By George A. Cioffi MD

ISBN-10: 1615251170

ISBN-13: 9781615251179

Subject matters on glaucoma comprise the epidemiologic elements; hereditary and genetic components; intraocular strain and aqueous humor dynamics; and scientific review, clinical administration and surgical remedy. includes various photographs illustrating sickness entities and surgical recommendations. final significant revision 2008 2009.

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Extra resources for 2011-2012 Basic and Clinical Science Course, Section 10: Glaucoma (Basic & Clinical Science Course)

Sample text

The combination ofthe lens manipulation and the use of viscous fluid often temporarily reduces the clarity of the cornea and may make subsequent fundus examination, visual field testing, and photography more difficult. These lenses provide the clearest visualization of the anterior chamber angle structures and may be modified with antireflective coatings for use during laser procedures. The Posner, Sussman, and Zeiss 4-mirror goniolenses allow all 4 quadrants of the chamber angle to be visualized without rotation of the lens during examination.

In inexperienced hands, dynamic gonioscopy may be misleading, as undue pressure on the anterior surface of the cornea may distort the chamber angle or may give the observer the false impression of an open angle. The examiner can detect this pressure by noting the induced folds in Descemet's membrane. With all indirect gonioscopy techniques, the observer may manipulate the chamber angle by repositioning the patient's eye (having the patient look toward the mirror) or by applying pressure with the posterior surface of the lens to provide more complete evaluation of the' chamber angle.

CHAPTER 3: Clinical Eva luation. 43 Figure 3-5 Blood in Schlemm's canal. Note the red line posterior to the trabecular meshwork in this patient with elevated episcleral venous pressure result ing in blood reflux into Schlemm's canal. (Courtesy of G. A. ) vessels are oriented either radiall y along the iris or circum fe rentially (i n a serpentine manner) in the Ciliary body face. Vessels that cross the scleral spur to reach the trabecular meshwork are usually abno rmal (Fig 3-6). The vessels seen in Fuchs heterochromic iridocyclitis are fine, branching, unsheathed, and m eandering.

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