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Section 15: Ophthalmic Disorders

All the following are typical optic disc changes seen in primary open-angle glaucoma (POAG) except:

A. Nerve fiber layer defects

B. Cup-to-disc ratio of >0.5

C. Splinter hemorrhages

D. Papilledema

The answer is D. Papilledema is not exhibited in POAG (see Table 110-2).

All the following are typical visual field findings in primary open-angle glaucoma (POAG) except:

A. Enlargement of the blind spot

B. General central field constriction

C. Reduced contrast sensitivity

D. Altered color vision

The answer is B. General peripheral field constriction is prominent in POAG. Loss of central vision is more prominent in other ocular diseases (eg, Adult Macular Degeneration) (see Table 110-2).

The following are typical symptoms of primary angle-closure glaucoma (PACG) except:

A. Blurred or hazy vision with halos around lights

B. Acute ocular pain or discomfort

C. Nausea, vomiting, abdominal pain and diaphoresis

D. Double vision

The answer is D. Double vision would generally not be exhibited in most cases of PACG and only one eye is affected (see “Clinical Presentation” box.)

Patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) do not often exhibit which of the following signs?

A. Optic disc abnormalities

B. Cloudy cornea

C. Elevated intraocular pressure

D. Visual field loss

The answer is B. A cloudy cornea is often exhibited in primary angle-closure glaucoma because of the acute IOP rise experienced in these patients. Patients with POAG or ocular hypertension (OHT) often do not exhibit highly elevated IOP and therefore their cornea often appear normal (see Clinical Presentation Box).

Which of the following is not normally considered a risk factor for OHT or POAG?

A. Family history

B. Black and Latino/Hispanic ethnicity

C. Elevated intraocular pressure (IOP)

D. Central corneal thickness greater than 555 microns

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