Exam 3 - Visual and Sensory Issues Flashcards
cataracts
-cloudy lens
- gradual onset of painless, blurry vision
- may end in blindness
risk factors of cataracts
- older age
- eye trauma
- congenital risk
- diabetes
- corticosteroid use
- smoking and ETOH consumption
cataract manifestations
- painless
- uni or bilateral vision changes
- blurry
- halo around lights
- altered color perceptions
- glare issues at night
- decreased accommodation
nonproliferative retinopathy
- capillary micro aneurysms, retinal swelling, hard exudate
- macular edema: plasma leaks from macular blood vessels
- capillaries rupture, leading to “dot or blot” hemorrhaging
proliferative retinopathy
- advanced
- new blood vessels are fragile and leaky
hypertensive retinopathy
- high blood pressure creates blockages in retinal blood vessels
- severe HTN can cause sudden visual loss related swelling of the optic disc and nerve
- normal vision is restored with treatment of HTN
detached retina
- retina has a tear or leak
- vitreous humor flows behind the retina
- rapid, progressive detachment from the choroid
clinical manifestations of detached retina
- sudden, unilateral vision loss
- painless
- may see floaters
- flashes of light
are related macular degeneration
- most common cause of irreversible vision loss in people over 60 in the US
risk factors for macular degeneration
- family history
- genetics
- UV light
- hyperopia
- smoking
- light colored eyes
dry macular degeneration
- yellow deposits in the retinal pigment epithelium
wet macular degeneration
- growth of new, leaky blood vessels in an abnormal location of the retina
manifestations of macular degeneration
- early: no symptoms
- later: blurred darkened vision, blind spots, distorted vision
treatment for macular degeneration
- if vision does not improve, treatment is limited
- medications are injected into the eye
glaucoma
- elevated intraocular pressure (IOP)
- vision changes OR optic nerve damage
risk factors for open-angle glaucoma
- elevated IOP
- older age
- African american race
- family history
- myopia
- diabetes, HTN, migraines
open angel glaucoma pathogenesis
- abnormal trabecular meshwork
- reduced drainage of aqueous humor into canal of Schlemm
- imbalance between inflow and outflow
- results in increased IOP and vision problems
clinical manifestations of open angle glaucoma
- none usually
- progressive loss of sight
- vague eye pain
- halos around lights
- tunnel vision
closed angle glaucoma
- much less common
- abnormal angle between the iris and later cornea
- outflow is blocked when the pupil is dilated
risk factors for closed angle glaucoma
- asian american ethnicity
- female
- hyperopia
- family history
- older age
what type of closed angle glaucoma is an emergency
- acute
- outcome based on time from onset to treatment
what triggers an acute episode of closed angle glaucoma
- anticholinergic drugs
acute closed angle glaucoma - clinical manifestations
- unilateral
- severe eye pain
- nausea and vomiting
- blurry vision, halos
- reddened eyes
- dilated pupil - non reactive to light
- cloudy cornea
glaucoma and blindness
- due to the increased IOP
- more pressure on inner eye structures
- decreased blood flow to optic nerve
- nerve fiber death -> blindness
how to treat acute angle crisis
- surgical intervention
optic-topical beta blockers
- timolol and betaxolol
- “chill out” drugs
MOA for timolol and betaxolol
- bloc sympathetic nervous system stimulation of beta receptors
indications of timolol and betaxolol
- open angle glaucoma maintenance treatment
- if acute angle closure, need drops asap and other interventions
side effects of timolol and betaxolol
- transient burning and discomfort
- if systemic, can have systemic effects
patient teaching for timolol and betaxolol
- must take otherwise will progress to blindness
- apply nasolacrimal pressure with instillation
prostaglandin analog drug
latanoprost
MOA of latanoprost
increases outflow drainage of aqueous humor
indication of latanoprost
- open angle glaucoma
- ocular hypertension
alpha-adrenergic agonist drug
brimonidine
MOA of brimonidine
- decreases aqueous humor production
- may increase drainage/outflow
indication for brimonidine
used for open angle glaucoma and increased intraocular pressure
side effects of brimonidine
- burning/stinging
- dry mouth
- fatigue, H/A, blurred vision, hypotension
carbonic anhydrase inhibitor drug
dozolamide
MOA dozolamide
- decreased production of aqueous humor
- second line treatment
side effects of dozolamide
- stinging
- bitter taste
- allergic reactions(conjunctiva or lid reactions)
meniere disease
- endolymphatic hydrops
- episodic disorder of the middle ear
- can be unilateral or bilateral
- excessive endolymph and pressures in the membranes disrupt vestibular (balance) and hearing function
clinical manifestations of meniere disease
- recurring episodes of vertigo (usually with N/V)
- hearing loss
- ringing in the ears (tinnitus)
- feeling of fullness
