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Exam (elaborations)

TONOMETRY & IOP Exam Questions with Complete Answers.

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TONOMETRY & IOP Exam Questions with Complete Answers. Intraocular pressure - Correct Answers ● Determined by aqueous humor production and outflow . ● Must be maintained at a level not harmful to ocular tissue. Aqueous production - Correct Answers Produced by the ciliary processes of th...

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  • October 14, 2024
  • 17
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • TONOMETRY & IOP
  • TONOMETRY & IOP
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TONOMETRY & IOP Exam Questions with Complete
Answers.
Intraocular pressure - Correct Answers ● Determined by aqueous humor
production and outflow .
● Must be maintained at a level not harmful to ocular tissue.

Aqueous production - Correct Answers Produced by the ciliary processes of
the ciliary body

Aqueous production: Mechanisms - Correct Answers ○ Active secretion -
accounts for 80-90% of aqueous production; energy dependent; NOT IOP
dependent
○ Ultrafiltration - driven by hydrostatic pressure; fluid moves from high pressure
area to low pressure area
○ Diffusion - molecules move from area of high concentration to area of low
concentration; aqueous has
↓macromolecules while blood plasma has ↑macromolecules; may cause a small
amount of aqueous production

Outflow of aqueous mostly produced by? - Correct Answers active secretion
(80-90%)

Ultrafiltration:
____ eye pressure (IOP) = ____ of a gradient = ____ aqueous produced -
Correct Answers higher

less

less

4 steps of aqueous flow - Correct Answers 1. Formed in ciliary process
2. Flows into posterior chamber
3. Through lens-iris diaphragm
4. Into anterior chamber (AC)

Aqueous Outflow Pathways
Uveoscleral Outflow vs Trabecular Outflow - Correct Answers Uveoscleral
Outflow (unconventional): 5-35%
-NOT pressure/IOP dependent

Trabecular Outflow (conventional): 65-95%
-IS pressure/IOP dependent

,*aqueous flows up from warm (posterior AC) down to peripheral AC and it
cools. This aqueous mostly outflows with ____ outflow - Correct Answers
trabecular

Trabecular Meshwork acts like ______. As aqueous goes through this filter,
______ are filtered out;

TM: also has _____ that phagocytose waste


Uveal TM has ___ pores (chordlike); Corneoscleral TM has ____pores
(sheetlike) - Correct Answers biomechanical filter
RBC & WBC & others


endothelial cells

biggest
smaller

____ IOP is a risk factor for Glaucoma

is this because of too much aqueous production or too slow
outflow?

Is it uveoscleral or trabecular outflow pressure dependent?


problems mostly resides within _____ - Correct Answers High

Almost always because of too slow outflow
instead of too much aqueous production!


Most high IOP and open angle glaucoma is
caused by an obstruction within the TM

juxtacananicular tissue

Factors increasing TM outflow: - Correct Answers 1) IOP
↑IOP → ↑aqueous outflow via TM pathway

2) Accommodation
↑contraction of ciliary muscle
→ pulls on TM & opens its pores → ↑outflow

, 3) EVP(episcleral venous pressure) -tissue between conj & sclera-
1mmHg ↑ in EVP = 1mmHg ↑ in IOP

Causes of Increased EVP(episcleral venous pressure) - Correct Answers
Valsalva
Gonioscopy
Carotid Cavernous fistula
Sturge-Weber Syndrome

2 long-term factors that affect IOP: - Correct Answers -Age

-Trauma

Main factors causing transient IOP change: - Correct Answers Medications,
pharmaceutical agents

(Pupillary dilation >>> increases IOP)

Other factors causing transient IOP change - Correct Answers 1) Time of day
(diurnal variation) - IOP highest in AM before rising

2)Accommodation
can ↓ IOP quickly

3) Posture
sitting to supine = ~2-3 mmHg ↑IOP

4) Exercise
increase IOP from straining, lifting

5) Cardiac cycle
○ Systole: ↑ intraocular blood volume → ↑ IOP
○ Diastole: ↓ intraocular blood volume → ↓ IOP

6) Trauma, inflammation
Ex: Retinal detachment → usually causes ↓IOP

Glaucoma Medications: Classes - Correct Answers 1) Cholinergics (i.e.
Pilocarpine)
Stimulates ACh, opens up pores of TM and
allows more aqueous to outflow → decrease
IOP

2) Anticholinergics (tropicamide)
Blocks ACh, complete opposite of cholinergic
inhibits sphincter → ↓outflow → ↑IOP

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