Board Certified Ophthalmologist Glaucoma Diagnosis and Management Questions and Answers Flashcards
6 cards from real Board Certified Ophthalmologist practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Board Certified Ophthalmologist Glaucoma Diagnosis and Management Questions and Answers flashcards as text
A 58-year-old patient presents with an intraocular pressure of 34 mmHg, a cup-to-disc ratio of 0.8, and nasal step visual field defect. Which initial medical therapy is most appropriate?
Answer: Topical prostaglandin analog
Topical prostaglandin analogs such as latanoprost are first-line therapy for primary open-angle glaucoma due to their efficacy and once-daily dosing.
Which diagnostic finding on optical coherence tomography (OCT) is most characteristic of early glaucomatous damage?
Answer: Thinning of the retinal nerve fiber layer in the inferior temporal sector
Early glaucomatous damage typically manifests as RNFL thinning, most commonly in the inferior temporal sector corresponding to the arcuate nerve fiber bundles.
A patient with pseudoexfoliation syndrome is found to have unilateral elevated IOP of 28 mmHg. What mechanism most likely accounts for the pressure elevation?
Answer: Trabecular meshwork obstruction by exfoliative material
Pseudoexfoliative material accumulates in the trabecular meshwork, reducing aqueous outflow and causing elevated intraocular pressure.
During gonioscopy of a patient with acute angle-closure glaucoma, which Shaffer grading would you expect to see in the affected eye?
Answer: Grade 0 (closed angle)
Acute angle-closure glaucoma presents with a Shaffer grade 0, indicating complete iridotrabecular contact and closure of the drainage angle.
Which visual field test pattern is most specific for moderate glaucomatous progression beyond early disease?
Answer: Arcuate scotoma connecting to the blind spot
An arcuate scotoma that connects to the physiologic blind spot follows the retinal nerve fiber layer pattern and is highly characteristic of moderate glaucomatous damage.
A 72-year-old patient on maximum tolerated medical therapy still shows progressive optic nerve cupping. Which surgical intervention has the highest long-term success rate for primary open-angle glaucoma?
Answer: Trabeculectomy with mitomycin C
Trabeculectomy with mitomycin C remains the gold standard surgical intervention for medically uncontrolled primary open-angle glaucoma with the best long-term IOP reduction.