Basic Eye Disorders 1 Flashcards
Cataracts affects which population?
1 in 2 elderly
Cataract is due to _____ damage to the lens proteins that reduce _____.
- oxidative
- solubility
(insoluble OPACITIES form in otherwise transparent tissue)
In cataract, ________ w/in lens causes clouding of vision and progressive vision loss.
protein clumping (coagulation and crystallization)
Senile cataracts is _______ (unilateral/bilateral) and has a ______ appearance.
- unilateral or bilateral
- radial
Cataracts has 3 main pathophysiologic causes*** (***different than risk factors; see chronic vision loss)
(other than idiopathic)
- congenital/viral
- chromosomopathy (trisomy 21)
- inborn error of metabolism
First dx test done if you suspect cataracts
pin hole
pin hole test
visual acuity chart through a pin hole, if it improves then nothing wrong w/ macula or retina.
How is cataracts dx?
Examining fundus: reduced or obstructed red reflex
Diabetic retinopathy occurs in almost all ______ patients and the majority of _____ patients
- DMT1
- DMT2
Diabetic retinopathy affects 1 in _____.
2,500
______ are particularly affected by increased blood sugar and lose the ability to auto-regulate.
Vascular pericytes
hemorrhage over the macula will lead to _______.
sudden vision loss
What causes cotton-whool spots?
retinal capillaries infarct → hypoxia
(possibly infarct of neuron → mitochondrial accumulation at the swollen ends)
neovascularization (diabetic retinopathy) is the result of _______.
ischemia
What is the main difference in proliferative vs. non-proliferative diabetic retinopathy
neovascularization
(proliferative can hemorrhage→visualized with green slit)
diabetic retinopathy occurs 10-15 years after dx, and chronic retinal problems can lead to ________.
retinal detachment → sudden vision loss
(TQ!!)
visual acuity in patients with diabetic retinopathy depends on ______.
involvement of the macula
Non-proliferative diabetic retinopathy is treated with _______; proliferative is treated with ________.
- surgery (temp. improvement)
- anti-VEGF
How do you measure the anterior chamber depth
ophthalmoscopy: measure the distance between the iris reaction and the cornea
a shallow anterior chamber indicates ________.
glaucoma
3 Most common causes of red eye
- Keratoconjunctivitis
- uveitis
- Acute Glaucoma (side of face hurts, medical emergency)
Who does closed angle glaucoma affect (2)
- asians
- pts w/hyperopia
MC cause of viral conjunctivitis and kerititis
adenovirus
(also HSV & VZV)
Cobblestoning of the conjunctiva, watery discharge and an abrupt onset indicates ________.
viral conjunctivitis
Eosinophils are found in _____ (allergic/bacterial) conjunctivitis and keratitis; neutrophils are found in ________ (allergic/bacterial).
- allergic
- bacterial
herpes keratoconjunctivitis usually affects which population?
- children
- neonates
Hutchinson sign
lesions on nose, related to herpes zoster conjunctivitis and keratitis
________ (microbe) seen in patients who use tap water to clean their contacts
acanthamoeba
MC cause of vision loss in the elderly?
dry macular edema
(1 in 40 white females)
Macular degeneration is always ______ (unilateral/bilateral)
bilateral
How are drusen visualized on fundoscopic exam?
green light filters out red, blue filters out yellow
Dry macular degeneration presents with ______ (slow/sudden) vision loss
slow
Dry form of macular degeneration is due to idiopathic _________.
disintegration of retinal pigment epithelium & loss of overlying photoreceptors
Wet form of macular degeration is ________(slow/sudden)
can be either progressive or sudden
Patient states, “I see worse in the middle of my vision.” What do you suspect?
Wet form of macular degeneration
Lack of visual acuity w/pinhole indicates _______ involvement.
retina
(seen in wet form of macular degeneration)
Optic neuritis is strongly associated with _______ (diz)
MS
(precedes MS by a few years)
optic neuritis may simulate ____(diz).
glaucoma
optic neuritis presents with ____ (2) due to inflammation of the optic nerve.
- papilledema
- pale white disc where margin is obscured
A woman comes in with numbness in her arm, a headache and has papilledema. Dx?
optic neuritis
Head MRI of a patient with optic neuritis may reveal ______.
optic nerve demyelination
