Eye Disease Flashcards

1
Q

highlights of eyedrops administration

A

contacts must be removed

pull eyelid back to form pocket

don’t touch eye with dropper

keep eye closed 1-3 min following administration

wait 10 minutes between administration of multiple drugs

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2
Q

nasal lacrimal occlusion

A

essential part of eye drop administration

cover the nasal lacrimal duct with index finger to prevent systemic absorption

decreases side effects and dose, allows for better drug potency

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3
Q

eye ointment administration highlights

A

warm ointment in hand 1-2 minutes

discard first .25 in of medication

close eye and don’t rub for 1-2 minutes

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4
Q

eye diseases

A

cataracts
macular degeneration
retinopathy
glaucoma

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5
Q

leading cause of blindness around the world

A

cataracts

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6
Q

cause of cataracts

A

aging **

also sunlight, smoking, family history, trauma, DM and steroid use

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7
Q

clinical features of cataracts

A

yellowing of the lens

myopic shift (brief improvement in near vision)

lost color discrimination and distant vision

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8
Q

cataracts pathophys

A

as lens ages, new layers are added

these layers compress lens nucleus and it becomes harder

yellowing of lens

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9
Q

cataracts dx and treatment

A

opthalmic exam (slit lamp, direct light) and decreased visual acuity

treatment: surgery (lens implant)

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10
Q

2 blood supplies to retina

A

choroidal blood vessels (outer retina, photoreceptors -75%)

central retinal artery (supplies central portion of retina)

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11
Q

retinopathy risk factors

A

DM

HTN

smoking

hyper cholesteremia

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12
Q

diabetic retinopathy (clinical features)

A

asymptomatic finding

loss of vision

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13
Q

diabetic retinopathy fundus exam findings

A

cotton wool patches

neovascularization

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14
Q

cotton wool patches

A

diabetic retinopathy

caused by infarcted nerve fibers

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15
Q

neovascularization

A

diabetic retinopathy

hypoxia of retina causes formation of new blood vessels in the eye

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16
Q

hypertensive retinopathy

A

asymptomatic but can have decreased vision

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17
Q

hypertensive retinopathy fundoscopic exam findings

A

papilledema
AV nicking
Retinal hemorrhages

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18
Q

AV nicking

A

hypertensive retinopathy

indentation in veins where there are arteries that cross

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19
Q

macular degeneration

A

degenerative changes to central retina

causes loss of central vision

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20
Q

macular degeneration risk factors

A
age
family history 
female 
caucasian 
smoking
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21
Q

macular degeneration exam

A

ophthalmic exam shows scattered pale yellow spots

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22
Q

pharmacologic treatment of macular degeneration

A

ranibizumab/Lucentis

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23
Q

ranibizumab/Lucentis

Indication

A

neovascular macular degeneration

improves remaining vision, may preserve vision

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24
Q

ranibizumab/Lucentis

MOA

A

inhibits VEGF so REDUCES new blood vessel growth

via monthly eye injections

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25
Q

ranibizumab/Lucentis

ADR

A

increased IOP
Traumatic cataract
detached retina

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26
Q

vitamins used in macular degeneration

A
ascorbic acid 
vitamin E 
beta carotene 
Zinc Oxide 
Cupric oxide
27
Q

Open angle glaucoma

A

pathophysiology not understood BUT

decreased aqueous humor outflow and increased aqueous production

28
Q

clinical features of open angle glaucoma

A

asymptomatic

slow loss of vision (peripheral first then central)

optic neuritis

29
Q

testing for open angle glaucoma

A

peripheral and central field examination

measure IOP

30
Q

OAG goals of therapy

A

prevent further loss of visual function

minimize adverse effects of therapy

maintain IOP below pressure at which further optic nerve damage is unlikely

31
Q

which agents increase aqueous humor outflow

A

prostaglandin analogs

a-adrenergic agonists

cholinergics

32
Q

classes of agents that decrease aqueous humor production

A

b-adrenergic antagonists
a-adrenergic agonists
carbonic anhydrase

33
Q

first line agents in OAG

A

b-blockers

prostaglandin inhibitor

34
Q

second line agents in OAG

A

selective a-2 receptor agents

cholinergic agents

35
Q

third line agents in OAG

A

topical carbonic anhydrase

36
Q

b-blockers

A

traditional first line for both open and closed angle glaucoma

decrease IOP by reducing formation of aqueous humor

37
Q

b-blokcers list

A

timolol (Timoptic)
levobunolol (betagan)
betaxolol (Betoptic)

38
Q

B-blockers adr (systemic)

A

bronchospasm
pulmonary edema
respiratory arrest
bradycardia

39
Q

CIs to beta blockers

A

COPD
Asthma
CHF
PE

betazolol is less likely to cause some of these diseases

40
Q

prostaglandin

A

1B agent in treating OAG

better compliance but more expensive $$$

41
Q

prostaglandin local ADR

A

increased iris pigmentation

hypertrichosis (excessive hair growth)

darkening of eyelashes

42
Q

A-2 adrenergic agonists (list)

A

bromonidine/Alphagen

combination w/t 1st line agents

43
Q

A-2 adrenergic agonists MOA

A

decreases IOP by increasing humor outflow

44
Q

carbonic anhydrase inhibitors

route + indication

A

brinzolamide/Azopt (Topical/DROPS) - open angle

acetazolamide/Diamox (systemic) - closed angle

45
Q

carbonic anhydrase inhibitors CI

A

SULFA ALLERGIES

46
Q

cholinergic lis and MOA

A

pilocarpine soln/isopto carpine

increase outflow by pulling open trabecular meshwork

47
Q

cholinergic and angle closer glaucoma treatment

A

pilocarpine doesn’t work until we already get the pressure reduced

48
Q

Pinguecula

A

yellow-white, flat/raised lesions over the sclera

doesn’t involved cornea

slit lamp exam

protect eyes, moisture, topical steroid or NSAIDS

49
Q

Pterygium

A

fold of fibrovascular tissue that extends onto cornea

slit lamp dx

topical steroid or NSAID, surgical exception if in visual access

50
Q

ophthalmic lubricants

indicaitons and MOA

A

relief of eye irritation and dry eyes

tonicity, adjust pH, increase eye contact time

OTC

51
Q

Opthalmic NSAIDs

list of drugs (2)

A

Ketoralac (Acular)

Diclofenac (Voltaren)

52
Q

ophthalmic NSAID indications (4)

A

post operative inflammation after cataract surgery

ocular itching

Pingueceula

pterygium

53
Q

ophthalmic NSAID MOA

A

reduce prostaglandin E2 production

minimal systemic absorption

54
Q

ophthalmic corticosteroids

A

prenisolone (Pred-Forte)
Triamcinolone (Triesence)
Tobamycin/Dexamethasone (tobraDex)

55
Q

ophthalmic corticosteroids indications

A

ocular inflammatory conditions

56
Q

ophthalmic corticosteroids ADRS

A

can cause glaucoma

57
Q

ophthalmic corticosteroids

CIs

A

pts w/herpes keratitis

pts w/problems of elevated IOP

58
Q

blepharitis

clinical features

A

crusty, thick eyelid margins

itching, burning, foreign body sensation, tearing

59
Q

blepharitis treatment

A

scrub margins with baby shampoo

warm compress

if severe can add ABX

60
Q

Dacryoadentitis

A

inflammation of lacrimal gland

pain, swelling, redness over outer one third of upper eyelid

must rule out cellulitis

61
Q

dacryoadentitis treatment

A

mild cases treat augmenting or kelfex

severe- admit with IV ABX

62
Q

chalazion clinical features

A

sub acute

non tender papule on inner surface of eyelid

cause: blocking meibomian gland

63
Q

chalazion treatment

A

warm compress

refers if not relieved

64
Q

hordeolum

A

“sty:

rapid onset

painful, tender, erythematous pustule on lid of margin

commonly caused by staph aureus