Common Conditions of the Eye Flashcards
What is a cataract?
Opacification of the lens
Why do cataracts develop?
Older fibres are never shed and so the lens gets thicker and thicker
What are the signs and symptoms of cataracts?
Spoke like opacities can be seen going from outside
Patient will complain of blurry vision - more common in low light
In mature will be mostly blind and milky white appearance seen on eye
When should a cataract get fixed?
Once a patients lifestyle is impaired
What are secondary causes of cataracts?
Trauma
Steroid eye drops
What is nuclear sclerosis?
Where inside of cataract is getting affected
Patient sees more red colour
What are sutural and zonular cataracts?
Childhood cataract formed due to opacification in utero
Only affects fibres that where present when mother was impacted
What are the consequences of sutural cataracts if untreated?
Brain starts compensating and can lead to child never developing vision in that eye
How do you manage cataracts?
Surgery small incision in lens capsule and remove old lens and place plastic lens in capsular bag
Lens placed in posterior chamber
What is glaucoma?
Raised intraocular pressure
What are the consequences of raised IOP?
Pressure on nerve fibres on surface of retina causes the nerve fibres to die out leads to visual field defects
Then leads to blindness
What are the train signs of glaucoma?
Raised IOP
Visual field defects
Optic disc changes on ophthalmoscopy
How do you manage POAG?
Eye drops to decrease IOP
Laser trabeculopasty
Trabeculectomy surgery
What is POAG?
Primary open angle glaucoma
What are the symptoms of angle closure glaucoma?
Sudden onset, painful, vision lost/blurred, headaches
What can be seen on examination in angle closure glaucoma?
Red eye, cornea opaque as raised IOP drives fluid into cornea, AC shallow and angle closed
Pupil mild-dilated
IOP severely raised
What is the mechanism of angle closure?
Functional block in small eye
Mid-dilated pupil
Iris sticks to pupillary border
How do you manage an acute episode of angle closure?
Decrease IOP - IV infusion, analgesics, constrictor eye drops, steroid eye drops, beta blocker drops (if no contra-indications)
Iridotomy - both eyes to bypass blockage
What are causes of infectious corneal ulcers?
Viral, bacterial, fungal
What are causes of non-infective corneal ulcers?
Trauma, corneal degradation or dystrophies
What is a consequence of large corneal ulcers?
Opaque corneas
What is the clinical presentation of corneal dystrophies?
1st to 4th decade
Decreased vision
What is lattice dystrophy?
Deposition of amyloid material in corneal stroma
How do patients with lattice dystrophy present?
Eye irritation, photosensitivity, pain and blurred vision
Bilateral criss-crossing opacities in storm on examination
What is the treatment of lattice dystrophy?
Managing symptoms
Corneal transplant in late stages
What is Fuch’s endothelial dystrophy?
Asymmetrical bilateral progressive oedema
What causes Fuch’s endothelial dystrophy?
Destruction and death of endothelial cells leads to oedema and opacification of cornea
What is treatment of Fuch’s endothelial dystrophy?
Symptomatic treatment
Corneal transplant
What is uveitis?
Inflammation of the uvea
What is anterior uveitis?
Iris with or without ciliary body inflamed
What is intermediate uveitis?
Ciliary body inflamed
What is posterior uveitis?
Choroid inflamed
What are the causes of uveitis?
Isolated illness
Non-infectious autoimmune causes
Infectious causes (TB)
Associated with systemic diseases (ankylosing spondylitis)
What is the pathophysiology of anterior uveitis?
Inflamed anterior uvea leaks plasma and WBC into aqueous humor
Hazy anterior chamber
What is the pathophysiology of intermediate uveitis?
Ciliary body is inflamed and leaks cells and proteins
Causes hazy vitreous
What is the pathophysiology of posterior uveitis?
Choroid is inflamed as it sits under retina, often spreads there causing blurred vision
What is conjuctivits?
Self limiting bacterial or viral infection of conjuctiva
What are the signs and symptoms of conjuctivits?
Red watering eyes, discharge
No loss of vision as long as doesn’t spread to cornea
What is external style conjunctivitis?
Infection of hair follicle of eyelash
What is internal style conjuctivitis?
Blockage and infection of meibomian glands
What is the treatment for conjunctivitis?
Warm compress
Eyelid hygiene
May need surgical incision and curettage
