Glaucoma 2

What is the next structure, in the drainage of aqueous fluid, after passing through Schlemm’s canal?

• Root of ciliary body

• Lymphatic channels

• Trabecular meshwork

• Collector channels

Answer explanation

TM — SC — CC — midscleral venous plexus— episcleral venous plexus

Which of the following topical corticosteroids have the highest chance of causing increased IOP after prolonged use?

• Fluorometholone

• Dexamethasone

• Prednisolone

• Difluprednate

Answer explanation

IOP increase d/t steroid use (greatest to least):

Difluprednate > Dexamethasone > Prednisolone > Fluorometholone > Hydrocortisone

31/F known hx of Graves and pigmentary glaucoma suddenly stopped her glau medication. She noted sweating, weight loss and hot flashes during the this time. Which glau medication did she stop?

• Timolol

• Brimonidine

• Dorzolamide

• Pilocarpine

Answer explanation

Stopping beta blockers will exacerbate symptoms of hyperthyroidism.

Which of the ff is a more distinct feature of Normal Tension Glaucoma (NTG) compared to the high tension Primary Open Angle Glaucoma (POAG)?

• Less disc hemorrhages in NTG

• Larger disc size in NTG

• Steeper optic disc margins in NTG

• Less prominent peripapillary atrophy (PPA) in NTG

Answer explanation

The following features are more characteristic of NTG:

1. Increased disc hemorrhages

2. More prominent PPA

3. More disc sloping

4. Larger disc size

5. Visual field defects deeper and closer to fixation

What is the main conclusion of the Collaborative Initial Glaucoma Treatment Study (CIGTS)?

• Tx of individuals with ocular hypertension (OHT) decreases rate of conversion to glaucoma from 9% to 4%

• Caucasians with advanced glaucoma did better with initial trabeculectomy compared to initial laser trabeculoplasty

• Initial medical and surgical therapy had similar visual field outcomes at 5 years since start of treatment

• 62% of untreated patients compared to 45% of treated patients showed progression on their visual fields

Answer explanation

CIGTS:

Determined the effectiveness of IOP lowering in preserving the visual field;

Newly-diagnosed POAG pxs were treated either with medications or trabeculectomy;

Primary outcome = visual field loss

A is finding of OHTS

B is finding of AGIS

D is finding of EMGT

*read on these studies as these will be discussed by Dr Del Rosario in his lecture on Tuesday (he will call on people daw)

How do you find Hi5 quizzes so far?

• Questions too easy

• Questions just right

• Questions too difficult