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BMB Test 2 > B7.034 Ophthalmologic Diseases Overview > Flashcards

B7.034 Ophthalmologic Diseases Overview Flashcards

1
Q

etiologies of cataracts

A 
process of aging
-70% of people > 75
congenital
-rubella infection
genetic anomaly
-Lowe syndrome, Wilsons
secondary to various diseases, trauma, inflammation, radiation, meds (etc)
-steroids and diabetes
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2
Q

basics of an eye exam

A 
visual acuity
pupillary response
ocular motility
slit lamp exam
fundus exam
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3
Q

glare vision testing

A

shine light in eyes

in case of cataracts, this can worsen vision

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4
Q

types of cataracts

A

nuclear
cortical
posterior subcapsular
posterior

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5
Q

treatment of cataracts

A

cataract removal with/without intraocular lens implantation

phacoemulsification

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6
Q

posterior capsular opacification

A

most common “complication” of cataract surgery
-leftover cataract cells proliferate on back of lens
about 40% of patients require YAG laser capsulotomy to resolve

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7
Q

most common cause of acute glaucoma

A

angle closure

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8
Q

symptoms of angle closure glaucoma

A 
pain
blurred vision
halos
nausea/vomiting
headache
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9
Q

signs of angle closure glaucoma

A 
conjunctival injection
fixed mid-dilated pupil
"steamy" or edematous cornea
elevated intraocular pressure
history of hyperopia
Asian race
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10
Q

why can hyperopia lead to angle closure glaucoma

A

smaller eye than average
structures more likely to be compressed
far sighted

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11
Q

treatment for angle closure glaucoma

A

IV Diamox
topical glaucoma meds
laser iridotomy (hole in iris to bypass usual channel that is closed off)

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12
Q

epidemiology of macular degeneration

A

leading cause of irreversible central vision loss among people 52 and up

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13
Q

symptoms of macular degeneration

A

metamorphopsia and decreased central vision (opposite of glaucoma, which tends to cause loss of peripheral vision first)

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14
Q

where is the macula

A

darkish spot 2 disc diameters from the optic nerve

high proportion of cones here

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15
Q

what is metamorphopsia

A

distortion of vision in addition to blurring

tested with grid to determine if it looks wavy

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16
Q

exam for macular degeneration

A

visual acuity
ophthalmoscopy
optical coherence tomography
fluorescein angiography

17
Q

changes seen in macular degeneration

A

drusen
retinal pigment epithelium (RPE) changes
neovascular membrane

18
Q

drusen

A

hyaline nodules in Bruch’s membrane, which separates RPE from inner choroidal vessels

19
Q

RPE changes in macular degeneration

A

hyper and hypopigmentation
can occur with or without drusen
variable effect on vision

20
Q

progression of macular degeneration

A

10-20% of eyes with AMD develop a neovascular membrane, which means a defect in Bruch’s membrane, leading to wet macular degeneration

21
Q

worse prognostic factors in macular degeneration

A

larger membrane

closer to center of fovea

22
Q

treatment of dry macular degeneration

A

ocular AREDS vitamins to slow progression

Amsler Grid testing to monitor progression to wet form

23
Q

treatment of wet macular degeneration

A

intravitreal injections of anti-VEGF

-decreased swelling and abnormal blood vessels to get rid of fluid

24
Q

diabetic eye changes

A

changes in refraction
-myopic shift (near sighted)
posterior subcapsular cataracts
retinopathy

25
Q

epidemiology of retinopathy

A

patients with IDDM for 5 yrs have 23% probability
after 15 years, 80% probability
NIDDM have lower probability

26
Q

importance of annual dilated diabetic eye exam

A

patients can have retinopathy without visual complaints

27
Q

exam for diabetic eye changes

A

visual acuity
ophthalmoscopy
optical coherence tomography
fluorescein angiography

28
Q

mild-moderate findings in diabetic retinopathy

A

dot and blot hemorrhages
hard exudate
macular edema

29
Q

severe findings in diabetic retinopathy

A

cotton wool spots (ischemic retina)
venous bleeding
intraretinal microvascular abnormalities (IRMA)

30
Q

proliferative diabetic retinopathy

A

when leakage occurs, the eye thinks it isn’t getting oxygen, and it increased VEGF to build new blood vessels to the periphery
there new blood vessels are crappy

31
Q

sequalae of proliferative diabetic retinopathy

A

vitreous hemorrhage
retinal hemorrhage
retinal detachment

32
Q

treatment of macular edema in diabetics

A

eye drops
focal laser treatment
intravitreal injections with anti-VEGF and steroids

33
Q

why do laser treatments help in diabetic retinopathy

A

kills peripheral retina, so eye no longer thinks its deprived of O2, bc that area no longer exists

34
Q

treatment of diabetic retinopathy

A 
panretinal photocoagulation (PRP)
intravitreal injections with anti-VEGF and steroids
surgery
35
Q

what is a cherry red spot on the macula

A

central retinal artery occlusion (CRAO)

36
Q

when might you see a cherry red spot

A

diabetes, HTN, increase cholesterol
-emboli from carotid can cause stroke in the eye
metabolic storage diseases
-tay sachs, neimann pick, sandhoff

37
Q

laser vision correction options

A

surface ablation

ablation under a flap

38
Q

good candidate for LASIK

A 
18 and up
contact lens wearer or failure
willingness to tolerate healing phase
consistent prescription for 1 year
desire
39
Q

who should avoid LASIK

A 
unrealistic expectations
pregnant and nursing women
unstable prescriptions
history of uncontrolled autoimmune disease
history of certain infections/diseases

BMB Test 2 (22 decks)

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