Glaucoma DNB questions

 Anatomy

1. Describe anatomy of angle of anterior chamber of eye. 

2. **Anatomy of angle structure with diagram. 

3. ***Draw a labeled diagram of the angle structures. Specify the grading by Spaeth’s method and RP centre method for gonioscopy. 6+2+2

4. *** a) Production, circulation and drainage of aqueous humour. 

b) Describe components of blood ocular barrier and its clinical importance.

Physiology

1. Physiology of aqueous humor production. 

2. **Discuss formation and drainage of Aqueous humour. (10) 

3. 
   

Pachymetry

1. Describe the different modalities of measurement of corneal measurement and role of corneal thickness in glaucoma. 

Tonometry

1. Principles of Goldmann applanation tonometry. 

2. Principles, technique, advantages and possible sources of error in performing Goldmann’s applanation tonometry. (2+2+3+3) 

3. 
   

Gonioscopy

1. ****Draw a diagram of angle of anterior chamber. Discuss the grading and various methods of gonioscopy. 4+3+3 

2. *****Give various methods of grading of anterior chamber angle. Discuss principle of gonioscopy and various types of gonioscopes. What are the other modalities to see anterior chamber angle? 

3. (3+4+3)

UBM

1.         What is Ultrasound biomicroscopy (UBM)? Discuss in brief the principles of UBM. 

b) What are its advantages/ disadvantages over anterior segment OCT?

Pathogenesis

1. ****Describe various concepts that explain the pathogenesis of glaucomatous ocular damage 

Congenital Glaucoma

1. Write down the clinical picture and management of congenital glaucoma. 

2. **Discuss in detail about congenital glaucoma- clinical features and management options. (5+5) 

3. **Discuss clinical features, pathogenesis, differential diagnosis and management primary congenital glaucoma. 

4. ***Genetics, Pathophysiology, differential diagnosis and management of primary congenital glaucoma. (2+2+3+3) 

5. 
   

Complicated Glacoma

1. Medical management of traumatic hyphema. Mention the indications of surgical intervention? 

2. **Management of traumatic hyphaema with secondary glaucoma. 

3. ****Grading, investigations, complications and management of traumatic hyphema. 

(2+2+2+4)

4. ***What is the treatment algorithm for hyphema indicating the role of hospitalization, medical treatment and surgery? 10 

5. Management of a case with florid neovascularisation of the iris, dense cataract, IOP=42 mm hg, visual acuity 3/60 and proliferative diabetic retinopathy. 

6. **Management of neovascular glaucoma. 

7. *****Pathogenesis, causes, presentation and management of neovascular glaucoma. (2+2+3+3) 

8. ****Describe etiopathogenesis, clinical features and treatment of neovascular glaucoma. 

9. ***Discuss the investigations and management of a 55 year old diabetic patient presenting with neovascular glaucoma and cataract with visual acuity 3/60 and IOP of 46 mm of hg. 

10. What is “Reverse pupillary block glaucoma"? Give the clinical appearance, investigations and management of this glaucoma. 

11. *****What is advanced glaucoma? Give pathogenesis of glaucomatous ocular damage. How will you follow up a case of advanced glaucoma? What are the various treatment options? 

(2+2+2+4)

1. 
   

Open Angle Glaucoma

1. Describe modern methods for the diagnosis and management of primary open angle glaucoma. 

2. Disc changes in open angle glaucoma.

3. **What are the minimum diagnostic criteria for Primary Open Angle Glaucoma (POAG)? Give severity classification of POAG with concept of target pressure? 

4. ***What are the minimum criteria for Primary Open Angle Glaucoma (POAG). Give severity classification of POAG with concept of target pressure. 3+7 

5. ****Define open angle glaucoma suspect. Discuss the management options and follow up. What are the Global Indices in automated perimetry? 2+4+4 

6. 
   

Angle Closer Glaucoma

1. Management of acute attack of angle closure glaucoma. 

2. Pathophysiology of primary angle closure glaucoma. 

3. Write down modern classification of angle closure glaucoma and its relevance. 

4. AIGS classification and the management strategy for primary angle closure glaucoma in a systemic manner. 4+6 

5. **Discuss aetiopathogenesis, diagnosis and management of acute angle closure glaucoma. 

6. 
   

Normal Tension Glaucoma

1. Discuss clinical features, pathogenesis and management of normal tension glaucoma. (3+3+4) 

Drugs

1. List the various prostaglandin analogues available in the management of glaucoma. Give their mechanism of action, dose schedule and side effects. 

Laser PI

1. Describe the indications, technique and complications of laser peripheral iridoplasty and laser peripheral iridotomy. 

Surgery

1. Ahmed glaucoma valve. 

2. **What are artificial drainage shunts? Write briefly about various drainage devices. Give indications and complications of these devices. 

3. ****Types, indications, advantages and complications of glaucoma drainage devices. (2+2+3+3) 

4. Write down the common post-operative complication of trabeculectomy and how to manage it. 

5. What are the factors related to success or failure of glaucoma filtering surgery. Also give indications of anti-metabolites. 4+4+2 

6. **Discuss the differential diagnosis and management of shallow anterior chamber in first postoperative day after trabeculectomy. 

7. ***What are glaucoma drainage devices available? What is their mechanism of action? What are the complications following surgery? What is their role in glaucoma management as compared to conventional modulated trabeculectomy? 

8. ****Diagnosis and management of a case of shallow anterior chamber on the first postoperative day following trabeculectomy. (5+5) 

9. 
   

Visual Fields

1. Give important points while analyzing given visual filed for glaucoma and its limitations. 

2. **Write about diagnostic features of glaucomatous field defect on automated perimetry (30-2). 

3. 10

CPC

1. Describe diode laser cyclophotocoagulation. 

2. Define LASER. Discuss its effects in ocular tissues and how is it useful in treating glaucomas. 

2+ 4+4

Miscellaneous

1. Discuss the causes of unilateral cupping of disc. 

2. What is ectopia lentis? Discuss clinical features and complete management of spherophakia and associated problems in a patient with Weill -Marchesani syndrome. 2+8 

3. What is Sturge-Weber syndrome? Give its classification, clinical signs, investigations and principles of management of associated glaucoma. 2+(2+3+1+2) 

4. Define and enumerate the iridocorneal endothelial syndromes (ICE). Describe their salient features and management. (5+5) 

5. a) Define ocular hypertension. 

b) Investigations and management of a case of ocular hypertension. [2+ (4+4)]