4-mirror gonioscopy

Start Studying!

Terms

undefined, object

copy deck

Unlike the 3-mirror, the 4-mirror sits _________, and thus you do not have a need for a fluid.: only on the cornea
The mirrors are angle at ___?: 64 degrees
Can you use a fluid with 4-mirror if you want to?: yes
Name 3 types of 4-mirror.: 1-Zeiss
2-Posner
3-sussman
The posner lens is made of ____ and has a ___ handle.: plastic, fixed
T of F: you must rotate the 4-mirror lens to see all 4 angles.: false
The small footplate allows you to perform ____ gonio.: compression
What is the purpose of compression gonio?: To indent the central cornea to cause the aqueous in the anterior chamber to be pushed back over the peripheral iris. This will lower the IOP.
If your patient has a PAS, upon compression gonio, will you be able to open up and see any more angle structures?: no, the iris is stuck and will not budge.
If compression WILL allow you to see deeper angle structures, then the patient has ______.: primary acute angle closure.
Will laser iridotomy help a patient with PAS.: no
Describe acute angle closure glaucoma.: iris is stuck to the lens near the pupil. Fluid accumulates in the post. chamber and causes an iris bombe.
The eye is ___ and ___ during an acute angle closure glaucoma attack.: red, painful
T of F: the patient may experience nausea and vomiting during an acute angle closure glaucoma attach.: true, they also have reduced vision and may see haloes.
What is an important step in the treatment of primary acute angle closure glaucoma? Why?: compression gonio. this allows some fluid to drain to lower the dangerously high IOP>
The 4-mirror is more/ or less stable over the eye than the 3-mirror.: 4-mirror is LESS stable than e-mirror
Goldmann gonio lens provides a _____ view than the 4-mirror.: clearer
Would you perform gonio if you see hyphema during slit lamp.: No!. You could cause a re-bleed.
Would you perform gonio if your patient has a penetrating ocular injury?: no.
Would you perform gonio is your patient has a severe cornea trauma?: no, (ie. chemical burns or abrasions)
Would you perform gonio if the patient has an ocular surface infection?: no
For both 3-mirror and 4-mirror use _____ to numb the eye before gonio.: 0.5% proparacaine
You can use ____ if you want to keep bubbles out.: artificial tears
The beam on the slit lamp should be oriented_____, ____ wide and ___ tall.: vertically, 3mm, maximum height
Mag for 4-mirror is _____?: 16x same as 3-mirror
What is a lid speculum? Can you use if for gonio?: a device that holds the eye lids open. yes
The first angle to examine is the _____ angle. This means the light is placed over the ____ mirror.: inferior angle, light on the Superior mirror first
If you see a big glare on the view what can you do?: move the light housing outward about 5-10 degrees.
What is the only "thing" you will be rotating while doing gonio 4-mirror?: rotate the light beam. Vertical beam for sup/inf angle. horizontal beam for nas/temp angle.
For a better view, tilt the lens ____ the mirror.: away from
For a better view, have the patient look _____ the mirror.: towards
If you are looking at the inferior angle, tilt your lens ______?: slightly down (away from mirror)
For narrow angle, you can push on the edge of the lens in the ____ direction as the mirror you are looking in.: same
While looking at a narrow temporal angle, you can push on the edge of the lens over the _____ mirror.: nasal
Is it possible to use compression to break a fresh anterior synechia?: yes
What are 3 abnormalities that you may see when doing compression gonio?: 1-iridodialysis (a ripped away iris
2- foreign bodies
3- cyclodialysis (ciliary body is separated from sclera--this causes hypotony)
What level disinfection is required for gonio lens?: high-level
What are 3 examples of high-level disinfectant substances?: 1- 2% glutaraldehyde/20 minutes
2-3% H2O2/ 10 minutes
3- 1:10 bleach/15 minutes
Where do you put the bleach if you choose to use it?: in the little well/cup that touched the eye.
Do you turn the gonio lens on its side to soak it in glutaraldehde?: yes
Name 4 ways that the angle structures can be different from person to person.: 1- congenital differences
2- pigment
3- width
4- iris processes
Does pigment increase with age?: yes
The wedge technique "point" directly to _____?: Schwalbe's line
What are 3 acquired individual differences in angle structures?: 1-age
2- trauma
3-disease
What is the order (post to ant) of the angle structures?: CB, SS, TM,SL
Describe your light housing when performing the wedge technique.: optic section
Schwalbe's line is presisely where?: at the termination of decemet's membrane
The wedge looks like a __?: Y
T or F:The non-pigmented TM is anterior.: true
If you see a pinkish line, what are you looking at. What is it?: top of post. TM, Canal of Schlemm
The angle is at risk for closure if ______________.: if only half or less of the TM is visible in all quadrants.
The only angles you can check with the wedge technique are ___ and ___.: superior and inferior (due to light beam constraints)
When doing the wedge, what do you do with the light housing?: move it slowly to an angle of 20 degrees.
The bands of light forming the "Y" are on the corneal __ and __?: epithelium and endothelium
Should iris processes alarm you?: no, they are normal
The iris process connect the ___ to the ___?: peripheral iris, TM
Can iris processes elevate the IOP?: yes
_____ is a prominent anteriorly displaced Schwalbe's line. This occurs in 10-15% of normals: posterior embryotoxon
If you see NVI, should you rotate the gonio lens to see the entire 360 degrees?: yes, do this also to find a foreign body, looking at the PAS and angle recession
Where does NVI usually begin?: at the pupillary ruff (it could start at the angle though)
A blood vessel that crosses the SS is _____.: abnormal
What are the 3 characteristics of pigment dispersion syndrome?: 1- iris transillumination
2-krukenburg's spindle
3-dense brown pigmentation of TM
DO people with pigment dispersion syndrome have an increased risk for glaucoma?: yes, by 50%
In angle recession, blunt trauma may tear the ___ from its insertion into the SS.: ciliary body
In angle recession, glaucoma may occur in ___ or ____.: month, years
Patients with angle recession will present with:: 1-unilateral visual field loss
2- visual acuity loss
3-optic nerve head cupping
In angle recession, is it possible to to develop primary open angle glaucoma of the OTHER eye?: yes (WTF??)
NVI (the bad vessels) grow is a _____ direction, while "good" vessels are ___.: upwards, around
IN angle recession you will see ___ displaced iris which reveals a ____ CBB.: posterior, widened
Will a PAS occur as a result of angle recession?: yes, sadly but true
What is pseudoexfoliation syndrome?: material produced from the basement membrane of the ciliary epithelium, zonules and lens capsule: clogs up the TM.
Patients with pseudoexfiliation syndrome (PEFS) have ____ the risk for glaucoma.: 6X
In PEFS, you will see ____ with the slit lamp. You will also see __ with gonio.: white flaky material on pupillary margin and on anterior lens capsule.

irregular black pigment on the TM inferiorly
What is pathognomonic form PEFS? What is this?: Sampaolesi's line. THis is a scalloped band of pigment ANTERIOR to SL.
A ____ is the adhesion of peripheral iris to the corneal endothelium in the corneal periphery.: PAS
A PAS will cover up the ___?: TM
If a patient has a PAS with elevated IOP, they are said to have ________. (long title): secondary angle closure without pupillary block
If you see a neoplasm in or near the angle, they have an _____?: angle tumor

Start Studying!

Deck Info

Number of cards 78