Glaucoma- Clinical Examination Qs&As A+
methods to view anterior chamber angle - ANS-- ultrasound biomicroscopy
- gonioscopy
when to perform gonio? - ANS-- all glaucoma suspects, glaucoma patients, and narrow angle
patients
- key to obtaining the correct diagnosis of the type of glaucoma pres...
Glaucoma - Clinical Examination Qs&As A+ methods to view anterior chamber angle - ANS-✔✔ - ultrasound biomicroscopy - gonioscopy when to perform gonio? - ANS-✔✔ - all glaucoma suspects, glaucoma patients, and narrow angle patients - key to obtaining the correct diagnosis of the type of glaucoma present grade 4 angle (Schaefer) - ANS-✔✔ >20 degrees grade 3 angle (Schaefer) - ANS-✔✔ 10-20 d egrees grade 2 angle (Schaefer) - ANS-✔✔ <10 degrees grade 1 angle (Schaefer) - ANS-✔✔ partially/completely closed angle documentation of angle during gonioscopy - ANS-✔✔ - anterior structures viewed - amount of pigmentation - abnormal findings ultrasound biomicroscopy - ANS-✔✔ - uses ultrasound echoes characteristic of the tissue/fluid properties - low frequency penetrates deeper with lower resolution - higher frequency penetrates shallower with higher resolution - units operate at 50MHz with penetration o f 4-5mm and axial resolution of 25 microns and lateral resolution of 50 microns range of frequencies used for ultrasound biomicroscopy - ANS-✔✔ - 10MHz (globe and orbit) - 20MHz (cornea to posterior lens) - 35-50MHz (cornea to anterior lens - 100MHz (cornea) what does ultrasound biomicroscopy show? - ANS-✔✔ - anterior chamber angle anatomy - iris - ciliary body - lens/IOL - anterior vitreous - pars plicata what is included on gonioscopic examination - ANS-✔✔ - pupil margin, iris processes, ir is insertion, iris configuration - anterior chamber angle structures and pigment - lens surface - iris and angle vessels - zonules and ciliary processes - angle appearance after dilation and abnormalities iris sphincter tears at pupillary margin - ANS-✔✔ indication of previous trauma space between iris and lens with associated atrophy - ANS-✔✔ - may indicate Herpes related uveitis - previous acute angle closure glaucoma
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