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
Which type of glaucoma is most commonly associated with elevated episcleral venous pressure?
Answer: Sturge-Weber syndrome-associated glaucoma
Sturge-Weber syndrome causes elevated episcleral venous pressure from arteriovenous malformations, which impedes aqueous outflow and leads to secondary glaucoma.
A 45-year-old myopic male presents with pigment dispersion on the corneal endothelium in a Krukenberg spindle pattern. What is the most likely underlying mechanism for potential IOP elevation?
Answer: Liberation of iris pigment granules that clog the trabecular meshwork
In pigmentary dispersion syndrome, mechanical rubbing of the posterior iris against the zonules releases pigment granules that obstruct the trabecular meshwork.
What is the target IOP reduction percentage generally recommended as initial therapy for a patient newly diagnosed with primary open-angle glaucoma?
Answer: 20-30% reduction from baseline
Major clinical trials including the OHTS and EMGT established that an initial 20-30% IOP reduction from baseline significantly reduces the risk of glaucomatous progression.
Which finding on a dilated fundus examination best differentiates glaucomatous optic neuropathy from physiologic cupping?
Answer: Asymmetric cup-to-disc ratio with focal notching of the neuroretinal rim
Focal notching of the neuroretinal rim, especially inferiorly or superiorly, with asymmetric cupping between eyes is pathognomonic for glaucomatous damage rather than physiologic cupping.
In a patient with neovascular glaucoma secondary to proliferative diabetic retinopathy, what is the most critical initial treatment step?
Answer: Panretinal photocoagulation and/or intravitreal anti-VEGF injection
Treating the underlying retinal ischemia with panretinal photocoagulation and anti-VEGF therapy is essential to halt the neovascular drive before addressing IOP surgically.
Which medication class should be avoided in a patient with narrow angles at risk for angle-closure glaucoma?
Answer: Topical anticholinergics such as cyclopentolate
Anticholinergic agents cause pupillary dilation that can precipitate acute angle-closure in anatomically predisposed eyes with narrow angles.