Eye Disorders Flashcards
What are the three layers of the tear?
Oil (from meibomian glands)
Water (from lacrimal glands)
Mucus (from conjunctiva cells)
What is subconjunctival hemorrhage?
Extravasation of blood underneath conjunctiva
What is the cause of subconjunctival hemorrhage?
Cough/sneezing, vomiting, straining
Strenuous exercise
Severe HTN, bleeding do
What is the tx of subconjunctival hemorrhage?
Self-limiting
What should not be started in subconjunctival hemorrhage?
ASA/NSAIDs
What is the etiology of dry eye syndrome?
Inadequate tear production
Accelerated tear evaporation
What is the presentation of dry eye syndrome?
Blurred vision with eye stain
Burning, gritty, foreign body sensation
What are the causes of dry eye syndrome with inadequate tear production?
Autoimmune (Sjogren's) Lacrimal damage (SJS, radiation) Lacrimal deficiencies (Age, post lasik/cataract surgery, medications)
What medications can cause dry eye syndrome?
1st generation antihistamines
Antiemetics
Antidepressants
What are the causes of dry eye syndrome with accelerated tear evaporation?
Inadequate tear composition
Meibomian gland dysfunction
Clogged gland
Chronic skin condition (eczema, etc)
What is the treatment of mild dry eye syndrome?
Artificial tears QID
Lubricants
What are the treatments for moderate to severe dry eye syndrome?
Artificial tears up to 12 times daily
Lubricating gel or ointment QHS
Lacrisert (artificial tear insert)
When should Restasis be used?
Secondary to sjogrens or meibomian dysfunction
What are the treatments for severe chronic dry eye?
Restasis
Xiidra
Plugs
Does restasis or xiidra have the fastest onset?
Xiidra
What are the AEs of Xiidra?
Taste disturbances
Burning on administration
Reduced visual acuity
What are the types of plugs for severe chronic dry eyes?
Punctal
Cannicular
What is a chalazia?
Eyelid cyst
Does a cyst or stye come from an infectious origin?
Stye
What is the etiology of chalazia?
Meibomian gland occlusion
Extravasation of lipid material into eyelid soft tissue
What is the etiology of hordeola?
Localized infection
External (eyelash follicle) most common
What is hordeola?
Stye
What is the presentation of a cyst?
Localized to eyelid
Forms small nontender nodule
What is the presentation of a stye?
Forming a small yellowish pustule
Pustule will rupture and discharge pus w/in 2-4 weeks
What is the etiology of blepharospasms?
Ocular irritation (long standing dry eye)
Medications (DAs)
Worsened by: fatigue, sleep deprivation, anxiety, bright light
What is the tx of blepharospasms?
Remove/correct cause
Wear sunglasses/improve sleep
Treat sx
What are last line options for blepharospasms?
Botulinum toxin
Surgery
What are cataracts?
Progressive opacification of lens
What are RFs for Cataracts?
Age Exposure to UV/X-rays Smoking/EtOH Malnutrition/DM Ophthalmic corticosteroids
What are the early presentations of cataracts?
Loss of contrast sensitivity (vision at night)
Need more light to see well
What are latent presentations of cataracts?
Blurred vision
Visual acuity
What are preventions for cataracts?
UV coated sunglasses
Ophthalmic exams
What is the treatment for early staged cataracts?
Corrective prescription lens
What is the treatment for latent staged cataracts?
Surgical intervention/lens replacement
What is AMD
Atrophy or degeneration of the macula
Age-related Macular Degeneration
What are RFs for AMD?
FH
Caucasian
Smoking/HTN
What is atrophic AMD presentation?
Dry
Drusen (Irregular pigmentation of the macula)
What os the presentation of wet AMD?
Neovascularization Drusen Hyperpigmentation of macula Hemorrhages Exudate
What is the treatment for atrophic AMD?
PreserVision:
Vitamin C
Beta-Carotene
When do we treat atrophic AMD?
RFs for advanced disease
What is the treatment for Wet AMD?
VEGAs
How are VEGAs administered?
Intravitreal
What disease is exopthalmos associated with?
Grave’s disease
What diseases is retinopathy associated with?
DM
HTN
What deficiency is kerotamalacia associated with?
Vitamin A
What is the cause of exopthalmos?
Autoimmune mediated
What are the presentations for exopthalmos?
Dry eye Eyelid retraction and lag Staring Decreased visual acuity Photophobia Hyperthyroidism
Will treatment of Grave’s disease improve exopthalmos?
No
What is the treatment for exopthalmos?
Lubrication to protect cornea
Corticosteroids if severe
What is the presentation of acute severe HTN retinopathy?
Retinal hemorrhage
Cotton wool spots
Yellow exudates
Papilledema
What is the presentation of chronic HTN retinopathy?
Narrowing of arteries
Hardened artery (AV nicking)
Restricted blood flow (Copper appearance)
What are the types of DM retinopathy?
Nonproliferative
Proliferative
What is the presentation of nonproliferative DM retinopathy?
Microaneurysms
Cotton wool spots
Macular edema
What is the presentation of DM retinopathy?
Neovascularization
Frail vessels
Formations of fibrous tissue
Cause retinal detachment
What is the treatment for nonproliferative DM retinopathy?
Mild-moderate: observe`
If DM macular edema: VEGA or LP
What is the treatment for proliferative DM retinopathy?
VEGAs and LP
If no macular edema: VEGAs = LP
If macular edema: VEGAs > LP
What are the causes of vit A deficiency?
Alcoholism Underdeveloped countries Sprue/celiac disease Pancreatitis/IBD Cirrhosis
What is the presentation of Vit A deficiency?
Night blindness
Dry eyes
