2.8: The Eye and Systemic Disease (2)

Question 1

Cardiovascular Disease: Name three cardiovascular related causes of eye disease/damage?

Answer 1

• Diabetes - Hypertension - Vascular Occlusion

Question 2

Describe the effect of diabetes on the eyes?

Answer 2

Causes diabetic retinopathy Microvascular changes due to poor glucose control There is proliferative of new vessels which can bleed causing cloudy vision and destruction of the retina

Question 3

Symptoms of diabetic retinopathy?

Answer 3

Microaneurysms (Dot and Blot Haemorrhages) Cotton Wool Spots Hard Exudates

Question 4

What does this picture show?

Answer 4

Cotton Wool Spots

Question 5

What does this picture show?

Answer 5

Hard Exudates

Question 6

What does the picture show?

Answer 6

Dot and Blot Haemorrhage

Question 7

What does the red arrow show?

Answer 7

Flame Haemorrhage

Question 8

Affect of diabetic retinopathy on vision?

Answer 8

Blurred/Cloudy Vision Vision Loss Blindness

Question 9

Describe the categories of diabetic retinopathy?

Answer 9

• No retinopathy - Mild } - Moderate } Non-Proliferative Retinopathy - Severe } - Proliferative Retinopathy

Question 10

Treatment for diabetic retinopathy?

Answer 10

• Laser Treatment - Eye Injections (Anti-VGEF) - Surgery (Removal of some vitreous)

Question 11

Describe affect of hypertension on the eyes? Who does this affect most?

Answer 11

Hypertension can cause damage to the eyes and retinopathy More damaging in young than in elderly (elderly have atherosclerotic retinal vessels)

Question 12

Signs of hypertensive retinopathy?

Answer 12

• Silver or copper wiring - Cotton wool spots - Hard exudates - Retinal Haemorrhage - Optic Disc Oedema

Question 13

What is accelerated hypertension?

Answer 13

This is seen in young patients Rapid acceleration in hypertension Causes damage to the retina and loss of vision

Question 14

Describe central retinal artery occlusion? Symptoms and Signs?

Answer 14

Blockage of the main artery of the retina This is sudden loss of vision - Profound loss - Painless - Cherry Red Spot

Question 15

If you saw a cherry red spot, what would you think?

Answer 15

Central Retinal Artery Occlusion

Question 16

What is this?

Answer 16

Central Retinal Artery Occlusion - Notice the cherry red spot

Question 17

Describe central retinal vein occlusion? Symptoms and signs?

Answer 17

Blockage of the main vein of the retina This causes sudden visual loss - can range from mild to severe May or may not cause ischaemia Symptoms: - Blurred vision - Loss of vision - Painless - Floaters Signs: - Extensive Haemorrhages

Question 18

What is this? Cause?

Answer 18

Extensive Haemorrhage Caused by central retinal vein occlusion

Question 19

Describe branch retinal vein occlusion?

Answer 19

Painless loss in vision caused by the occlusion of a branch of the vein that supplies the retina Patients may notice part of their visual field lost or may be asymptomatic

Question 20

Name three inflammatory diseases that can affect the eye?

Answer 20

• Granulomatosis Disease - Giant Cell Arteritis - Thyroid Disease

Question 21

Describe the link between sarcoidosis the eyes?

Answer 21

Sarcoidosis can cause inflammatory eye disease Causes anterior uveitis

Question 22

Causes of anterior uveitis?

Answer 22

Infective - Herpes Simplex - Herpes Zoster - TB Non-Infective - Sarcoidosis - Idiopathic - Rheumatoid Arthritis

Question 23

What is giant cell arteritis? Symptoms?

Answer 23

This is inflammation of the large and medium sized arteries Also called temporal arteritis Symptoms include headache, jaw claudication, visual loss and malaise

Question 24

Describe Thyroid Eye Disease? Symptoms of thyroid eye disease?

Answer 24

This is thyroid disease (systemic) having local effects on the eye. Symptoms - Proptosis (Protruding eyes) - Lid Lag - Chemosis of anterior segment Can cause glaucoma

Question 25

What characterises Thyroid Eye Disease?

Answer 25

Swelling of extra ocular muscles and orbital fat

Question 26

What is the most common cause of bilateral and unilateral proptosis?

Answer 26

Thyroid Eye Disease

Question 27

Treatment of thyroid eye disease?

Answer 27

• Treat underlying thyroid disease - Ocular Lubricants (Dry Eyes) - Surgical Decompression

Question 28

Describe connective tissue diseases that affect the eye?

Answer 28

SLE Rheumatoid Arthritis Marfans

Question 29

Describe SLE and the eye? What immunological tests do you do to confirm SLE?

Answer 29

SLE is a multi-systemic immunological disease ANA and Anti-dsDNA Causes ocular inflammation

Question 30

Describe rheumatoid arthritis and the eye?

Answer 30

Causes keratoconjunctivitis sicca (dry eye) May also lead to scleritis and corneal melt