Term
| What are the 3 purposes of IOP discussed in lecture? |
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Definition
1) Maintain integrity of globe
2) Maintain retina and choroid
3) Nourishes: Lens, Endothelium of Cornea, Vitreous, and TM |
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Term
| What are the 6 indications for tonometry? |
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Definition
1) As part of comprehensive eye exam
2) Part of any red eye workup, follow up, and management protocol
3) Prior to any dilated fundus procedure
4) Dx, tx, mgmt of glaucoma
5) Dx, tx, mgmt of uveitis
6) Cases of ocular trauma |
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Term
| What are the methods used for measuring IOP? |
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Definition
1) Digital Palpation
2) NCT air puff
3) Goldmann Tonometry (GAT)
4) Hand-held Perkins
5) Tonopen |
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Term
| When would you need to use palpation to acquire a tonometry reading? |
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Definition
| mentally challenged or pediatric pt |
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Term
| Repeated readings of indentation tonometry will result in increased aqueous outflow, therefore doing what to IOP? |
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Definition
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Term
| What is the definition of GAT? |
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Definition
| measure of the force required to flatten a corneal area to a specific size in order to obtain the IOP |
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Term
| Do repeated readings of GAT affect ocular volume or pressure? |
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Definition
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Term
| What is the preservative in Fluress? |
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Definition
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Term
| When do you use the red line? |
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Definition
| when there is 3D of more of corneal astigmatism |
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Term
| What do you do when you have 3 or more D of K cyl? |
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Definition
convert K readings to minus form
1) Use axis at which K value is least |
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Term
| What setting do you ALWAYS start with on your drum? |
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Definition
1gm
UNLESS pt has history of high IOP >20, then start at 2gm |
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Term
| If mire separation is far apart where do you turn the drum to move the mires closer together? and further apart? |
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Definition
| turn drum toward pt, and toward examiner, respectively |
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Term
| What causes the mire pulsation in GAT? |
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Definition
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Term
| What are some cautions and contraindications for contact tonometry? |
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Definition
1) pts allergic to any form of anesthetic
2) pts with recurrent corneal erosions
3) bullous keratopathy and/or corneal hydrops (keratoconus)
4) corneal abrasions that are not totally healed
5) significant corneal edema
6) NCT |
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Term
| What are the simplistic CDC recommendations for cleaning the probe for GAT? |
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Definition
| simply wiping the tip with 70% isopropyl alcohol |
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Term
| What are the 3 components of the SL required to perform this GAT and obtain accurate IOP reading? |
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Definition
1) Pt housing
2) Illumination system
3) Viewing system |
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Term
| What are the 3 basic components of the applanation tonometer 900? |
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Definition
1) Applanation probe
2) Probe holder is mounted on a spring-loaded box
3) Measuring drum |
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Term
| What are some challenges to handle regarding GAT? |
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Definition
1) Small palpebral fissures
2) Dermatochalasis
3) "the flincher"
4) Lids touch the probe and mires will get too thick
5) "the trope" |
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Term
| T/F it is appropriate for patients to hold their own eyelids open |
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Definition
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Term
| Why is it important to be cautious of the mag while performing GAT? |
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Definition
| better overall assessment of equal alignment of mires |
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Term
| Which contact technique utilizes the same probe for GAT? |
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Definition
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Term
| What are indications for use of Tonopen tonometry? |
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Definition
1) Pediatrics
2) Geriatrics
3) Wheel Chair pts
4) CL exams (ppl prefer NCT) |
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Term
| What is the practice of using a Tonopen XL? |
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Definition
| by tapping 3x once pt is anesthetized |
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Term
| What are the realms of the Tonopen XL? |
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Definition
| average IOP is estimated with a reliability scale, ideal is 5% error and greater than 10% SHOULD be repeated |
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Term
| T/F Tonopen AVIA requires daily calibration |
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Definition
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Term
| What is the practice of Tonopen AVIA? |
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Definition
| press and release blue button once, wait for display, and BEEP |
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Term
| What is the innervation regarding cornea? |
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Definition
Afferent - CN V
Efferent - CN VII |
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Term
| What is the pathway of the GVE fibers regarding lacrimal innervation? |
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Definition
| GVE fibers from CN VII -> pterygopalatine ganglion -> latch on via V2 zygomatic branch -> infraorbital fissure -> lacrimal N (off V1) |
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Term
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Definition
| CNVII -> greater petrosal n -> n of pterygoid canal -> pterygopalatine ganglion -> maxillary n (V2) -> zygomatic n -> lacrimal n (off V1) -> lacrimal gland |
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Term
| Reflex Tearing (Afferent) |
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Definition
| Cornea/Nasal Mucosa -> Long/Short Ciliary n -> Nasociliary n -> V1 -> pain signal to trigeminal ganglion -> lacrimal nuc -> facial n -> same pathway as GVE of CN VII |
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Term
| What are the three components of corneal reflex? |
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Definition
1) Lacrimation
2) Blinking: due to stimulation of facial n. nucleus
3) Miosis: due to stimulation of EW nucleus |
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Term
| What is the onset of Benoxinate HCl? |
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Definition
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Term
| What is ideal screening for Glaucoma? |
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Definition
includes:
1) measurement of IOP
2) stereoscopic assessment of ONH
3) central visual field |
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Term
| Is IOP lower or higher in affected eye of iritis or uveitis? |
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Definition
| initially lower in affected eye |
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Term
| What are the 7 factors that cause transient IOP change? |
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Definition
1) Diurnal variation
2) Accommodation (slight DECREASE)
3) Posture = Supine
4) Valsalva movement
5) Lid squeezing/apprehension/holding breath
6) External pressure on the globe
7) BP |
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Term
| The OHTS dealt with patients with IOP greater than what? |
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Definition
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Term
| What is a culprit for Ocular HTN? |
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Definition
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Term
| Individuals had a comparative low CCT under what value dealing with converting from ocular HTN to POAG? |
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Definition
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Term
| What seems to be the principle cause of GAT error? |
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Definition
| Corneal Elasticity rather than CCT |
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Term
| WHat is used based on the principle of contour matching as opposed to applanation? |
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Definition
| Dynamic Contour Tonometry |
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Term
| T/F DCT is a variable force tonometer |
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Definition
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Term
| How long is a complete measurement cycle for a PASCAL probe? |
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Definition
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