Senses-L01-Eye-(A)-POAG (+ Dx)

from TG

What is the normal range of intraocular pressure (IOP)

8 to 21 mmHg.

What are key diagnostic features of primary open-angle glaucoma (POAG)

Increased IOP, optic nerve head abnormality, open anterior chamber angle, and characteristic visual field loss.

What distinguishes POAG from secondary glaucoma

POAG has no identifiable cause for IOP elevation or optic nerve damage.

What are some differential diagnoses for POAG

Steroid-induced glaucoma, pigmentary glaucoma, pseudoexfoliation glaucoma, trauma-induced glaucoma, and intermittent angle-closure glaucoma.

What is the primary pathology in POAG

Defective trabecular meshwork leading to impaired aqueous humor drainage and increased IOP.

How does POAG initially affect vision

Peripheral vision loss while central vision remains intact.

What are major risk factors for POAG

Thin central corneal thickness, race, age, and family history.

How does POAG progress over time

It is chronic, progressive, and irreversible, leading to optic nerve fiber loss and optic disc cupping.

Why is POAG often diagnosed late

It is asymptomatic in early stages and vision loss occurs gradually.

What is a key distinguishing feature of optic neuropathy in POAG

Cupping of the optic disc.

When do patients with POAG usually present with symptoms

Late in the disease course.

At what IOP level do symptoms typically appear in narrow-angle or secondary glaucoma

35 mmHg or higher.

What clinical history aspects are important in evaluating POAG

Past ocular history, ocular surgery, trauma, past medical history, current medications, and risk factors for glaucomatous optic neuropathy.

What are common secondary causes of glaucoma that must be ruled out in POAG

Steroid use, pigment dispersion, pseudoexfoliation, trauma, or prior ocular surgery.

Who should be targeted for POAG screening

African Americans, elderly individuals, and those at high risk.

What combination of tests is most effective for POAG screening

Intraocular pressure measurements and optic nerve assessment.

What are key examinations for suspected POAG

Slit lamp examination, funduscopy, tonometry, gonioscopy, and pachymetry.

What lab tests help rule out other causes of optic neuropathy

CBC count, erythrocyte sedimentation rate, syphilis serology (MHA-TP), and serum protein electrophoresis.

What imaging studies are used to evaluate POAG

Fundus photography, retinal nerve fiber layer imaging, confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography.

When is neuroimaging indicated in POAG evaluation

When visual field loss suggests an alternative neurological cause.

What investigational imaging modalities may aid in POAG evaluation

Fluorescein angiography, ocular blood flow analysis, color vision measurements, contrast sensitivity testing, electrophysiologic tests, and ultrasound biomicroscopy.

Why is POAG often diagnosed late

It is asymptomatic until the late stages.

What history factors are important in POAG evaluation

Ocular trauma, systemic steroid use, and family history of glaucoma.

What funduscopic finding is characteristic of POAG

Increased cup-to-disc ratio.

What visual field defects are seen in POAG

Defects consistent with optic nerve damage, typically affecting peripheral vision first.

How can nerve fiber layer measurements confirm POAG

They reveal an abnormally thin nerve fiber layer over the optic nerve.