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Ophthamology > Chronic Ophthalmologic Disorders > Flashcards

Chronic Ophthalmologic Disorders Flashcards

1
Q

Refractory error

The lens of the eye loses the ability to focus due to loss of elasticity

Effects - Difficult to see objects up close

A

Presbyopia

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2
Q

Most common age-related problem in ophthalmology

A

Presbyopia

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3
Q

This disease is 50-100 different versions of an optic nerve disease
(neuropathy) with characteristic optic nerve head and visual field
changes

A

Glaucoma

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4
Q

What are the types of glaucoma?

A

Primary Open-Angle (most common)

Angle Closure (emergency)

Childhood

Secondary (after trauma or disease)

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5
Q

What is the most common type of glaucoma?

A

Primary Open-Angle

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6
Q

What demographics/groups are at more risk for glaucoma?

A

Common in patients who may be least able to treat themselves or
gain access to care

Elderly

African Americans

Diabetics and CV disease

Individuals with elevated IOP

1st degree relatives with glaucoma

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7
Q

Which type of glaucoma is described below?

High incident in AA population

Adult onset

More likely to go blind

Bilateral (but not always symmetric)

Usually takes years or even decades (can slowly result in complete
blindness)

Compliance an issue

A

Primary Open-Angle Glaucoma

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8
Q

List some causes of secondary glaucoma

A

Trauma
Iritis
Chronic Steroid use
Diabetic Retinopathy
Ocular Vascular occlusion

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9
Q

What is the most important testing in glaucoma?

A

Visual Field Testing

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10
Q

What are the screening guidelines for a Type 1 diabetic?

A

Annual ophthalmologic exams starting 5 years after diagnosis

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11
Q

What are the screening guidelines for a Type 2 diabetic?

A

Annual ophthalmologic exams starting at the time of diagnosis

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12
Q

What are the two main glaucoma characteristics?

A

Optic Nerve Head Changes

Visual Field Changes

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13
Q

In glaucoma, what are the goals of treatment?

A

Halt further vision loss (cannot regain what is lost)

Halt further optic nerve damage

Slow progression

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14
Q

Vision loss in the center of the field of vision - Loss of central vision ONLY

Leading cause of permanent visual loss in older population

Caused by the deterioration in the central portion of the retina known as the macula

A

Macular Degeneration

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15
Q

What is the leading cause of permanent visual loss in older population?

A

Macular Degeneration

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16
Q

What is the macula responsible for?

A

responsible for focusing central vision in the eye, and it controls our ability to read, drive a car, recognize face/colors, and see objects in fine detail

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17
Q

What are the two classifications of macular degeneration?

A

Atrophic
Neovascular

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18
Q

What type of macular degeneration is described below?

Gradually progressive bilateral loss of vision due to atrophy and
degeneration of the outer retina and retinal pigment epithelium

A

Atrophic

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19
Q

What type of macular degeneration is described below?

Choroidal new vessels grow between the retinal pigment epithelium and brunch membrane leading to accumulation of fluid, hemorrhage, and fibrosis

Onset of vision loss is more rapid and more severe

A

Neovascular

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20
Q

Which type of macular degeneration accounts for 90% of all cases of
legal blindness d/t macular degeneration?

A

Neovascular

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21
Q

List some risk factors for macular degeneration

A

Caucasian
Female > male
Family history
Cigarette smoking

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22
Q

Which risk factor for macular degeneration doubles the risk?

A

Cigarette smoking

23
Q

What tool is used to assess for macular degeneration?

A

Amsler grid

24
Q

What does the Amsler grid assess?

A

Asses for acute vision changes in macular degeneration

25
Q

What is the cost common cause of vision loss after refractive error?

A

Cataract

26
Q

What is the most common cause of blindness worldwide?

A

Cataract

27
Q

A wing-like structure, typically found on the nasal side of cornea

Fleshy and typically triangular

A benign pathologic change in the bulbar conjunctiva at the palpebral
fissure that develops in an eye exposed to drying elements such as sun, wind, and dust

A

Pterygium and Pinguecula

28
Q

What is the difference between Pterygium and Pinguecula?

A

Pinguecula - Does not involve the cornea

Pterygium - Invades the cornea

29
Q

What are the indications for surgery in cases of Pterygium and Pinguecula?

A

Growth threatening vision by approaching the visual axis

Marked induced astigmatism

Severe ocular irritation

30
Q

What is the most common cause of blindness in working age Americans?

A

Diabetic Retinopathy

31
Q

What is the best predictor of diabetic retinopathy?

A

A1c

32
Q

At what A1c level needs to be achieved to help prevent diabetic retinopathy?

A

must keep below 7

33
Q

Defined as spontaneous, rhythmic, back-and-forth movement of one
or both eyes

Rhythmic “jumping”

A

Nystagmus

34
Q

What are the three most common types of nystagmus?

A

End gaze

Jerk (drug induced)

Pendular

35
Q

What type of nystagmus is described below?

Attempt to maintain gaze in extreme lateral gaze

Not unusual for eye to drift back slightly from the extreme horizontal gaze and then refixate with a small jerk movement

Disappears as gaze is shifted

A

End gaze

36
Q

What type of nystagmus is described below?

Drug induced

Dilating, barbiturates, sedatives – jerk nystagmus in all positions of gaze

A

Jerk (drug induced)

37
Q

What type of nystagmus is described below?

Searching

commonly seen in individuals who are visually impaired from birth

A

Pendular

38
Q

What types of nystagmus should alert the provider to central lesion ideology?

A

Vertical, bidirectional, or unilateral

39
Q

Peripheral or central nystagmus?

Horizontal nystagmus may be present

Bilateral

Unidirectional

Rotary/horizontal

NEVER vertical

Improves with visual fixation

A

Peripheral (outside CNS)

40
Q

Peripheral or central nystagmus?

Vertical nystagmus may be present

Bilateral or unilateral

Bidirectional or unidirectional

Usually no change with fixation

A

Central (brainstem or cerebral dysfunction)

41
Q

Misalignment of visual axis, one or both eyes are divergent away from the midline

Imbalance in ocular muscles

A

Strabismus

42
Q

20% of patients with retinoblastoma present with what symptom/sign?

A

strabismus

43
Q

What are the four types of strabismus?

A

Esotropia
Exotropia
Hypertropia
Hypotropia

44
Q

What type of strabismus is described below?

“in” or “cross-eyed”

One or both eyes deviated towards the nose

Age of onset: 2-5 years

After age 5, suspect a CNS disease

A

Esotropia

45
Q

What type of strabismus is described below?

“out”

One or both eyes deviated outward

A

Exotropia

46
Q

What type of strabismus is described below?

“up”

Most often seen in adults after trauma or stroke, but do also occur in children

A

Hypertropia

47
Q

What type of strabismus is described below?

“down”

Most often seen in adults after trauma or stroke, but do also
occur in children

A

Hypotropia

48
Q

What tests can be used to diagnose strabismus?

A

Cover/uncover test

Corneal light reflex (Hirschberg test)

49
Q

Unilateral or bilateral decrease in visual acuity that occurs as a result
of a lack of a clear image falling on the retina

Asymptomatic – detected only by screening

A

Amblyopia

50
Q

This condition is why we screen for strabismus

A

Amblyopia

51
Q

This condition can only occur during the critical period of development

Birth to 8-9 years

A

Amblyopia

52
Q

What is the treatment for Amblyopia?

A

Occlusion - Force the “lazy” (wandering) eye to work

53
Q

What is the concern and complication of Amblyopia?

A

loss may be permanent

Once it’s turned off, you can’t turn it back on

Ophthamology (6 decks)

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