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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Hussein Hollands, Davin Johnson, Simon Hollands, Delan Jinapriya, David L. Simel, Sanjay Sharma

Sections:  Clinical Scenario, Methods, Results, Discussion, Case Resolution, References

Topics Discussed: glaucoma, primary open-angle glaucoma

Excerpt: "A healthy 72-year-old white man with a family history of glaucoma returns to your clinic for his yearly check-up. An optometrist last saw him 5 years ago, at which time he was told his eyes were normal and he had 20/20 vision without requirement for spectacle correction. What are the clinical signs of glaucoma and what is the role of the generalist physician in screening for the condition? Glaucoma is an optic neuropathy characterized by irreversible loss of retinal ganglion cells, resulting in progressive thinning of the retinal nerve fiber layer. It is often associated with higher IOP and can broadly be classified into open-angle and closed-angle forms based on the morphological appearance of the iridocorneal angle at which aqueous drainage takes place. In POAG, the iridocorneal angle appears anatomically open and morphologically normal on clinical examination...."
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