10-pathology

Question 1

Damage to which corneal layer is most likely to lead to irreversible low vision?

Answer 1

endothelium -only layer that truly does not regenerate

Question 2

What’s the leading cause of legal blindness in the U.S. for those over 65?

Answer 2

AMD - drusen that progress thru the Bruch’s, involving the RPE and PRs - likely mech: UV-induced oxidation & free radical formation; and hereditary component.
-MUST have dry before getting wet.

Question 3

Pts w/ aniridia are at a much higher chance of what?

-what are some other things to notes regarding the condition?

Answer 3

SECONDARY GLAUCOMA

-usually bilateral, AD inheritance, possible nystagmus 2’ to macular hypoplasia (usually not only iris that’s messed up), strab (usually exo), corneal scarring, lens sublux.

Question 4

difference b/w glare and photophobia?

Answer 4

glare - affects vision

photophobia - excessive neural stimulation (to ANY part of trigeminal) causing abnormal visual tolerance to light

Question 5

5 conditions known to induce photophobia:

Answer 5

keratitis, corneal ulcer, iritis (uveitis), albinism, aniridia

Question 6

corneal compromise would likely lead to what two main sx?

Answer 6

glare, pain

Question 7

3 co-morbidities of aniridia?

Answer 7

glaucoma (secondary), nystagmus, cataracts

Question 8

functional visual complaints of a pt w/ marfan’s syndrome?

Answer 8

everything.

-diplopia, glare, decreased contrast, blurred vision, VF defects

Question 9

functional visual complaints of a pt w/ albinism?

• two anterior seg findings of a albino? Include CT findings)
• posterior seg potential finding?

Answer 9

glare (photophobia probably as well d/t dec. light absorption), decreased contrast

• anterior: Alt ET/Nystagmus
• posterior: macular hypoplasia - main reason for the majority of findings

Question 10

T/F: vertical nystagmus is oftten congenital and benign

T/F: there is no known tx for nystagmus

Answer 10

FALSE - typically pathological
-note: acquired forms of nystagmus associated w/ neuro disorders, injury, medication - more concerning

FALSE - prism (null point), etc.

Question 11

Which type of nystagmus is more often associated w/ brain damage?

-what’s the other type of nystag? associations if horizontal? vertical?

Answer 11

JERK nystagmus - upbeat, downbeat, and horizontal nystag- refer these out

PENDULAR

• if horizontal: MS, congenital VA loss
• if vertical: optic chiasm lesion

Question 12

what percentage of AION pts will go on to have AION in the OTHER eye w/i 3 yrs?

-likely to produce what type of vf defect?

Answer 12

25%! - must watch closely

-altitudinal

Question 13

Silver - What is the earliest finding seen before diabetic retinopathy occurs?

Answer 13

Loss of pericytes from the capillary wall - then M/As form

Question 14

What’s the most common cause of moderate vision loss in diabetic pts?

Answer 14

DME - diabetic macular edema

Question 15

losing the demarcation of the (outer/inner) retinal layers (aka ___) is the most recent way of thinking that vision is affected in diabetic changes.

Answer 15

inner retinal layer disorganization - DRIL