Gonioscopy

• What is the Van Herick method used for in examining the AC?

  It assesses angle depth.
• What does the iris shadow indicate in the Van Herick method?

  It helps determine the angle depth.
• Which method is rarely used now for examining the AC?

  The Smith Method.
• How does a slit lamp contribute to AC examination?

  It provides a small spot of light for detailed observation.
• What advantage does gonioscopy provide in AC examination?

  It gives more information about the angle structure.

  
• What does OCT stand for and what is its purpose in AC examination?

  Optical Coherence Tomography; it quantifies depth and visualizes structures non-invasively.

  
• What does the Van Herick grading system assess?

  It assesses the angle depth in the anterior chamber.
• What does a GRADE 4 in the Van Herick system indicate?

  It indicates an open angle with a ratio of 1:1.
• What does a GRADE 1 in the Van Herick system suggest?

  It indicates a narrow angle and closure is likely.
• What is another name for the shadow test?

  Oblique light test.
• What are the indications for performing gonioscopy?

  Narrow angle, assessing suitability for pupil dilation, and diagnosing glaucoma.
• Why is gonioscopy essential for glaucoma management?

  It is crucial for diagnosis, classification, and management of glaucoma suspects.
• What signs of angle closure glaucoma (ACG) should be looked for during gonioscopy?

  Non-infected red eye, headache, and haloes.
• What anatomical structures are visible during gonioscopy?

  Iris, ciliary body, scleral spur, trabecular meshwork, Schwalbe’s line, and cornea.

  
• What does the ciliary body look like during gonioscopy?

  Its color varies and its width depends on the position of iris insertion and angle.
• What is Schwalbe’s line?

  A thin grey or pearly white line representing the peripheral termination of Descemet’s membrane.
• What are the advantages of using a 4 mirror gonio lens?

  It does not require a viscous medium and allows for static and dynamic gonioscopy.
• What is a disadvantage of the Goldmann “Universal” 3 Mirror Gonioscope?

  The lens must be rotated to evaluate all 360 degrees of the angle.
• What is the purpose of applying a coupling medium to the gonio lens?

  To ensure proper contact between the lens and the cornea.
• What should be done before inserting the gonio lens?

  Clean and disinfect the gonio lens.
• What is the recommended position for the patient during gonioscopy?

  The patient should be comfortably positioned at the slit lamp with their head against the rests.
• What is the purpose of instilling anesthetic drops before gonioscopy?

  To minimize discomfort during the procedure.
• How should the gonio lens be held during insertion?

  Between the thumb and second finger, ensuring proper orientation.
• What should be done if lashes are trapped under the gonio lens?

  Reinsert the lens to ensure proper contact.
• What is the first angle to view during gonioscopy?

  The inferior angle.
• What should be done to stabilize the gonio lens during examination?

  Anchor the hand gently against the patient's cheek or the slit lamp.
• What is the purpose of adjusting the slit lamp's illumination system?

  To ensure it does not block either eyepiece and provides optimal visibility.
• What is the significance of the iris taking up the central mirror during gonioscopy?

  It indicates proper alignment and centering of the gonio lens.

  
• What should be done if the gonio lens appears to be off-center during examination?

  Adjust the lens to ensure it is centered on the cornea.
• What is the purpose of rotating the gonio lens during examination?

  To view all quadrants of the angle.
• What is the advantage of using a 6 mirror gonio lens?

  It allows for a faster examination time with a 360-degree view.

  
• What is the disadvantage of using a 3 mirror gonio lens?

  It may require more rotation to evaluate all angles.

  
• What is the purpose of using a coupling fluid with the Goldmann “Universal” 3 Mirror Gonioscope?

  To keep the lens in place and produce a stable image.
• What should be considered regarding the cushioning agent used with the Goldmann lens?

  Old agents can be abrasive and toxic to the cornea.
• What is the general procedure for informing the patient before gonioscopy?

  Explain what the test involves and why it needs to be performed.
• What should the patient expect during the gonioscopy procedure?

  They may feel a little uncomfortable, but it won’t hurt.
• What is the recommended method for cleaning and disinfecting gonio lenses?

  Use lukewarm water with disinfectant or chlorhexidine.
• What is the purpose of using a lint-free cloth after disinfecting the gonio lens?

  To dry the lens without leaving fibers behind.
• What should be done if the patient rubs their eyes during the procedure?

  Advise them not to rub their eyes.
• What is the significance of aligning the illumination system with the viewing system?

  It ensures optimal visibility and prevents obstruction of the eyepieces.