FREE Board Certified Ophthalmologist Glaucoma Management Questions and Answers Flashcards
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Read the first 6 FREE Board Certified Ophthalmologist Glaucoma Management Questions and Answers flashcards as text
A patient with primary open-angle glaucoma on maximum tolerated medical therapy continues to show visual field progression. What is the most appropriate next step in management?
Answer: Laser trabeculoplasty
Selective laser trabeculoplasty (SLT) is an appropriate escalation step before incisional surgery in patients failing medical therapy.
Which of the following medications acts by decreasing aqueous humor production AND increasing uveoscleral outflow?
Answer: Brimonidine
Brimonidine, an alpha-2 agonist, has a dual mechanism of reducing aqueous production and enhancing uveoscleral outflow.
A 55-year-old patient presents with acute angle-closure crisis. After initial medical management with topical and systemic agents, what is the definitive treatment?
Answer: Laser peripheral iridotomy
Laser peripheral iridotomy is the definitive treatment for acute angle-closure by eliminating pupillary block.
What is the target IOP reduction generally recommended as an initial goal for newly diagnosed primary open-angle glaucoma?
Answer: 20-30% from baseline
A 20-30% reduction from baseline IOP is the standard initial target recommended by major glaucoma trials including the OHTS and EMGT.
Which visual field defect pattern is most characteristic of early glaucomatous damage?
Answer: Arcuate scotoma
Arcuate (Bjerrum) scotomas following the nerve fiber layer pattern are the hallmark early visual field defect in glaucoma.
A patient on chronic topical prostaglandin analog therapy develops progressive periorbital darkening and increased iris pigmentation. What is the most appropriate management?
Answer: Counsel the patient that changes are cosmetic and typically irreversible, then discuss whether to continue or switch therapy
Prostaglandin-associated periorbital changes and iris darkening are cosmetic side effects; the decision to continue or switch should involve shared decision-making with the patient.