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SURG - Neuro III > Common Causes of Vision Impairment > Flashcards

Common Causes of Vision Impairment Flashcards

1
Q

which visual acuity scores are indiciative of

  • no / mild visual impairment?
  • moderate visual impairment?
  • severe visual impairment?
A
  • mild to none: 20/30 - 20/50
  • moderate: 2/70 or worse
  • severe: 20/200 or rose
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2
Q

following an eye complaint, a physician should complete what examinations before consulting a specialist?

A
  1. Visual acuity testing of each eye individually
  2. Confrontation visual field testing
  3. Extraocular motility
  4. Pupillary reaction
  5. Tonometry (pressure)
  6. Ophthalmoscope
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3
Q

corneal abrasian

  • causes
  • clinical presentation
  • workup
  • treatment
A
  • causes: trauma, contacts
  • clinical presentation: foreign body sensation, redness / pain
  • work-up: f_lourescein staining_
  • treatment:
    1. psuedomonas covering topical Abx:
      • CLS
      • fluoroquinilones
    2. cyclopentate / atropine - for comfort
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4
Q

what should not be used to to treat corneal abrasian?

A

numbing drops - tetracaine / procrainamide

these can inhibiting growth & healing of corneal epithelium

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5
Q

discuss the protocols for prescribing the following ocular treatment

  • numbing drops
  • topical steroids
A
  • numbing drops (procainamide / tetracaine) - NEVER
  • topical steroids - only by an eye doctor specifically
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6
Q

fill out

A
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7
Q

viral conjunctivitis

  • clinical presentation?
  • type of disarchage?
  • inflammation pattern?
  • other exam findings
  • treatment
A
  • presentation: presents with cold sx +/- migrates from one eye → other
  • discharge: watery
  • inflammation: follicular pattern
  • other exam findings: swollen pre-auricular lymph nodes
  • treatmentL: typically no meds (is self limited)
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8
Q

viral conjunctivitis

  • clinical presentation?
  • type of disarchage?
  • inflammation pattern?
  • other exam findings
  • treatment
A
  • presentation: recent cold sx +/- migrates from one eye → other
  • discharge: watery
  • inflammation: follicular pattern
  • other exam findings: swollen pre-auricular lymph nodes
  • treatmentL: typically no meds (is self limited)
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9
Q

bacterial conjuncitivitis

  • clinical presentation?
  • type of discharge?
  • inflammation pattern?
  • other exam findings
  • treatment
A
  • presentation: no cold sx
  • discharge: mucopurulent
  • inflammation: papillary reaction
  • other exam findings: n/a
  • treatment: topical Abx + consider STIs
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10
Q

which STIs are common causes of bacterial conjuncitivis?

how are they different?

how are they treated?

A
  • chlamydia - chronic, indolent
  • gonococcal - virulent, dangerous

systemic treatment

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11
Q

allergic conjunctivitis

  • clinical presentation
  • treatment
A
  • presentation: bilateral itching in young patients
  • treatment:
    • cool compresses
    • artificial tears
    • topical / oral: anti-histamines, mast cell stabilizers
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12
Q

what is the most common cause of conjunctivitis?

A

viral

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13
Q

herpes keratitis

  • clinical presentation
  • inflammatory reaction
  • other exam findings
A
  • presentation: foreign body sensation + pain/redness
  • inflammatory reaction: follicular
  • other exam findings: dendritic branches on flourescein staining
  • treatment: anti-virals + referring to opthalmology
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14
Q

herpes zoster opthalmicus

  • presentation
  • treatment
  • complications
A

i.e., herpez zoster keratititis

  • presentation: unilateral painful rash over CN V area, including multiple crusted blisters on nose
  • treatment: oral anti-virals within 72 hours + urgent referral to optho
  • complications: post-herpetic neuralgia
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15
Q

corneal ulcer from infectious keratititis

  • causes
  • presentation
  • treatment
A
  • causes: bacterial m/c, consider herpes, fungal, acanthamoeba
  • treatment: based on etiologic agent. NO STEROIDS - they worsen fungal & acanthamoeba causes
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16
Q

identify

A

viral conjuncitivitis

watery discharge

follicular reaction

17
Q

identify

A

bacterial conjuncitivits

mucopurulent discharge

papillary reaction

18
Q

identify

A

herpes keratitis

dendritic branching (flourescein staining)

19
Q
  • identify
  • explain cause
  • note the treatment
A
  • herpes zoster opthalmicus (keratitis)
  • reactivation of VZV via nasocilliary nerve
  • treatment: ORAL antivirals within 72 hours + urgent optho referral to prevent post-herpetic neuralgia
20
Q

identify

A

corneal ulcer

21
Q

presbyopia

  • definition
  • cause
  • treatment
A
  • definition: age-related far-sightedness (can’t see near)
  • cause: hardening of lens throughout aging → inability to acomodate
  • treatment: reading glasses + reassurance
22
Q

ambylopia

  • definition
  • cause
  • work-up
A
  • ambylopia: delayed eye movement - “lazy eye”
  • causes: m/c = strabismus - poor ocular alignment
  • work-up:
    • cover test / uncover test
    • brucker screening test
      • deviated eye = whiter / brighter reflex
23
Q

what is this test?

what is showing?

A

bruckner screening test - dx of ambylopia

deviated eye = whiter / brighter reflex

24
Q

define & identify the cause of

  • myopia
  • hyperopia
  • astigmatism
A
25
Q

cataracts

  • definition
  • cause
  • treatment
A
  • definition: painless clouding of the lens
  • cause: aging m/c
  • treatment: surgery
26
Q

glaucoma is the ___ cause of blindness in the US?

A

2nd leading

27
Q

what are the risk factors for primary open angle glaucoma?

A
  • increased IOP
  • increased cup:disc ratio
  • increased age
  • thinner central corneal thickness
  • family hx - 6x inc w/ 1st degree relatives
  • AA - 6x higher > caucasions
28
Q

what is normal intraocular pressure (IOP)?

A

10-21

29
Q

what exam findings are evident of increased cupping of the optic nerve?

A
  • enlarged, hollow spot on disc
  • C:D ratio > 0.5
  • assymetry
30
Q

physicians should check what things if suspicious of primary angle glaucoma?

A
  • visual fields
  • intraocular pressure - IOP > 21
  • optic nerve cupping - C:D ratio > 5, assymetry, hollow disc spot
31
Q

primary open angle glaucoma - treatment

A

all target lowering IOP:

  • eye drops that reduce production / increase outflow of aqueous humor
  • laser procedures / other surgeries
32
Q

which glaucoma eye drops

  • decrease aqueous humor synthesis
  • increase aqueous humor outflow?
A

decrease production

  • alpha agonists - epinephrine (a1), brimonidine (a2)
  • b-blockers - olols: timolol, carteolol, betaxolol
  • diuretics - acetazolamide

increase outflow

  • cholinomimetics - physiostigmine, pilocarpine, carbachol
  • prostaglandins - prosts: bimatoprost, lataoprost
33
Q

place the glaucoma eye drops in their correct position in the cart

A
34
Q

age related macular degeneration (AMD)

  • epidemiology
  • cause
  • risk factors
  • exam finndings
  • treatment
A
  • epidemiology: leading cause of irreversible central visual loss amongst people > 50 in the US
  • presentation: metamorphopsia (distortion) → scotoma (vision loss)
  • cause: macula has high [] of cones centrally → fine detailed central vision
  • exam findings:
    • drusen: yellow lipid & protein deposits
    • wetness: choroid neovascularization
  • risk factors:
    • smoking
    • HTN
    • nutrition
  • treatment:
    • dry AMD: high dose anti-oxidants + smoking cessation / lifestyle changes
    • wet AMD: anti-vascular endothelial growth factor intraocular injection
35
Q

age related macular degeneration (AMD) is the leading cause of ___ ?

A

irreversible central vision loss amongs people > 50 years in the US

36
Q

what major risk factors pre-dispose AMD?

A
  • smoking
  • HTN
  • nutrition
37
Q

what is the treatment for dry AMD?

A
  • high dose antioxidants
  • smoking cessation + other lifestyle changes
38
Q

what exam finding is indicate of wet AMD?

what is the mainstay treatment for wet AMD?

what are the pros / cons of this treatment?

A
  • finding: choroidal neovascularization
  • mainstay tx: anti-vascular endothelial GF intraocular injection
    • ​cons:
      • requires monthly visits
      • requires many needles
      • high tx burden for elderly patints

SURG - Neuro III (4 decks)

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