Board Certified Ophthalmologist FREE Board Certified Ophthalmologist Glaucoma Management Questions and Answers 2

Question 1

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?

Accepted Answer

Laser trabeculoplasty

Answer

Selective laser trabeculoplasty (SLT) is an appropriate escalation step before incisional surgery in patients failing medical therapy.

Question 2

Which of the following medications acts by decreasing aqueous humor production AND increasing uveoscleral outflow?

Accepted Answer

Brimonidine

Answer

Brimonidine, an alpha-2 agonist, has a dual mechanism of reducing aqueous production and enhancing uveoscleral outflow.

Question 3

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?

Accepted Answer

Laser peripheral iridotomy

Answer

Laser peripheral iridotomy is the definitive treatment for acute angle-closure by eliminating pupillary block.

Question 4

What is the target IOP reduction generally recommended as an initial goal for newly diagnosed primary open-angle glaucoma?

Accepted Answer

20-30% from baseline

Answer

A 20-30% reduction from baseline IOP is the standard initial target recommended by major glaucoma trials including the OHTS and EMGT.

Question 5

Which visual field defect pattern is most characteristic of early glaucomatous damage?

Accepted Answer

Arcuate scotoma

Answer

Arcuate (Bjerrum) scotomas following the nerve fiber layer pattern are the hallmark early visual field defect in glaucoma.

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Board Certified Ophthalmologist FREE Board Certified Ophthalmologist Glaucoma Management Questions and Answers 2