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Ophthalmology > Anterior Chamber Disorders > Flashcards

Anterior Chamber Disorders Flashcards

1
Q

Open-angle Glaucoma

A
  • Optic neuropathy results in progressive loss of retinal ganglion cell axons.
  • Peripheral visual fields lost first, then central vision, then blindness
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2
Q

How does open angle glaucoma progress?

A

Peripheral fields —> Central vision —> Blindness

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3
Q

Glaucoma Sequelae

A
  • Slowly progressive irreversible damage to the optic nerve.

- Loss of vision goes unnoticed until severe

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4
Q

Primary Open-angle Glaucoma (POAG) Symptoms

A
  • Symptoms are rarely experienced
  • No loss of visual acuity as long as central vision is preserved.
  • Irreversible
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5
Q

How is POAG diagnosed?

A
  • Characteristic nerve damage on fundis exam and elevated intraocular pressures.
  • Cupping
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6
Q

Cupping

A
  • A cup that is greater than 50% of the vertical disc diameter.
  • Glaucoma can cause the cup to enlarge
  • Cup gets bigger in a vertical oval type pattern.
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7
Q

Optic Cup

A
  • White, cup-like area in the center of the optic disc.
  • Normal cup/disc ratio is 1/3
  • There is some normal variation here
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8
Q

Do all patients with open angle glaucoma have elevated IOP?

A

No, not all patients with OAG have elevated IOP.

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9
Q

IOP > 40. what should you do?

A

Emergency Referral.

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10
Q

IOP 30-40. what should you do?

A

Urgent referral within 24 hrs.

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11
Q

Screening recommendations

A
  • 40-60 yrs w/o risk factors: ever 3-5 yrs.
  • Every 1-2 yrs w/ risk factors
  • Periodic exams for black men and women btw ages 20-39.
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12
Q

Acute Angle-Closure Glaucoma (AACG)

A

Occurs only with closure of a pre-existing narrow anterior chamber angle.

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13
Q

What brings on AACG

A

Dark theatre, pharmacological Mydriasis, anticholinergenics,

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14
Q

AACG symptoms

A
  • Rapid Onset
  • Severe eye pain/HA
  • Profound visual loss
  • May have photophobia
  • N/V
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15
Q

AACG signs

A

Conjunctival redness
Corneal edema or cloudiness
Shallow anterior chamber
Mid-dilated pupil not reactive to light

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16
Q

Is angle AACG an emergency?

A

Absolutely.

17
Q

If it will be greater than an hour before AACG pt can be seen, what should be given?

A

Acetazolamide, Mannitol, glycerol.

- Decrease IOP

18
Q

AACG tx continued

A

Timolol (Timoptic)
Apraclonidine (Ioponide)
Pilocarpine (Isopo)
One drop of each, one minute apart.

19
Q

Uveitis

A
  • Intraocular inflammation
  • Is immunologic in most cases
  • Associated with HLA B27
20
Q

Causes of Uveitis

A
  • CMV: Cytomegalovirus (immunocompromised)
  • Toxoplasmosis
  • Syphillis
  • Cat scratch disease
  • HSV and HZV
21
Q

Anterior Uveitis

A
  • 4 times more common than posterior.

- May be seen together with panuveitis

22
Q

Anterior Uveitis Symptoms

A
  • Eye pain
  • Redness
  • May have visual loss
23
Q

Posterior Uveitis S/S

A
  • Usually painless
  • Cells seen in vitreous
  • Inflammatory lesions on retina and choroid
  • Gradual vision loss
  • Often Bilateral
  • Yellow or pigmented lesions
24
Q

Infectious uveutis tx

A
  • Antiviral or antibiotics

- Glucocorticoids

25
Q

Noninfectious uveitis tx

A

Anterior: Topical glucocorticoids and dilating drop
Posterior: Periocular injection of triamcinolone or systemic corticosteroids.

26
Q

Iritis

A
  • Usually idiopathic
  • May be autoimmune associated
  • Blunt trauma, corneal inflammation
27
Q

Iritis is commonly associated with ______?

A

Uveitis

28
Q

Iritis Presentation

A
  • Deep eye pain
  • Photophobia
  • Redness, ciliary flush
  • Pupillary constriction
  • Synechiae can form
29
Q

Which type of agent should be given to a patient with iritis?

A

A cycloplegic agent, but avoid atropine.

30
Q

Complications of Iritis

A
  • Cataracts
  • Calcifications of cornea
  • Glaucoma
  • Uveitis
  • Blindness
31
Q

Hyphema

A
  • A suspension of red blood cells in the aqueous humor.

- Due to direct trauma to the eyeball

32
Q

grades of hyphema

A

Grade 1: Less than 1/3 of the chamber
Grade 2: 1/3 to 1/2 of the chamber
Grade 3: 1/2 to total chamber
Grade 4: Total clotted blood “8-ball hyphema”

33
Q

Is hyphema a medical emergency?

A

Yes. Refer to optho or ER immediately.

34
Q

About 15-20% of people w/ hyphema have further bleeding in ____ to ____ days.

A

Three to five. Compliance is very important.

35
Q

Hyphema Meds

A
  • 1% atropine may be used.
  • Steroid drops
  • Beta blockers if increased IOP.
  • Cover eye with shield
36
Q

Home instructions for hyphema

A
  • Bedrest with head of bed elevated.
  • No strenuous activity
  • No bood thinners
  • Tylenol can be taken
37
Q

Hypopion

A

The presence of pus or puslike fluid in the anterior chamber of the eye.
Similar to hyphema, but puslike.

38
Q

Cataracts

A

Opacity of the lens
Leading causes of blindness in the world.
Easily cured by surgery
Complex pathophysiology

Ophthalmology (12 decks)

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