Glaucoma
 

The cup: disc ratio (gives the number) is increased. There is  notching at the neuroretinal rim (usually inferiorly and best  seen where the retinal vessels enter the disc. The sharp turning  of the blood vessels is described as bayoneting). Other examination: look at the opposite eye for any cup asymmetry look for signs of medical or surgical treatment for the  glaucoma and also for any secondary causes of glaucoma (refer to common cases in glaucoma)

Questions:

1. What changes may occur in the opitc disc in glaucoma?

Answer
Generalized signs:

large optic cup
asymmetry of the cup disc ratio
progressive enlargement of the cup

Focal signs

notching of the rim
vertical elongation of the cup
regional pallor
nerve fiber layer loss
splinter haemorrhage

Other signs

exposed lamina cribosa
nasal displacement of the vessels
baring of circumlinear vessels

 

2. What is the name of this lens and how does it differ from Goldmann's contact lens?

Answer
A Zeiss goniolens. It has the advantages over Goldmann's contact lens in that it does not require a viscous coupling liquid, it is quick to use because the lens contains four mirrors and therefore does not require rotation as in Goldmann's lens. In addition, the lens can be used to indent the eye to check the angles of the trabecular meshwork.

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