Board Certified Ophthalmologist Glaucoma Diagnosis and Management 5

Question 1

Indentation gonioscopy showing a 'double hump' sign is characteristic of:

Accepted Answer

Plateau iris configuration

Answer

The double hump reflects the peripheral iris draped over anteriorly positioned ciliary processes, typical of plateau iris.

Question 2

The definitive initial procedure for acute primary angle closure due to pupillary block, once the cornea clears, is:

Accepted Answer

Laser peripheral iridotomy

Answer

LPI equalizes pressure between the posterior and anterior chambers, relieving pupillary block.

Question 3

The EAGLE trial found that, in PAC with IOP ≥30 mmHg or PACG, clear lens extraction compared with LPI was:

Accepted Answer

More effective and cost-effective

Answer

EAGLE showed clear lens extraction yielded better IOP control, quality of life, and cost-effectiveness than LPI.

Question 4

In the Ocular Hypertension Treatment Study, which baseline factor was a strong independent predictor of conversion to POAG?

Accepted Answer

Thinner central corneal thickness

Answer

OHTS identified thinner CCT, along with older age, higher IOP, larger cup-to-disc ratio, and higher PSD, as predictive.

Question 5

Which patient is at highest risk for hypotony maculopathy after trabeculectomy with mitomycin C?

Accepted Answer

Young myopic man

Answer

Young age, male sex, and myopia (thinner, less rigid sclera) increase risk of hypotony maculopathy.

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