ODP quiz 2 UPDATED ACTUAL Exam
Questions and CORRECT Answers
- CORRECT ANSWER -
Pigmentary Dispersion Syndrome (PDS)
characteristics - CORRECT ANSWER - concave bowing of peripheral iris causes physical
contact of the posterior iris with the zonules
Bilateral
YOUNG MYOPIC MALES
PDS Findings - CORRECT ANSWER - liberation of pigment from posterior iris
iris transillumination defects
Krukenberg's spindle
pigment deposition on zonules and posterior lens capsule
Uniform TM hyperpigmentation
Scheie's stripe
Focal point for 20D - CORRECT ANSWER - 2 in
Complications for PDS - CORRECT ANSWER - RD
,exercise activates dispersion
can have large diurnal variations in IOP as well as spikes in IOP due to pigment release and
exercise
PDS conversion to pigmentary glaucoma - CORRECT ANSWER - underdiagnosed in
black patients
10-20 convert to gluacoma
Pigmentary Glaucoma
characteristics - CORRECT ANSWER - pressure elevates and causes glaucomatous
changes to optic nerve in those with PDS
must have ONH changes
thought to be pigment granules accumulate in the TM and cause dysfunction of trabecular
endothelial cells
Older you get, the less pigmentation and krukenberg spindles due to lens pushing the iris forward
treatment of pigmentary glaucoma - CORRECT ANSWER - Pilocarpine
glaucoma meds
peripheral iridotomy
-laser hole to neutralize anterior and posterior pressure
-studies show no benefit
-low risk procedure
,ALT (argon laser trabeculoplasty)
SLT( selective laser trabeculoplasty)
Pseudoexfoliation syndrome - CORRECT ANSWER - made of elastic fibers (fibrillin and
alpha-elastin) and non-collagenous basement membrane material (laminin) that forms fibrils
coated with glycosaminoglycan hyaluronic acid
PES associations - CORRECT ANSWER - hyperhomocystemia
high caffeine usage
LOXL1 (lysyl oxidase-like 1) gene
PES findings - CORRECT ANSWER - patchy hyperpigmentation of the TM
pigment mixed with amyloid
Kurkenberg spindles
Bulls eye lens
PES Complications - CORRECT ANSWER - don't dilate well
can have marked increase in IOP following dilation
use apraclonidine/iopidine before dilation to prevent spike
, phenylephrine causes more amyloid release than other dilation drops***
more complicated cataract surgery
lens can dislocate
slightly higher risk for Alzheimer's
PES management - CORRECT ANSWER - RTC 6 months
Pt.education about wearing sunglasses
>21mmHg lower IOP with glaucoma medications
Exfoliative Glaucoma (XFG) - CORRECT ANSWER - one of the most common
secondary open angle glaucomas
angle is open in terms of gonioscopy appearance
pigment does not seem to contribute to increased outflow resistance
unlike in pigmentary glaucoma
fluctuations in IOP of 15mmHg or greater in 35% of patients
harder to treat than poag
XFG mechanisms - CORRECT ANSWER - connective tissue elastosis due to exfoliation
leads to structural and functional alteration and increased vulnerability of the lamina cribosa
toward elevated IOP
Questions and CORRECT Answers
- CORRECT ANSWER -
Pigmentary Dispersion Syndrome (PDS)
characteristics - CORRECT ANSWER - concave bowing of peripheral iris causes physical
contact of the posterior iris with the zonules
Bilateral
YOUNG MYOPIC MALES
PDS Findings - CORRECT ANSWER - liberation of pigment from posterior iris
iris transillumination defects
Krukenberg's spindle
pigment deposition on zonules and posterior lens capsule
Uniform TM hyperpigmentation
Scheie's stripe
Focal point for 20D - CORRECT ANSWER - 2 in
Complications for PDS - CORRECT ANSWER - RD
,exercise activates dispersion
can have large diurnal variations in IOP as well as spikes in IOP due to pigment release and
exercise
PDS conversion to pigmentary glaucoma - CORRECT ANSWER - underdiagnosed in
black patients
10-20 convert to gluacoma
Pigmentary Glaucoma
characteristics - CORRECT ANSWER - pressure elevates and causes glaucomatous
changes to optic nerve in those with PDS
must have ONH changes
thought to be pigment granules accumulate in the TM and cause dysfunction of trabecular
endothelial cells
Older you get, the less pigmentation and krukenberg spindles due to lens pushing the iris forward
treatment of pigmentary glaucoma - CORRECT ANSWER - Pilocarpine
glaucoma meds
peripheral iridotomy
-laser hole to neutralize anterior and posterior pressure
-studies show no benefit
-low risk procedure
,ALT (argon laser trabeculoplasty)
SLT( selective laser trabeculoplasty)
Pseudoexfoliation syndrome - CORRECT ANSWER - made of elastic fibers (fibrillin and
alpha-elastin) and non-collagenous basement membrane material (laminin) that forms fibrils
coated with glycosaminoglycan hyaluronic acid
PES associations - CORRECT ANSWER - hyperhomocystemia
high caffeine usage
LOXL1 (lysyl oxidase-like 1) gene
PES findings - CORRECT ANSWER - patchy hyperpigmentation of the TM
pigment mixed with amyloid
Kurkenberg spindles
Bulls eye lens
PES Complications - CORRECT ANSWER - don't dilate well
can have marked increase in IOP following dilation
use apraclonidine/iopidine before dilation to prevent spike
, phenylephrine causes more amyloid release than other dilation drops***
more complicated cataract surgery
lens can dislocate
slightly higher risk for Alzheimer's
PES management - CORRECT ANSWER - RTC 6 months
Pt.education about wearing sunglasses
>21mmHg lower IOP with glaucoma medications
Exfoliative Glaucoma (XFG) - CORRECT ANSWER - one of the most common
secondary open angle glaucomas
angle is open in terms of gonioscopy appearance
pigment does not seem to contribute to increased outflow resistance
unlike in pigmentary glaucoma
fluctuations in IOP of 15mmHg or greater in 35% of patients
harder to treat than poag
XFG mechanisms - CORRECT ANSWER - connective tissue elastosis due to exfoliation
leads to structural and functional alteration and increased vulnerability of the lamina cribosa
toward elevated IOP
