O2B Gonio

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What is gonioscopy?

procedure to view the anterior eye using a gonioscope
What can you see with gonio when dilated/not dilated?
- anterior chamber angle without dilation
- peripheral fundus when dilated
What are the reasons to evaluate the anterior angle chamber?
- glaucoma
- determination of likelihood of angle closure
- examination of abnormal structures in angle
- iris tumours
- ocular trauma
- Pseudoexfoliation syndrome
- Pigment dispersion syndrome
- Rubeosis irides
What are the contraindications for gonio?
- Corneal abrasions or ocular trauma
- Hyphaema
- Lacerated or perforated globe
- Following ocular surgery including cataract surgery
- Recurrent corneal erosion syndrome
- Corneal keratopathy
- Anterior uveitis-iritis including patients with known recurrent attacks
What are the 6 layers visible with the anterior angle?
- LICKING TOILETS SHALL CAUSE ILLNESS
- schwalbe's line
- trabecular meshwork
- schlemm's canal
- scleral spur
- ciliary body
- iris
What are the characterisitics of schwalbe's line?
- fine white line- not always visible
- indicates termination of descemet's membrane
- line becomes pigmented with age
what is psuedoexfoliation?

accumulation of granular amyloid-like fibres found in schwalbe's line
What are the characteristics of the trabecular meshwork?

contains 2 distinct bands- non pigmented anterior line, pigmented posterior line
What are the characteristics of schlemm's canal?
- not visible
- only seen if contains blood
What are the characteristics of the scleral spur?
- defined light coloured band
- point of attachment of ciliary body to sclera
What are the characteristics of the ciliary body band?
- darker brown/grey uniform colour
- if visible- angle is very wide
What is the characteristic of the image in gonio?

inverted but NOT reversed
Why is the goldmann lens gonio limited?
- 4 mins
- needs coupling fluids
- corneal dehydration
What are the advantages of using a goldmann?
- Versatility
- Gonioscopic angle evaluations
- Direct posterior pole examination through contact
- Peripheral retinal examinations extending to ora if good dilation
What are the disadvantages of using a goldmann?
- corneal dehydration
- only 1 view of the angle at a time
- need to rotate for view
- scary for px
Zeiss type advantages?
- 360 view without rotation
- no coupling fluids needed
- allows indentation gonio
- less imposing for px
Zeiss type disadvantages?
- view less mag and sharp
- harder stability
What is the Schaffer classification of anterior chamber angles?
- 0/0/iridocorneal contact present, apex of corneal wedge not present
- 1/10/schwalbe line present
- 2/20/only trabeculum present
- 3/25-35/scleral spur present
- 4/35-45/ciliary body easily visible
What is the modified Schaffer classification of anterior chamber angles?
- narrow angle/<10/less than 1/3 of trabecular seen
- intermediate/10-20/entire trab seen
- wide/>20/ciliary body present
How can you tell that the angle is acutally closed?

if beam from iris and posterior cornea are coincident

Author

sookylala

175491

Card Set

O2B Gonio

Description

gonio

Updated

2012-10-28T14:38:41Z

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