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Ophthalmology > Diseases > Flashcards

Diseases Flashcards

1
Q

Chronic low-grade inflammation of the eyelids; can wax and wane; associated with increased risk of chalazion and hordeolum

A

Blepharitis (meibomianitis)

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2
Q

Sxs: Foreign body sensation, burning, dry eye, erythema of eye lids, irregular lid margins, flaking and crustiness, variable acuity, itching, tearing

A

Blepharitis (meibomianitis)

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3
Q

Sty; acute, localized lesion; infection of eyelid

sxs: painful and tender to touch

A

Hordeolum

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4
Q

Chronic, granulomatous blockage of meibomian glands

Sxs: Raised and non-tender (non infectious)

A

Chalazion

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5
Q

Nasolacrimal duct; obstruction/inflammation, lesion under medial canthus area

A

Dacrocystitis

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6
Q

Sxs: Raised/tender lacrimal sac or duct; possible purulent dishcarge through puncta

A

Dacrocystitis

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7
Q

Turning out of eyelids usually due to aging

Sxs: Epiphora (excessive watering), grittiness, dryness

A

Ectropion

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8
Q

Eyelashes irritating the eye

A

Trichiasis

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9
Q

Sxs: Itching, tearing, glossy injection of conjunctiva (low-grade erythema) with follicles, papillae (bumps), and watery d/c

A

Allergic conjunctivitis

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10
Q

Sxs: Red eyes of varying intensity, mucopurulent d/c, often worse in AM

A

Bacterial conjunctivitis

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11
Q

Most commonly adenovirus, very contagious

Sxs: Mild to very red eye, watery d/c

A

Viral conjunctivitis

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12
Q

What should you look for in PE when diagnosing viral conjunctivitis

A

Check pre-auricular node

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13
Q

Very common, yellow-white raised lesions on conjunctiva (usually at 3 and 9 o’clock), do not affect the cornea (near limbus)
Sxs: Redness, dryness, foreign body sensation

A

Pinguecula

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14
Q

Wing-shaped fibrovascular growth arising from the conjunctiva and extending onto the cornea; lesion can be highly vascularized

A

Pterygium

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15
Q

Sxs: High vascularization may cause dryness, foreign body sensation, can induce an increase in astigmatism

A

Pterygium

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16
Q

Physical drooping of the lid; minimal/possible superior visual defects

A

Ptosis (horner’s syndrome with mitosis and anhidrosis)

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17
Q

Ulcerations on cornea, causes cornea to be less sensitive (check corneal reflex); linear, branching epithelial ulcerations with terminal bulbs

A

Viral Keratitis caused by HSV

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18
Q

What are the two types of keratitis

A

Viral and bacterial

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19
Q

Rapid progression; corneal destruction may be complete in 24-48 hours.

Sxs: Corneal ulceration, blurred vision, acute red eye, pain, photophobia, discharge

A

Bacterial keratitis

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20
Q

Sxs: Red eye, pain, watery discharge, reduced acuity, usually unilateral

A

Viral keratitis

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21
Q

“Dry eye”

Cornea disorder

A

Keratitis (keratoconjunctivitis sicca) corneal ulcers

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22
Q

Sxs: Gritty , Foreign body sensation, Burning, Variable acuity, Paradoxically excess tearing (because your tears are crap)

A

Keratitis (keratoconjunctivitis sicca)

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23
Q

Caused by something hitting the eye

Sxs: Mild to extreme discomfort, Photophobia, Tearing, Discomfort with blinking

A

Corneal abrasion

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24
Q

Something stuck in eye; history is critical

Sxs: Scratchy, painful

A

Corneal foreign body

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25
Q

From bacterial infection

(same sxs and txt as bacterial keratitis, but has white ulcer); Ask abt contact lens

A

Corneal ulcer

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26
Q

Sxs: Blurred vision, Red eye, Pain, Photophobia, Discharge

A

Corneal ulcer

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27
Q

Serious! MEDICAL EMERGENCY.
Infection posterior to orbital septum
Extensive swelling and erythema of the eylids and surrounding tissue; Very painful

A

Orbital cellulitis

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28
Q

Sxs: Very painful, Blurred vision, HA, Diplopia, EOM restriction, Possibly proptosis (bulging)

A

Orbital cellulitis

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29
Q

Acute, rapid rise in IOP due to the trabecular meshwork being occluded by the iris (known as a pupillary block)
OCULAR EMERGENCY!

A

Closed angle acute glaucoma

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30
Q

Sxs: Very intense sx (acute); IOP > 50; Very inflamed eye, Mid-dilated and sluggish pupil (fixed), Possibly steamy cornea, Pt c/o reduced acuity, HA of varying degree, N/V

A

Closed angle acute glaucoma

31
Q

Damage to the optic nerve causing VF loss/defects; Generally associated with eleavated IOPs (>22); Be cautious: many have IOPs

A

Open angle chronic glaucoma

32
Q

Sxs: Optic nerve damage, VF loss, “splinter”/”Drance” hemorrhages on the optic disc/nerve, most often asymptomatic, increased “cupping” @ optic nerve center

A

Open angle chronic glaucoma

33
Q

How to assess for open-angle glaucoma

A

Assessment w/ a slit-lamp
Look at chamber angle
Tonomotry: IOP measurement
Evaluate optic nerve through dilated pupils (use a stereoscopic view)
Pachymetry: measures central corneal thickness
Threshold visual fields - automated
Analyze retinal nerve fibers

34
Q

Blood in anterior chamber clogs the trabecular meshwork

Usually due to trauma

A

Hyphema

35
Q

Any insult to the interior or exterior of the eye creates an immune rxn by this tract.; The damage done by inc. WBCs is worse than any benefit; Caused by trauma, systemic infection, or idiopathic.

A

Anterior uveitis

36
Q

Linked to: Spondylitis, IBD, Reactive Arthritis, Juvenile RA, Syphilis, Lyme Disease

A

Anterior uveitis

37
Q

Sxs: Floaters, Blurred vision, Pain, Redness, Photophobia , Excessive tearing, Decreased vision, Occasionally HA, nausea

Injection (ciliary or limbal flush); Redness around limbus; Cells and flare (protein) in anterior chamber; Keratic precipitation in posterior cornea; Possible miotic pupil

A

Anterior uveitis

38
Q

Less common

Linked to: Choroiditis, Retinitis, Toxoplasmosis* (most common cause)

A

Posterior uveitis

39
Q

Sxs: Blurred vision; NO pain, redness, photophobia; Cells in vitreous (white spots seen), Possible retinal lesions

A

Posterior uveitis

40
Q

Can cause a secondary glaucoma
AKA “inflammatory (low-grade) iritis” and “Posner-Schlossman Syndrome
IOP >40 due to cells in the anterior chamber clogging the trabecular meshwork

A

Iritis

41
Q

Sxs: Intermittent episodes of blurred vision

Mantains an open angle

A

Iritis

42
Q

RELATIVE OCULAR EMERGENCY, Peeling away of the retina from the retinal pigment epithelium (RPE), which attaches from the choroid

Three types:
Regmatogenous
Due to break or tear
Fluid occupies space between the RPE and retina

Exudative, No break, Just fluid

Tractional, Fibrocellular bands in the vitreous contract and detach the retina, Seen in very advanced diabetics

A

Retinal detachment

43
Q

Sxs: Flashes of light, Increase in floaters, Possible curtain or shadows in periphery, Central vision might be affected
*Confrontation fields are important

Pigmented cells in vitreous, Vitreous hemorrhage, Elevation of retina seen w/ ophthalmoscopy, Usually need to dilate

A

Retinal detachment

44
Q

Blockage most often due to embolism
Hollenhorst plaque (cholesterol) often seen at bifurcations of a blood vessel & looks yellow
Also consider Giant Cell/Temporal Arteritis; collagen vascular disorder

A

Central Retinal Artery Occulsion (CRAO)

45
Q

Sxs: One eye, Painless vision loss, Episodes of transient vision loss; Overall whitening of posterior pole, Classic cherry red spot in macula, Probably APD (Marcus Gunn pupil), Narrowed retinal arterioles, Boxcarring of the blood column

A

Central retinal artery occlusion (CRAO)

46
Q

Most often caused by atherosclerosis of the adjacent central retinal artery - results in compression of the CRV near the lamina

Ischemic: More serious; hemorrhages; cotton wool spots; higher risk of neovascularization

Non-ischemic: Less hemorrhaging; no pupillary problem; better acuity

A

Central Retinal Vein Occulusion (CRVO)

47
Q

One eye, Painless loss of vision, Variable acuity loss ; Extensive 4 quadrants of hemorrhaging, Dilated vessels, Tortuous (wavy) veins, Cotton wool spots (ischemia), Macula edema, Neovascularization (later in ds process)

A

Central Retinal Vein Occulusion CRVO

48
Q

Often caused by hypertension and arteriosclerosis

c/c Hypertensive Retinopathy

A

Branch Retinal Vein Occlusion (BRVO)

49
Q

Sxs: One eye, Peripheral blind spots, Variable acuity loss

More superficial hemes in retina; Can include cotton wool spots, vessel toruosity, macula edema; Sometimes neovascularization

A

Branch Retinal Vein Occlusion (BRVO)

50
Q

Damage to the retinal blood vessels of varying degree; Leading cause of blindness in working age Americans; can cause macular edema

*MUST recommend annual eye exams!
Damage can begin w/o sxs

A

Diabetic retinopathy

51
Q

What are the two types of diabetic retinopathy?

A

Non-proliferative; proliferative (more severe)

52
Q

Sxs: Can be asymptomatic; Blurred vision; Red flag: if change within a few months period, Shadows, Missing spots, Reduced night vision, Cotton Wool spots (ischemia)

A

Diabetic retinopathy

53
Q

Sxs: Enlarged and blocked blood vessels: microaneurysms

Bleeding (retinal hemorrhages) and fluid leakage

A

Non-proliferative diabetic retinopathy

54
Q

Sxs: Neovascularization (new vessels) - fragile and can hemorrhage; Can lead to vitreous hemorrhage

A

Proliferative diabetic retinopathy

55
Q

Sxs: Bilateral, Often asymptomatic, Occasionally blurred vision, Arteriolar narrowing, A/V nicking at crossings, Arterioles look sclerotic - “copper/silver” wiring, Associated flame shaped hemes with cotton wool spots

A

Hypertensive retinopathy

56
Q

Dry, Non-exudative, No hemorrhages, Chronic: Vision loss is painless and gradual

A

Dry macular degeneration

57
Q

Wet, Exudative, AKA “Neovascular”, Acute

A

Wet macular degeneration

58
Q

Sxs: Gradual loss of central vision, Metamorphopsia (wave in vision), Dx with Amsler Grid, Can be asymptomatic

Macular drusen (yellow deposits, deep in retina), Pigment clumping, RPE atrophy

A

Dry macular degeneration

59
Q

Sxs: Subretinal fluid (most often blood), Due to choroidal neovascularization - fragile vessels, Vision loss and distortion, Occurs quickly, Can have central or para-central blind spots

A

Wet macular degeneration

60
Q

Any opacity of the lens; The lens is about 65% water and 35% proteins, The proteins are arranged in a precise way, but over time the proteins may clump together and cloud some of the lens

Some correlation with free radical formation
Could be caused by sun exposure, aging, and unbalanced diets

A

Cataracts

61
Q

Yellow of brown discolor of central lens - blurs distance vision

A

Cataracts (nuclear sclerosis)

62
Q

Radial spoke-like opacities - causes glare

A

Cataracts (Cortical)

63
Q

Plaque-like opacities on posterior lens - often in younger pts

A

Posterior subscapular cataracts

64
Q

Causes of cataracts (8)

A 
Age
Steroids: systemic and topical
UV insult
Trauma 
Diabetes
Medications
Congenital
Rubella, Marfans, Downs syndrome
65
Q

Sxs: Slowly progressive loss of vision or blurring, Increase in glare, esp. at night, Halos around lights, Not a clear red reflex

A

Cataracts

66
Q 
Blood pooling in conjunctiva
Can be due to trauma or idiopathic
Investigate systemic causes if recurrent
(Warfarin, etc. use)
*CLARE - contact lens acute red eye
A

Subconjunctival hemmorhage

67
Q

Redness of varying intensity; For CLARE: Photosensitivity

A

Subconjunctival hemmorhage

68
Q

Strong relationship with MS; One eye, Afferent pupillary defect (APD) (Marcus Gunn), Reduced vision (temporary), Poor color vision, Central scotoma/sometimes inferior field defect, Possible pain on eye movement

A

Optic neuritis

69
Q

Involuntary movement of the eyes; Could be a symptom of underlying eye/medical problem; Due to: congenital, illness, accident, unknown cause

A

Nystagmus

70
Q

Sxs: Reduced visual acuity; Dec. depth perception, Balance/coordination problems

A

Nystagmus

71
Q

Increased intracranial pressure

Swollen optic nerve

A

Pappiledema

72
Q

Dermatomal pain, paresthesias, numbness and vesicular ruptures around eye

Hutchinson sign

A

Viral keratitis with HZV

73
Q

Hutchinson sign is associated with which cranial nerve?

A

5th

Ophthalmology (2 decks)

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