Eye Flashcards
Uvea
iris, cilia body/muscle, choroid
Posterior chamber
behind the iris, in front of lens
Conjunctivitis
inflammation engorges capillaries of conjunctivae –> pink/red
usually viral or allergic
u/l w/ purulent discharge - may be bacterial
Sunconjunctival hemorrhage
benign
blood trapped between conjunctiva and sclera
Scleral icteris
bilirubin deposits in conjunctiva –> yellow
Arches senilis
white/bluish ring at periphery of cornea
accumulation of cholesterol
Clouding of cornea
mucopolysaccharidoses - Hunter’s syndrome
Corneal abrasion
trauma, extremely painful
Anterior uveitis (iritis)
pain, redness of iris - extends into conjunctiva
photophobia
pus and inflammatory cells in anterior charger - pooling
assoc w/ reactive arthritis and ankylosing spondylitis (HLA-B27)
-sarcoidosis
Juvenile idiopathic arthritis
Posterior uveitis
Less common, more infectious
CMV, toxoplasmosis, cat scratch dz
assoc w/ psoriatic arthritis and IBD - HLA-B27
Cherry Red spot
central Retinal a. occlusion
Taysachs disease
Neumann-Pick dz
other lysosomal storage dz
Frontal eye field lesion
-scanning eye movement impaired
eyes deviate toward lesion
paramedian pontine reticular formation (PPRF) lesion
scanning eye movements impaired
eyes deviate away from lesion
Superior colliculus lesion
paralysis of upward gaze - Parinaud’s syndrome
“Nerd good at Calculus, looks down”
Retinoblastoma
Kids
loss of red reflex - white
Papilledema
swelling of optic disc, looks fuzzy, blurry
increased intracranial pressure
Central retinal artery occlusion
ischemia of eye
painless vision loss
pale retina w/ cherry red spot in macula
Retinal detachment
trauma, DM
sudden onset of flashing lights and floaters
reduction of vision - permanent if not reattached timely
looks billowy, wrinkled and pale
Diabetic retinopathy
Hard exudates - yellow colored spots
flame hemorrhages
cotton wool spots
Proliferative form:
proliferation of new blood vessels - neovascularization –> bleeding and scarring
tx: laser
Macular degeneration
loss of central vision
Risk: smoking
Tx: antioxidants: beta-carotene, vit C, lutein, selenium, zinc
Dry age related macular degeneration
drusen accumulates between retina and choroid
insidious loss of vision
Wet age-related macular degeneration
rapid
neovascularization in choroid
fragile new vessels bleed and damage photoreceptors
Tx: inject anti vascular endothelial growth factor or laser therapy
Glaucoma drugs - open angle
Inhibit production of aqueous humor:
Beta blockers
Carbonic anhydrase inhibitors - Acetazolamide
Improve outflow:
Prostaglandins
Alpha agonists - apraclonidine
Cholinergic agonist - pilocarpine
Laser trabeculoplasty
Acute angle-closure glaucoma
lens pushes forward against iris, blocks flow of aqueous humor from posterior chamber to anterior chamber
angle between sclera and iris becomes narrower - closed angle or narrow angle
EMERGENCY!
Abrupt onset of pain, HA (temporal, eyebrow), N, colored halos, rainbows around light
Red, teary eye w/ hazy cornea and fixed, mid-dilated pupil (not reactive to light) that is firm to palpation
Tx: laser iritomy - holes in iris to allow flow
Delay of more than 1 hours to ophtho give eyedrops: timolol, apraclonidine to reduce pressure
or systemic drugs: acetazolamide or mannitol
Open angle glaucoma
Tabular meshwork lost permeability
common, insidious form - usually b/l
Risk: older than 40, AA, FHx of glaucoma, myopia, and DM
Early stage: asx, elevated intraocular pressure
late: gradual loss of peripheral vision, permanent blindness if untreated
Glaucoma screening tools
Tonometry - air puff
optic cup (bright center):disc ratio normal less than 50%, greater than 50% = glaucoma
Classic presentation of cataracts
opacification of lens
usually b/l
slowly progressive, painless decrease in vision - difficulty driving at night, reading road signs, or reading fine print
Possible disabling glare from sunlight or oncoming headlights at night
Near-sightedness often early manifestation - “second sight” no longer need reading glasses
Risk: increased age, most common cause of blindness long term glucocorticoid use Tobacco etOH DM
