Exam 3 - Visual and Sensory Issues

Question 1

cataracts

Answer 1

-cloudy lens
- gradual onset of painless, blurry vision
- may end in blindness

Question 2

risk factors of cataracts

Answer 2

• older age
• eye trauma
• congenital risk
• diabetes
• corticosteroid use
• smoking and ETOH consumption

Question 3

cataract manifestations

Answer 3

• painless
• uni or bilateral vision changes
• blurry
• halo around lights
• altered color perceptions
• glare issues at night
• decreased accommodation

Question 4

nonproliferative retinopathy

Answer 4

• capillary micro aneurysms, retinal swelling, hard exudate
• macular edema: plasma leaks from macular blood vessels
• capillaries rupture, leading to “dot or blot” hemorrhaging

Question 5

proliferative retinopathy

Answer 5

• advanced
• new blood vessels are fragile and leaky

Question 6

hypertensive retinopathy

Answer 6

• 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

Question 7

detached retina

Answer 7

• retina has a tear or leak
• vitreous humor flows behind the retina
• rapid, progressive detachment from the choroid

Question 8

clinical manifestations of detached retina

Answer 8

• sudden, unilateral vision loss
• painless
• may see floaters
• flashes of light

Question 9

are related macular degeneration

Answer 9

• most common cause of irreversible vision loss in people over 60 in the US

Question 10

risk factors for macular degeneration

Answer 10

• family history
• genetics
• UV light
• hyperopia
• smoking
• light colored eyes

Question 11

dry macular degeneration

Answer 11

• yellow deposits in the retinal pigment epithelium

Question 12

wet macular degeneration

Answer 12

• growth of new, leaky blood vessels in an abnormal location of the retina

Question 13

manifestations of macular degeneration

Answer 13

• early: no symptoms
• later: blurred darkened vision, blind spots, distorted vision

Question 14

treatment for macular degeneration

Answer 14

• if vision does not improve, treatment is limited
• medications are injected into the eye

Question 15

glaucoma

Answer 15

• elevated intraocular pressure (IOP)
• vision changes OR optic nerve damage

Question 16

risk factors for open-angle glaucoma

Answer 16

• elevated IOP
• older age
• African american race
• family history
• myopia
• diabetes, HTN, migraines

Question 17

open angel glaucoma pathogenesis

Answer 17

• abnormal trabecular meshwork
• reduced drainage of aqueous humor into canal of Schlemm
• imbalance between inflow and outflow
• results in increased IOP and vision problems

Question 18

clinical manifestations of open angle glaucoma

Answer 18

• none usually
• progressive loss of sight
• vague eye pain
• halos around lights
• tunnel vision

Question 19

closed angle glaucoma

Answer 19

• much less common
• abnormal angle between the iris and later cornea
• outflow is blocked when the pupil is dilated

Question 20

risk factors for closed angle glaucoma

Answer 20

• asian american ethnicity
• female
• hyperopia
• family history
• older age

Question 21

what type of closed angle glaucoma is an emergency

Answer 21

• acute
• outcome based on time from onset to treatment

Question 22

what triggers an acute episode of closed angle glaucoma

Answer 22

• anticholinergic drugs

Question 23

acute closed angle glaucoma - clinical manifestations

Answer 23

• unilateral
• severe eye pain
• nausea and vomiting
• blurry vision, halos
• reddened eyes
• dilated pupil - non reactive to light
• cloudy cornea

Question 24

glaucoma and blindness

Answer 24

• due to the increased IOP
• more pressure on inner eye structures
• decreased blood flow to optic nerve
• nerve fiber death -> blindness

Question 25

how to treat acute angle crisis

Answer 25

- surgical intervention

Question 26

optic-topical beta blockers

Answer 26

- timolol and betaxolol - "chill out" drugs

Question 27

MOA for timolol and betaxolol

Answer 27

- bloc sympathetic nervous system stimulation of beta receptors

Question 28

indications of timolol and betaxolol

Answer 28

- open angle glaucoma maintenance treatment - if acute angle closure, need drops asap and other interventions

Question 29

side effects of timolol and betaxolol

Answer 29

- transient burning and discomfort - if systemic, can have systemic effects

Question 30

patient teaching for timolol and betaxolol

Answer 30

- must take otherwise will progress to blindness - apply nasolacrimal pressure with instillation

Question 31

prostaglandin analog drug

Answer 31

latanoprost

Question 32

MOA of latanoprost

Answer 32

increases outflow drainage of aqueous humor

Question 33

indication of latanoprost

Answer 33

- open angle glaucoma - ocular hypertension

Question 34

alpha-adrenergic agonist drug

Answer 34

brimonidine

Question 35

MOA of brimonidine

Answer 35

- decreases aqueous humor production - may increase drainage/outflow

Question 36

indication for brimonidine

Answer 36

used for open angle glaucoma and increased intraocular pressure

Question 37

side effects of brimonidine

Answer 37

- burning/stinging - dry mouth - fatigue, H/A, blurred vision, hypotension

Question 38

carbonic anhydrase inhibitor drug

Answer 38

dozolamide

Question 39

MOA dozolamide

Answer 39

- decreased production of aqueous humor - second line treatment

Question 40

side effects of dozolamide

Answer 40

- stinging - bitter taste - allergic reactions(conjunctiva or lid reactions)

Question 41

meniere disease

Answer 41

- 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

Question 42

clinical manifestations of meniere disease

Answer 42

- recurring episodes of vertigo (usually with N/V) - hearing loss - ringing in the ears (tinnitus) - feeling of fullness