1.2.3 Flashcards
DM ocular impact (8)
- blurred vision (macular oedema)
- dry eye disease
- diabetic retinopathy/maculopathy
- cataract (doubles risk)
- glaucoma (doubles risk)
- reduced corneal sensitivity
- delayed wound healing - increase risk of infection
- hyperglycaemia = myopic shift
- hypoglycaemia = hyperopic shift
HBP ocular impact
hypertensive retinopathy
CSR - stress
RA ocular impact
- dry eye disease - gritty/watering
- scleritis
process of diabetes + laymans
chronic condition
insulin (hormone) is produced by the pancreas and controls blood glucose levels by storing extra glucose in cells
when insulin is not produced (T1) or fails to respond (T2) - blood glucose levels increase
type 1 DM
insulin dependant (IDDM)
(total loss of insulin production)
type 2 DM
non-insulin dependant (NIDDM)
(insulin resistance)
how metformin works
reduces glucose produced by the liver and increases the effectiveness of insulin
treatment of IDDM
insulin injections
stop smoking
taking care of general health
treatment of NIDDM
diet and weight loss
manage BP/cholesterol/sugar
stop smoking
exercise
metformin (with meals)
ocular side effects of metformin
blurred vision
dry eye
treatment of RA
immunosuppressants:
methotrexate
hydroxychloroquine
rheumatoid arthritis process + laymans
the immune system attacks healthy cells which causes chronic inflammation and swelling of the joints. this can be managed with medications that slow down the immune system and reduce swelling
methotrexate ocular side effects
- dry eye disease
- blepharitis
hydroxychloroquine ocular side effects
- macular oedema (metamorphopsia)
- red colour defects
- bulls eye maculopathy
process of MS + laymans
autoimmune inflammatory condition where the body mistakenly attacks the brain, spinal cord and optic nerves - disrupts the flow of information from brain to body
risk factors: viral infections, smoking
MS ocular impact
optic neuritis - swelling of the optic nerve = blurred/reduced vision/TVO, pain on motility, RAPD, colour defects
nystagmus
double vision (muscle restriction)
optic neuritis treatment
spontaneous resolution 12 weeks
prednisolone
process of HBP + laymans
narrowing of arteries and increased pressure from blood against artery walls which means blood has to work a lot harder to pump blood around the body
normal = 120/80
increases risk of heart disease and stroke
ocular side effects of perindopril
blurred vison
yellow sclera - liver issue
treatment of MS
5 day course of steroids for relapses
gabapentin for nystagmus
hypertensive retinopathy
disc oedema
blot haem
microaneurysms
cotton wool spots
AV nicking (overlap)
copper wiring (hollow)
narrowing of arteries
ocular side effects of gabapentin
for nystagmus
steroid effects on the eyes
PSC cataract
increase IOP = galucoma
delayed wound healing = infection
treatment of HBP
perindopril
Lifestyle changes - diet/exercise/smoking
R0
no DR (recall 12 months)
R1
mild BDR (12 month recall)
at least one of any of the following:
- dot haem
- blot haem
- flame haem
- microaneurysm
- hard exudate
- cotton wool spot
R2
observable BDR (6 months recall)
4+ blot haem in 1 hemifield
R3
referable BDR (routine)
4+ blot haem in 2 hemifield
venous beading
IRMA
R4
proliferative DR (emergency)
- new BV (retinal may cause RD/iris may cause glauc)
- vitreous haem
- exudates less than 1 DD from fovea
IRMA
abnormal branching due to hypoxia
does not cross over BV
no leak on FA
NBV
cross over BV
leaks on FA
very thin
M0
no maculopathy within 2 DD
(12 months)
M1
hard exudates between 1-2 DD
(6 months)
M2
hard exudates within 1 DD
blot haem within 1 DD
retinal thickening
(routine referral)
endpoint maculopathy
ischaemia - no Tx (no blood flow)
