final session: glaucoma¤sentationen... · 2020. 3. 11. · final session: glaucoma daniel mojon,...
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Final Session: Glaucoma
Daniel Mojon, MD, FEBO, EMHSA
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sli.do
#saoo2020
Plenum 1
Plenum 2
Plenum 3
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Learning Goals:
- Origin of the word glaucos
- Connection between glaucos and cataracts
- Couching: how is done
- Gonioscopic findings
- Decision findings to lower IOP
- Medical treatment options / ATP or SLT
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AAO 2014
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Glaucos
- Pre-Hippocratic Era
Green eye, sea (not unhealthy!)
- Hippocrates (460-370 BC)
Pupils which have become γλαυκοu ́μεναι [glaukoumenai] or
ἀργυροειδέες [argyroeidees, silvery] or κυἀνεαι [kyaneai, cyan]
are useless (Aphorisms III.31.6)
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Couching first mentioned?
A) Small statue from the 5th dynasty (2457-2467 BC)
Egyptian Museum in Cairo
B) Code of Hammurabi (1792-1750 BC)
C) Indian surgeon in “Sushruta Samhita, Uttar Tantra”
Indian medical treatise (800 BC)
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2 years old child
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2 years old child
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2 years old childGonioscopic view of trabeculectomy
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What do you expect?
A) No filtering bleb
B) Nice, but too anterior filtering bleb
C) Nice, but too posterior filtering bleb
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Gonioscopic finding 3 weeks after deep sclerectomy
A) Miotics
B) Miotics and heat
C) YAG-laser synechiolysis
D) Laser iridotomy
E) Revision in the OR
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IOP 24 mm Hg: LEAST important for decision to lower IOP
A) Visual fields
B) Ganglion cell layer
C) Nerve fiber analysis
D) Optic nerve parameters
E) Central Corneal Thickness (CCT)
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First line treatement in a healthy 65 years old POAG patient
A) Prostaglandins
B) Beta-blocker
C) Carbo anhydrase inhibitors
D) Alpha-adrenergic agonists
E) Parasympathomimetics
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ALT or SLT?
A) ALT
B) SLT
C) Both should not be used anymore
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Take Home Messages
- Glaucos: Hippocrates no couching!
- Couching: ESCRS video
- Trabeculectomy: inner opening not too anteriorly
- Recent PAS after DS: miotics and heat!
- Decision making if IOP elevated
- First line treatment for elevated IOP
- Role of ALT / SLT
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