS?
    rubbing of iris pigment epithelium on lens zonules
  11. What predispositions of PDS?
    • big ant chamb
    • bowed iris and posterior
    • young, myopic, white, males
  12. What is krukenberg's spindle
    abnormal golden pigment deposition on corneal endothelium seen in PDS
  13. What is scheie stripe?
    during full dilation you can see pigment deposition on the zonules near the post lens capsule
  14. Pigment in the TM?
    • PXF: segmental and patchy
    • PDS: very dark, dense and diffuse
  15. What are some assoc of PDS to other conditions?
    lattice degneration and retinoschisis
  16. how does PDS cause glaucoma?
    • pigment accumulates in TM and impairs outflow
    • IOP rises
    • optic neuropathy
    • conversion rate: 10-50% over 15 years
  17. Management of PDS?
    • no glaucoma, no tx
    • monitor IOP spike post dilation
    • document iris contours
    • monitor
  18. Prophylatic PI for pds?
    • releives pressure, bowing of iris, rubbing
    • increases better circulation
  19. DDx for PDS?
    • PXF
    • trauma+ RD: unilateral
  20. how does ant NV cause glaucoma?
    • hypoxic signal sent from the post eye
    • NV growth on iris and in AC angle
    • obstructs angle
  21. What conditions cause iris NV?
    • dia ret
    • CRVO
    • CAO
  22. Management of NV glaucoma?
    • difficult
    • PRP
    • antiVEGF
    • otherwise extensive destructive surgery
  23. inflammatory glaucoma- ACG?
    pupil blocked: nv, synechiae, iris bombe,
  24. inflammatory glaucoma- OAG?
    inflammatory cells blocking TM or steroid use
  25. PSS?
    • mild ant uv with HIGH IOP
    • OAG
  26. steroid induced glaucoma?
    spike rf: POAG, foh glaucoma, highy myopia, diabetes
  27. What is angle recession?
    • abnormal widening of CB band due to separation of muscle fibres caused by blunt trauma to the eye
    • blunt trauma compresses globe and equatorial expansion occurs
    • POAG!
  28. how does angle recession cause glaucoma?
    • disrumption of TM and laceration of CB: restriciton outflow
    • can occur yearsss later
  29. phacolytic glaucoma?
    • cataract leaking proteins in AC
    • macrophages plug TM
  30. Phacomorphic glaucoma?
    large lens blocks angle
  31. ICE and glaucoma?
    • proliferation of abnormal corneal endo cells migrating across angle and onto iris
    • blockage of TM
  32. episclearl venous pressure and glaucoma?
    chronically raised episcleral venous pressure can make it more difficult for the aqueous to exit the eye

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