Common Eye Disorders Flashcards
1
Q
Cataracts
A
- partial or complete loss of transparency of the crystalline lens or capsule
- pathogenesis not fully understood
- lens gets cloudy and dirty
- associated with: aging, UV exposure, drugs/meds (particularly steroids), injury/trauma, systemic conditions (DM)
- leading cause of blindness in the world (not US)
2
Q
Amblyopia
A
- Lazy eye
- An eye that cannot see 20/20 even with best correction
- unilateral or bilateral
- causes: refractive, strabismic, deprivation
- must be corrected before age 7 or reduced vision can be permanent
3
Q
Refractive amblyopia
A
- large or unequal refractive error
- bilat high myopia, hyperopia, or astigmatism may cause bilat decreased acuity
- anisometropic: one eye myopic the other hyperopic
- eyes may be aligned or strabismic
- tx: rx glasses for full time wear and possible “patching” treatment
4
Q
Types of Cataracts
A
- Senile: related to aging, a yellowing of crystalline lens
- Congenital: present at birth or within 1 yr, may or may not affect vision
- Traumatic: secondary to injury or surgery - AKA Rosette cataract
- Posterior subcapuslar: often associated with corticosteroid use (fast growing)
- Cortical: caused by UV exposure over time
5
Q
Cataract symptoms
A
- gradual blurring or fuzzy vision
- issues with driving at night, “halos” or “starburst”
- looking through a film
6
Q
Cataract treatment
A
- surgical replacement of the crystalline lens and implantation of corrective implant
- results in 96% chance of vision restoration
7
Q
Strabismus
A
- misalignment of both eyes so that both eyes cannot be directed toward the object of regard
- Can be true muscle misalignment or refractive
- Esotroipa and exotropia
- type of amblyopia
8
Q
Esotropia
A
- type of strabismus
- eyes turn in toward nose
- infantile is diagnosed within first 6 months
- often requires surgery
- refractive: most commonly high hyperopia
- Treatment: rx glasses full time, possible surgery
9
Q
Exotropia
A
- type of stabismus
- usually 1-4 years of age
- often intermittent
- eyes turn out
- can increase with age
- common and typically do not need surgery
- Treatment: glasses, vision therapy, and surgery if needed
10
Q
Deprivation Amblyopia
A
- physical deprivation of visual axis resulting in a failure to develop normal visual pathways
- congenital cataracts
- ptosis
- surgical intervention often required
11
Q
Ocular malignancies
A
- retinoblastoma
- choriodal melanoma
- basal cell carcinoma
- squamous cell carcinoma
12
Q
Retinoblastoma
A
- most common eye cancer in children
- spontaneously arises in the retina through a gene mutation or deletion of chromosomes
- average diagnosis by age 23 months
- if you see a white pupil they need to be treated immediately
13
Q
Clinical characteristics of retinoblastoma
A
- Leukokoria (white pupil) - most common
- strabismus
- elevted white mass with indistinct borders in the fundus
- treatment: localized chemo/radiation, photocoagulation laster/thermal therapy, enucleation (take out eye)
- Prognosis: most curable of all childhood cancer
14
Q
Chorodial Melanoma
A
- most common primary malignant intraocular tumor
- second most common type of primary malignant melanoma
- area of dark pigmentation in eye
- more common over 55
- often asymptomatic
- linked to UV exposure, light colored iris, previous hx of nervus
- Can do an ultra sound to look for the depth
15
Q
Chorodial melanoma clinical features
A
- arises from melanocytes within choroid
- can cause retinal detachments
- # 1 place to metastasize is liver (need to check liver enzymes)
- left untreated can result in death
16
Q
Chorodial melanoma tx
A
- localized chemo/radiation
- photocoagulation laser/thermal therapy
- enucleation
17
Q
Basal Cell
A
- most common eyelid cancer
- rarely metastasize outside of immediate area
- can spread to orbit, sinus, brain
- 70% on lower lid
- tx: surgical removal (biopsy)
18
Q
Squamous cell carcinoma
A
- 2nd most common malignant eyelid tumor
- most common conjunctival cancer
- rarely metastasizes
- can invade orbit, sinuses, and brain
- early intervention is key
- tx: surgical removal (biopsy)
19
Q
Hordeolum
A
- AKA stye
- external: obstructed and infected (staph) hair follicle and adjacent glands of Zies and Moll (typically can tx with hot compress)
- internal: obstructed and infected meibomian gland (require oral abx)
- clinical features: red, swollen eyelid, painful to tough (external form of pustule on lid)
20
Q
Hordeolum tx
A
- warm compresses used in both
- external: may rupture on its own with compresses, RX abx
- internal: systemic abx
- if internal is not treated properly it will form granulomatous scar tissue (ie Chalazion) - will need to cut out
21
Q
Chalazion
A
- noninfectious granulomatous obstruction of the meibomian gland to EYELID
- swollen nodule on eyelid, not painful to touch
- tx: warm compresses and systemic abx
- if it does not respond may need surgical intervention (corticosteroid injection or excision)
- If they can tolerate Doxy try that first
22
Q
Internal stye vs Chalazion
A
- internal syte: red, swollen and painful
- chalazion: palpable, but not painful or red
23
Q
Corneal abrasion
A
- disruption of the epithelial cells of the cornea
- clinical features: red, painful eye, photophobic, FB sensation, a recent hx of trauma to the eye, and positive corneal staining with NaFl
24
Q
Corneal abrasion managment
A
- depends on size and location
- remove FB if present
- usually heal with little to no complications 48-72 hours if superficial
- Abx or bandage contact lens
- If vegetative matter NO steroids (possible fungal infection)
- monitor to make sure ulcer does not develop
25
Q
Corneal abrasion staining
A
- lights up scratch
- if vertical marks then whatever scratch their eye is under their upper eyelid
26
Q
Corneal ulcer
A
- infectious disruption of corneal epithelium and stroma
- often seen in patients who abuse contact lenses
- red, painful eye, sensitive to light with a visible CORNEAL OPACITY
- positive NaFl staining
- tx: abx, special contacts
- if not treated properly can be visually devastating
- if unresponsive to abx after 5 days send for further work up (acanthamoeba, fungal)
27
Q
Hepres Zoster
A
- reactivation of varicella zoster
- red, burning, painful rash, can affect any part of the body
- can affect the eye (ophthalmic herpes)
- Hutchinson’s sign: lesions on tip of the nose ( more likely to develop lesions on cornea)
- red painful eye, sensitivity to light, dendritic lesion on the cornea
- tx: oral antivirals, topical antivirals
- if not treated properly can cause permanent scarring and vision loss
28
Q
Retinal detachment
A
- Rhegmatogenous, exudative, tractional
- common systems: FLASHES OF LIGHT, increase floaters, curtain falling over vision
- ocular emergency: timely intervention necessary to restore vision - if not eye will die
29
Q
Exudative retinal detachement
A
- serous elevation of the retina without a retinal break
- fluid accumulation is due to breakdown of the normal inner or out blood retinal barrier
- causes: neoplastic, inflammatory, congenital abnormalities, vascular
30
Q
Rhegmatogenous retinal detachement
A
- elevation of the retina from the RPE by fluid in the subretinal space due to full thickness retinal break or tear
- usually spontaneous
- more common in people with myopia (long eye) as they tend to have retinal thinning
31
Q
Tractional retinal detachement
A
- detached retina appears concave with a smooth surface, cellular and vitreous membranes exerting traction on the retina are present
- happening on the surface and ripping it forward
- causes: diabetic retinopathy, sickle cell retinopathy, toxocaris, trauma
32
Q
Retinal detachment tx
A
- dependent on location and size
- Cryo-therapy: used for small holes or tears. “freezing” of hole or tear to create scar tissue to prevent progression to full detachment
- scleral buckle: used for large tears and full detachment. Scar tissue formed using cryo or laser then retina is sewn to actual “buckle” made of plastic silicone. Often requires vitrectomy (PPV)
- prognosis: visual outcomes dependent on size of detachment and timely intervention
