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Year 2 DO Diploma Revision > AOC - Big Three > Flashcards

AOC - Big Three Flashcards

1
Q

What is: Age Related Macular Degeneration

A

Progressive loss of central vision

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2
Q

Signs: Age Related Macular Degeneration (4 points)

A

Drusen

Degeneration of retina

Choroidal vessel become visible

New/weak blood vessels form

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3
Q

What is Drusen

A

Pale spots of extracellular material in basal lamina of choroid which is associated with ARMD and irregular pigment

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4
Q

What makes ARMD wet?

A

When the new blood vessels form, they’re weak and leak fluid/blood into the retina causing it to lift from the pigment epithelium

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5
Q

What is a result of Wet ARMD

A

Scarring and destruction of photoreceptors

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6
Q

Symptoms: DRY Age Related Macular Degeneration (3 points)

A

Gradual deterioration of visual acuity over a few years

Difficulty reading and task requiring detailed vision

Peripheral unaffected

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7
Q

Symptoms: WET Age Related Macular Degeneration (3 points)

A

Can notice distortion of central vision

Blurring of vision

Rapid progression

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8
Q

Cause: Age Related Macular Degeneration (2 points)

A

Believed to be degeneration of retinal pigment epithelium

Failure of these to breakdown waste products of retinal photoreceptors causes these to degenerate

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9
Q

Risk factors for ARMD (6 points)

A 
Age
Smoking
Excessive sunlight exposure
Female
Obesity 
Family history of ARMD
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10
Q

Treatment: WET Age Related Macular Degeneration (2 points)

A

Photodynamic Therapy - injection of light sensitive drug into veins, laser then directed at new blood vessels behind retina to activate drug and destroy them.

Injection every 6 weeks for 2 years to prevent the growth of new blood vessels

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11
Q

Treatment: DRY Age Related Macular Degeneration (1 points)

A

No effective treatment currently available

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12
Q

Advice for ARMD individuals (4 points)

A

Should retain periphery vision, unlikely to be completely blind

Dietary advice

Vitamin supplements can be considered

Treatment doesn’t restore vision but slows/prevents deterioration

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13
Q

What is Diabetic Retinopathy (3 points)

A

Term used to describe retina complications of diabetes.

Major cause of serious visual loss

More likely to occur the longer they’ve been diabetic

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14
Q

Signs: Diabetic Retinopathy (7 points)

A

Microaneurysms - bulges in capillary walls

Retinal haemorrhages - round or flame shaped

Hard Exudates - white, often circular deposits

Cotton-wool spots - fluffy looking deposits

Retinal oedema - fluid build up in retinal layers

Neovascularisation - formation of new blood vessels

Vitreous haemorrhages - bleeding of new weak vessels

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15
Q

Stages of Diabetic Retinopathy (4 points)

A

Background Retinopathy

Preproliferative Retinopathy

Proliferative Retinopathy

Diabetic Maculopathy

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16
Q

Background Retinopathy (4 points)

A

Microaneurysms

Retinal haemorrhages

Hard Exudates

(Treatment not required unless reaches macular)

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17
Q

Preproliferative Retinopathy

A

Background retinopathy with addition of cotton wool spots and irregular blood vessels

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18
Q

Proliferative Retinopathy

A

New blood vessels begin to form, which can cause haemorrhaging into the vitreous and possible retinal detachment

19
Q

Diabetic Maculopathy

A

Can occur with/without proliferative retinopathy

Common cause of serious vision loss

Occurs when haemorrhaging, hard exudates and oedema involve the macula

20
Q

Symptoms: Diabetic Retinopathy

A

Reduce visual acuity

Can be gradual if caused by macular oedema but sudden if macular or vitreous heamorrhage

21
Q

Cause: Diabetic Retinopathy

A

Process caused by damage to endothelial cells and retinal capillaries.

The capillaries can haemorrhage or fluid can leak into retinal layers causing exudates and oedema.

Blockage of vessels cause growth of new ones

22
Q

Treatment: Background Retinopathy

A

No treatment other than regular reviews

23
Q

Treatment: Preproliferative Retinopathy

A

No treatment but closer monitoring

24
Q

Treatment: Proliferative Retinopathy & Maculopathy

A

Photocoagulation - laser burn to retina to destroy or seal leaking or weak blood vessels

25
Q

What is Glaucoma

A

Disease that causes damage to retinal nerve fibres and optic nerve head. This produces visual field loss and in most cases have a high IOP

26
Q

Open Angle Glaucoma

A

Most common type

Most at risk: high myopes, afro Caribbean origin and people suffering from diabetes or high blood pressure

27
Q

Closed Angle Glaucoma

A

Caused by iris blocking trabecular meshwork

Often acute attacks

Individuals with small eyes (often hypermetropia) are most at risk

28
Q

Congenital Glaucoma

A

Rarest form

Occurs in newborns

IOPs high before or very soon after birth, stretching globe

29
Q

Signs: Open Angle Glaucoma

A

IOPs above 22mm Hg

Enlarged cupping of optic disc

Typical pattern of visual field loss

30
Q

Normal or Low Tension Glaucoma

A

Experiences enlarged cupping and field loss without high IOPs

31
Q

Symtoms: Open Angle Glaucoma

A

Usually symptoms less until serious field loss

32
Q

Cause: Open Angle Glaucoma

A

Production of Aqueous quicker than it can be drained

Thickening or compression of canal of schlemm and trabecular mesh work can reduce rate of drainage (occurs with age)

Increased IOP puts pressure on optic nerve head, reducing blood supply to retina causing field loss

33
Q

Typical pattern of field loss for Open Angle Glaucoma

A

Scotoma along 15 degrees isopter, enlarged blind spot and a nasal step

Untreated can lead to total blindness

34
Q

Treatment: Open Angle Glaucoma

A

Drops are used to slow the production of aqueous to reduce IOP

Trabeculopasty - laser can be used to open drainage channels in the trabecular meshwork

Trabeculectomy - incisions made in the sclera to allow drainage from the anterior chamber into the subconjunctival tissue

35
Q

Signs: Closed Angle Glaucoma

A 
In acute attack:
Red eye
Cornea cloudy
Pupil dilated into oval
Very high IOPs
36
Q

Symptoms: Closed Angle Glaucoma

A

Pain- can cause vomiting

Blurred vision

Can experience coloured halo around lights from corneal oedema

37
Q

Cause: Closed Angle Glaucoma

A

Shallow anterior chamber where angle can be blocked by iris

Dilated pupil for extended time can prevent aqueous outflow to cause dramatic increase of IOP

38
Q

Treatment: Closed Angle Glaucoma

A

Immediate treatment of systemic medication to reduce aqueous production

Miotic drops to reduce pupil size and withdrawing pressure from angle

Long term treatment is surgery

39
Q

What is Retinal Detachment?

A

Separation of the retina from the pigment epithelium

Usually followed by a vitreous detachment

40
Q

Signs: Retinal Detachment

A

Ophthalmoscope shows purple grey area on fundus that can be rippled/folded

Blood vessels in this area are darker than in other parts

U shape tear may be seen

41
Q

Symptoms: Retinal Detachment

A

Progressive loss of visual field that can appear as a shadow or net curtain

Flashes of light with movement

Floaters (often due to vitreous detachment that occurs before)

42
Q

Causes: Retinal Detachment

A

Retina only attached at ora serrata and optic nerve head so a tear can cause fluid to get behind and detach.

Tear can occur from thinning of retina or trauma to the eye

Axially myopic Px’s more prone due to stretched ocular tissue

43
Q

Treatment: Retinal Detachment

A

Urgent treatment required

Retinal tears can be treated with a laser or freezing to seal retina to pigment epithelium

Surgery required for large detached areas - can involve draining fluid behind retina and injecting gas infront to push retina back onto epithelium

Year 2 DO Diploma Revision (10 decks)

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