Mnemonics: Glaucoma
Risk Factors for Primary Open Angle Glaucoma (POAG)
What needs to be memorized: Age (elderly), Race (African descent), Family history, Myopia, Diabetes, Hypertension, Corticosteroid use
Mnemonic: "After Retirement, Family Members Don't Have Cash"
🔗 The Breakdown:
- After → Age (elderly patients)
- Retirement → Race (African descent)
- Family → Family history/Genetics
- Members → Myopia
- Don't → Diabetes
- Have → Hypertension
- Cash → Corticosteroids
Clinical Triad of Acute Angle Closure Glaucoma
What needs to be memorized: Severe eye Pain, Vision loss (blurred vision), Colored halos around lights
Mnemonic: "PVC Attack"
💡 Remember: Just like a sudden PVC pipe burst, acute angle closure is a sudden attack!
🔗 The Breakdown:
- P → Pain (severe eye pain)
- V → Vision decreased (blurred vision)
- C → Colored halos around lights
Causes of Secondary Glaucoma
What needs to be memorized: Trauma, Uveitis, Lens causes (phacolytic, phacomorphic, ectopia lentis), Intraocular tumors, Pseudoexfoliation, Steroids, Neovascular glaucoma
Mnemonic: "TULIPS-N" (Like the flower, but these cause secondary glaucoma)
🔗 The Breakdown:
- T → Trauma
- U → Uveitis
- L → Lens causes (phacolytic, phacomorphic, ectopia lentis)
- I → Intraocular tumors
- P → Pseudoexfoliation
- S → Steroids
- N → Neovascular glaucoma (from diabetes, CRVO)
Medical Management of Acute Angle Closure
What needs to be memorized: Drug sequence - Pilocarpine, Acetazolamide, Beta blockers (Timolol), Mannitol (osmotic agent), followed by definitive Laser iridotomy
Mnemonic: "Papa Achha Beta Mila, ab Laser karenge!"
💡 Remember: Papa got a good son, now we'll do laser! (for definitive treatment)
🔗 The Breakdown:
- Papa → Pilocarpine (miotic - constricts pupil)
- Achha → Acetazolamide (IV/oral - reduces aqueous production)
- Beta → Beta blockers (Timolol drops)
- Mila → Mannitol (hyperosmotic agent)
- Laser → Laser iridotomy (definitive treatment)
Risk Factors for Primary Angle Closure Glaucoma (PACG)
What needs to be memorized: Age (elderly), Female gender, Asian ethnicity, Shallow anterior chamber, Hypermetropia
Mnemonic: "It's A-FASH thing!" (Like saying "it's a fashion thing")
💡 Remember: The typical PACG patient is fashionably described by A-FASH!
🔗 The Breakdown:
- A → Age (elderly patients)
- F → Female gender
- A → Asian ethnicity (especially East Asian)
- S → Shallow anterior chamber
- H → Hypermetropia (hyperopia/far-sightedness)
Drugs That Precipitate Angle Closure Glaucoma
What needs to be memorized: Anticholinergics (Atropine), Antidepressants (TCAs), Antihistamines, Sympathomimetics, Topiramate
Mnemonic: "AAA-ST" (Triple-A Student)
💡 Remember: These "AAA-ST" drugs are dangerous for angle closure patients!
🔗 The Breakdown:
- A → Anticholinergics (e.g., Atropine)
- A → Antidepressants (especially TCAs)
- A → Antihistamines
- S → Sympathomimetics
- T → Topiramate
Visual Field Defects in Glaucoma
What needs to be memorized: Paracentral scotoma, Arcuate scotoma (Bjerrum), Nasal step (Ronne), Temporal island (end-stage)
Mnemonic: "PANT" (Vision gets torn like pants tearing)
🔗 The Breakdown:
- P → Paracentral scotoma (early defect)
- A → Arcuate scotoma / Bjerrum scotoma (most characteristic)
- N → Nasal step (Ronne nasal step)
- T → Temporal island (late/end-stage - only temporal field remains)
ISNT Rule - Normal Neuroretinal Rim Thickness
What needs to be memorized: Order of rim thickness from thickest to thinnest: Inferior → Superior → Nasal → Temporal
Mnemonic: "ISNT it obvious? ISN'T Temporal the thinnest?"
💡 Remember: In a normal optic disc, the neuroretinal rim follows ISNT rule. In glaucoma, this pattern is lost!
🔗 The Breakdown:
- I → Inferior (thickest rim)
- S → Superior
- N → Nasal
- T → Temporal (thinnest rim)
Gonioscopy Grading - Shaffer's Classification (Grades 4 to 0)
What needs to be memorized: Structures visible as angle narrows from Grade 4 (widest) to Grade 0 (closed): All structures → Scleral spur → Trabecular meshwork → Schwalbe's line → Nothing visible
Mnemonic: "All Super Teachers Say 'No'" (As angle closes from 4→0)
🔗 The Breakdown:
- All → All structures visible (Grade 4: Wide open, 35-45°)
- Super → Scleral spur visible (Grade 3: Open, 25-35°)
- Teachers → Trabecular meshwork visible (Grade 2: Narrow, 20°)
- Say → Schwalbe's line only (Grade 1: Very narrow, 10°)
- No → Nothing/None visible (Grade 0: Closed, 0°)
Diagnostic Triad for Glaucoma
What needs to be memorized: Three essential components - Raised Intraocular Pressure (IOP), Optic disc cupping/damage, Visual field defects
Mnemonic: "I Own Vision" (IOV)
💡 Remember: To diagnose glaucoma, check if patient can still say "I Own my Vision" by assessing all three!
🔗 The Breakdown:
- I → IOP (Intraocular Pressure - raised)
- O → Optic disc changes (cupping, CDR increase, ISNT loss)
- V → Visual field defects
