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Year 4 - Ophthalmology > Eyes and systemic disease > Flashcards

Eyes and systemic disease Flashcards

1
Q

what groups of diseases can cause eye problems

A

diabetes
hypertension
connective tissue diseases - SLE, RA, Marfans
inflammatory diseases - GCA, thyroid

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2
Q

What is the most important CVS disease of the eye

A

diabetic retinopathy

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3
Q

What eye diseases can DM cause

A

retinopathy

maculopathy

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4
Q

pathogenesis of diabetic retinopathy

A

chronic hyperglycaemia causes glycosylation of protein/BM resulting in loss of pericytes (cells that surround endothelium) which results in microaneurysms which can leak and cause ischaemia

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5
Q

What are the categories of diabetic retinopathy

A 
non-proliferative
- mild 
- moderate 
- severe 
Proliferative
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6
Q

what does proliferative retinopathy essentially mean

A

neovascularisation

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7
Q

signs of non-proliferative diabetic retinopathy

A 
microaneurysms 
dot + blot haemorrhages 
hard exudate
cotton wool patches 
abnormalities of venous calibre 
intra-retinal microvascular abnormalities (IRMA)
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8
Q

what are hard exudates

A

products of lipid breakdown

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9
Q

what are cotton wool patches

A

white fluffy areas from ischaemia and oedema of axon layer of retina

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10
Q

what is IRMA

A

intra retinal microvascular abnormalities are a precursor to neovascularisation

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11
Q

what causes neovascularisation

A

ischaemia drives VEGF to cause neovascularisation

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12
Q

Where can neovascularisation occur

A

disc NVD
periphery NVE
iris - rubeosis iridis

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13
Q

causes of vision loss in diabetic patients

A

retinal oedema affecting fovea
vitreous haemorrhage
retinal detachment

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14
Q

How can you classify maculopathy

A

none
observable
referrable
clinically significant

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15
Q

true or false, the retina is transparent

A

true, it appears pink becuase of the choroid layer beneath it

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16
Q

in maculopathy, central/peripheral vision is damaged?

A

central

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17
Q

what investigation is used to observe maculopathy

A

OCT - optical coherence tomography

18
Q

Management of diabetic eye disease

A

optimise diabetic control
laser - PRP (pan retinal photocoagulation)
surgery - vitrectomy
rehabilitation

19
Q

what does lasering the retina do

A

reducing O2 demand of the eye and making it less hypoxic

20
Q

management of neovascularisation around the macula

A

anti VEGF injections

since lasering is riskier

21
Q

appearance of the eye after lasering
fresh
old

A

fresh - white

old - dark

22
Q

in hypertensive retinopathy, appearance of fundus correlates to severity of hypertension and the state of retinal arterioles, true or false

A

true

23
Q

what sign is characteristic of hypertensive and DM retinopathy

A

cotton wool spots

24
Q

signs of hypertensive retinopathy

A 
attenuated blood vessels - silver/copper wiring 
hard exudates 
cotton wool spots 
retinal haemorrhages 
optic disc oedema
AV nipping
25
Q

features of CRAO

A 
sudden painless loss of vision 
white oedematous retina 
no necrosis from choroid collateral supply 
Cherry red spot at fovea 
rarely recovers
26
Q

features of CRVO

A

sudden painless loss of vision

range of visual loss

27
Q

How can arterial damage and atherosclerosis lead to CRVO

A

artery walls become thicker and atherosclerotic which impinges adjacent vein therefore occluding it

28
Q

what are the 2 main causes of uveitis

A

infective and non-infective

29
Q

list infective causes of uveitis

A 
TB 
HZV 
toxoplasmosis 
candidiasis 
syphilis 
Lyme disease
30
Q

list non-infective causes of uveitis

A 
sarcoidosis 
IBD 
Behcets 
HLA B27 
juvenile arthritis
idiopathic
31
Q

symptoms of GCA with polymylagia rheumatica

A 
loss of vision 
temporal scalp tenderness 
jaw claudication 
headache 
malaise
proximal muscle stiffness and pain
32
Q

GCA only affects arteries with an internal elastic lamina, true or false

A

true

therefore retinal arteries are unaffected

33
Q

how can features of thyroid eye disease (TED) be grouped

A

extraocular

ocular

34
Q

extraocular features of TED

A

proptosis
lid retraction, oedema, lag, pigmentation
restrictive myopathy (EOM)

35
Q

ocular features of TED

A 
anterior segment - 
chemosis 
injected vessels 
glaucoma 
diplopia 
posterior segment - 
optic nerve swelling
36
Q

ocular manifestations of SLE

A

scleritis
ocular inflammation
necrosis and perforation

37
Q

ocular manifestations of rheumatoid arthritis

A

keratoconjunctivitis sicca - dry
scleritis
corneal melt

38
Q

RA gives you intra/extra ocular disease

A

extra ocular disease

39
Q

ocular manifestations of Sjögrens syndrome

A

keratoconjunctivitis sicca
(also xerostomia)
infiltration of lacrimal gland

40
Q

ocular manifestations of Marfans syndrome

A

upward lens discolation

41
Q

in other conditions, the lens usually displaces downwards apart from in Marfans which displaces upwards, true or false

A

true

Year 4 - Ophthalmology (12 decks)

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