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MODHIII - Unit 3 > Diseases of the Eye > Flashcards

Diseases of the Eye Flashcards

1
Q

Xeropthalmia: where does it occur

A
  • primarily in developing country due to diet low in vitamin A
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2
Q

Why does vitamin A cause xeropthalmia

A
  • vitamin A necessary for cells of conjunctiva, which produce mucus of tear film
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3
Q

Xeropthalmia: disease process

A
  • chronic reduction in corneal tear film leads to loss of corneal transparency and in growth of blood vessels
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4
Q

Xeropthalmia is exacerbated by what disease in children

A
  • measles
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5
Q

Treatment for Xeropthalmia

A
  • limited

- corneal transplant results are poor

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6
Q

Other effect seen in Xeropthalmia

A
  • vitamin A deficiency also affects rod photoreceptors, can lead to night blindness
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7
Q

Similar outcomes of xeropthalmia due to other causes

A
  • observed in individuals with chemical or thermal corneal burns or chronic breakdown of corneal epithelium (dry eye, diabetes complications)
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8
Q

Keratoconus: incidence & who it effects

A
  • incidence: 1/2000; typically BILATERAL

- associated with down syndrome, marfan syndrome

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9
Q

Keratoconus: disease process

A
  • progressive thinning and ectasia of the cornea; occurs in ABSENSE of inflammation of vascularization
  • results in a cornea with a conical shape
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10
Q

Treatment for keratoconus & exacerbation

A
  • difficult with glasses
  • corneal transplantation has high degree of success
  • exacerbated by eye rubbing; should be discouraged
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11
Q

Corneal Dystrophies

A
  • heterogenous condition

- Fuchs Endothelial Dystrophy

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12
Q

Fuchs Endothelial Dystrophy: early and late

A
  • early: enothelial cells produce guttata (raised wart like growths)
  • late: endothelial cells die
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13
Q

Fuchs endothelial dystrophy: cause

A
  • loss of endothelial cells, which results in edema and bullous keratopathy (stomal swelling)
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14
Q

Vitamin A deficiency leads to what disease

A
  • Xeropthalmia
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15
Q

Metabolic Diseases

A
  • heterogenous

- hunter’s and hurler’s syndrome

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16
Q

Metabolic diseases: disease process

A
  • deposition of compounds in various parts of the body where they should not be
  • may affect cornea, retina, and/or optic nerve
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17
Q

Metabolic diseases: treatment

A
  • corneal transplant is an option, but many diseases affect retina and optic nerve as well, which would not help visual outcomes
  • hematopoietic stem cell transplants may help improve corneal clearity
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18
Q

Treatment for corneal damage and disease

A
  • eye drops & topical lubricating ointments: problem with compliance
  • amniotic membrane transplant
  • corneal transplant
  • artificail corneal-boston keratoprosthesis (KPro): will develop glaucoma, risk of retinal detachment
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19
Q

Cataract: disease process, causes, treatment

A
  • loss in lens transparency
  • causes: congenital or acquired-drugs(corticosteroids), genetic, infections of mother during pregnancy, biochemical disorders
  • early treatment important for children with congenital cataract, outcomes are typically good
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20
Q

Glaucoma: basics

A
  • visual field loss from peripheral to central
  • most due to high IOP but normal & low tension glaucoma exist
  • can be open-angle or closed angle and primary or secondary
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21
Q

Importance of IOP in glaucoma

A
  • high IOP is a risk factor for glaucoma, not guaranteed to get it if you have IOP
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22
Q

Primary open angle glaucoma

A
  • iridocorneal angle is open; few changes is trabecular meshwork
  • most genes unknown
23
Q

Secondary open angle glaucoma

A
  • angle is open but is occluded

- example: pseudoexfoliation glaucoma - pigment from iris breaks off and blocks the angle

24
Q

Primary angle closure glaucoma

A
  • angle is closed, reducing aqueous humor outflow
  • iris pushes forward angle narrows or closes
  • typically found in hyperopic individuals w/ shallow anterior chambers
25
Q

Secondary angle closure glaucoma

A
  • results from pathologies that draw iris over trabecular meshwork
  • medical emergency**
26
Q

Treatments for glaucoma

A
  • nothing new since the 80s
  • only approved treatments rely on reduction of IOP
  • eye drops: many different types & can be combined
  • sugery
27
Q

Treatments for glaucoma: eye drops

A
  • beta blockers: decrease amount of aqueous humor produced
  • prostaglandin analogs: increase the outflow from the eye
  • carbonic anhydrase inhibitors: decrease production of intraocular fluid
  • alpha agonists: decrease production and increase drainage of fluid
28
Q

Treatments for glaucoma: surgery

A
  • laser trabeuloplasty: increases drainage of the angle in POAG
  • iridotomy: laser treatment for narrow angle glaucoma that creates tiny holes in the iris
  • operative shunt: creates bypass drainage channel to lower eye pressure
29
Q

Age related macular degeneration: result, forms

A
  • results in damage to macula
  • occurs in dry or wet form
  • dry: characterized by drusen deposits in Bruch membrane
  • wet: neoangiogenesis (absent in dry form)
30
Q

Treatment for dry AMD

A
  • NO TREATMENT
31
Q

Treatment for wet AMD

A
  • injection of VEGF antagonists into vitreous every 3 months

- risk is needle being put into retina every 3 months

32
Q

Diabetic retinopathy: types

A
  • non proliferative & proliferative
33
Q

Diabetic neuropathy: cause

A
  • result of damaged blood vessels
34
Q

Non-proliferative DR: why non proliferative & abnormalities seen

A
  • non proliferative b/c eye doesn’t make new blood vessels during eary stage of disease
  • microaneurysms, breakdown of blood retinal barrier, macular edema
35
Q

Non proliferative DR: exudate location

A
  • exudates occur in outer plexiform layer

- may have micro occlusions

36
Q

Proliferative DR

A
  • characterized by neovascularization of optic nerve head or retina
  • may have hemorrhage; vitreous detachment
37
Q

Retinal detachment: disease process & types

A
  • separation of neural retina from retinal pigment epithelium
  • non rhegmatogenous: without a break in retina-vitreous border
  • rhegmatogenous: with a break of retina-vitreous border
38
Q

Retinal detachment: causes & treatment

A
  • causes: typically associated with trauma
  • treatment: laserpexy or cryopexy to reattach retina + virectomy + gas to press retina to the globe
  • outcomes are typically good
39
Q

Retinitis pigmentosa: cause, affect, treatment

A
  • inherited condition, 1/3600 incidence
  • affects rods, cones, and or RPE
  • affects peripheral vision first and early night blindness
  • NO treatments
40
Q

Retinal artery occlusion

A
  • sudden unilateral visual loss
  • results in diffuse infarct of retina
  • PALLOW OPTIC DISK AND CHERRY RED FOVEA
  • varied treatments to reduce occlusion
41
Q

Retinal vein occlusion

A
  • sudden unilateral vision loss
  • results in diffuse infarct of retina
  • OPTIC DISK SWELLING, RETINAL HEMORRHAGE AND DIALTED VEINS
42
Q

Compressive optic neuropathy: cause, associated with, treatment

A
  • results from pressure on the optic nerve in orbit
  • associated with Grave’s disease or neoplasm affecting orbit
  • treatments: removal of neoplasm, orbital decompression, CORTICOSTEROIDS
43
Q

Optic neuritis: key feature

A
  • orbital or ocular pain when moving eyes
44
Q

Optic neuritis: process

A
  • loss of vision secondary to demyelination and inflammation of optic nerve
45
Q

Optic neuritis: result, cause, treatment

A
  • results in scotoma of visual field
  • cause: MULTIPLE SCLEROSIS, infection, autoimmune, drug induced
  • treatment: corticosteroids does NOT show long term benefit
46
Q

Anterior ischemia optic neuropathy: types

A
  • non arteritic

- arteritic

47
Q

Anterior ischemia optic neuropathy: non arteritic cause

A
  • results from CV risk factors in patients w/ crowded optic disks
  • most cases are idiopathic
48
Q

Non arteritic AION: disease process

A
  • isolated white matter stoke in optic nerve
  • sudden unilateral visual loss
  • optic disk edema
  • MORE COMMON
49
Q

Non arteritic AION: treatment

A
  • high dose corticosteroids may be useful, no consensus
50
Q

Arteritic AION: cause

A
  • due to temporal arteritis
  • inflammation of medium sized blood vessels
  • occurs with advancing age
51
Q

Arteritic AION: result and treatment

A
  • results in complete vision loss in one eye, followed by other eye if left untreated
  • treatment: long course of corticosteroids
52
Q

Posterior ischemia neuropathy: when is ti diagnosed

A
  • disease of occlusion

- rule out all other disease then say it’s this

53
Q

Posterior ischemia optic neuropathy: affect, cause

A
  • affects retrobulbar portion of optic nerve
  • occurs in patients with HTN, diabetes, smokers
  • can occur as complication of spinal surgery
  • due to decreased blood flow, leading to death of optic nerve cells
54
Q

Posterior ischemia optic neuropathy: disease process

A
  • death of optic nerve cells causes inflammation, which compresses optic nerve in the optic canal

MODHIII - Unit 3 (20 decks)

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