Eyes N Ears Flashcards
Periorbital cellulitis
Haemorrhage
Viral conjunctivitis
- normally adenovirus
Allergic conjunctivitis
Blepharitis
Name three causes that could be stopping this red reflex [3]
Anything that blocks the reflection of light
- E.g. cataracts, vitreous haemmorrhage, retinoblastoma
During your fund. Exam you reach the optic disc.
What three things should you assess at this stage? [3]
Describe your findings from this image [3]
Have a system:
Disc margins:
- Bluured
Retinal veins:
- swollen
Other features:
- Retinal haemorrhages around disc
SHOWS papilloedema - indicates intracranial hypertension
Figure 1. Retinal photograph of the right eye showing papilloedema in a patient with IIH
When would you use a blue and green filter on a fundoscopy exam? [2]
Describe the three classifications of diabetic retinopathy? [2]
non-proliferative diabetic retinopathy (NPDR) marked by:
- microaneurysms
- retinal haemorrhages (dot haemorrhages)
- hard exudates (yellowish deposits of lipid due to vessel leakage)
proliferative diabetic retinopathy (PDR) (more advanced and severe stage), is characterized by:
- the proliferation of new, fragile blood vessels that can bleed into the vitreous, leading to vision loss due to VEGF upregulation
- can be new vessels on disc (NVD) OR new vessels everywhere (NVE)
Diabetic maculopathy:
- Presence of any retinopathy within 1 disc diameter around macula:
Can be:
- Focal
- Diffuse
- Ischaemic
How can PDR lead to blindness? [4]
- New blood vessels are very fragile; easily break and leak
- Retinal haemorrhage can lead to acute blindness
- If repeated; leads to fibrosis & scarring
- Can lead to: tractional retinal detachment: when scar tissue or other tissue grows on your retina and pulls it away from the layer underneath
Which pathology is depicted? [1]
Diabetic maculopathy: hard exudates near to the macula
What is depicted in this image? [1]
Proliferative diabetic retinopathy:
extensive vitreous haemorrhage obscuring most of fundus (white circle)}
What is the arrow pointing to? [1]
Cotton wool spot
What is depicted in this image? [1]
Non-proliferative diabetic retinopathy: blot haemorrhage (white circle)}
Describe what is happening in this image [1]
Proliferative diabetic retinopathy: NVD new vessels on the optic disc
What is the management of diabetic retinopathy? [5]
Laser photocoagulation
Anti-VEGF medications such as ranibizumab, bevacizumab & Aflibercept
Vitreoretinal surgery (keyhole surgery on the eye) may be required in severe disease or a vitrectomy may be necessary to clear severe vitreous hemorrhage or to relieve tractional retinal detachment.
Corticosteroids (triamcinolone, dexamethasone implant) can also be used, particularly in refractory DME.
Pan-retinal photocoagulation (PRP): laser used to make small burns evenly across the peripheral retina - should make blood vessels shrink and dissapear
Name this sign [1] and disease [1] that is a complication of diabetes
Prayer sign; diabetic cheiroarthropathy
The following term describes which sign of diabetic retinopathy
Damaged vessels may rupture and leak blood.
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
The following term describes which sign of diabetic retinopathy
Damaged vessels may rupture and leak blood.
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
The following term describes which sign of diabetic retinopathy
transient, small, whitish opacities with feathery edges located within the superficial retina and represent microinfarctions of small retinal arteriole
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
The following term describes which sign of diabetic retinopathy
transient, small, whitish opacities with feathery edges located within the superficial retina and represent microinfarctions of small retinal arteriole
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
The following term describes which sign of diabetic retinopathy
Deposits of lipids that have leaked onto the retina through damaged vessels.
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
The following term describes which sign of diabetic retinopathy
Deposits of lipids that have leaked onto the retina through damaged vessels.
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
The following term describes which sign of diabetic retinopathy
“Out-pouching” results from weakened capillary walls. The earliest visible clinical sign of diabetic retinopathy.
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
The following term describes which sign of diabetic retinopathy
“Out-pouching” results from weakened capillary walls. The earliest visible clinical sign of diabetic retinopathy.
Venous beading
Cotton wool spots
Hard exudates
Dot and blot haemorrhages
Microaneurysms
What is the most common cause of visual loss in patients with diabetes? [1]
Describe this [1]
Diabetic macular oedema (DMO)
DMO is the commonest cause of visual loss in patients with diabetes
DMO is characterised by oedematous changes in or around the macula. As the macula is responsible for central vision, affected patients tend to complain of blurred vision when reading or difficulty recognising faces in front of them. DMO is the commonest cause of visual loss in patients with diabetes.9
DMO can be subcategorised into three categories. Describe them [3]
Focal/diffuse macular oedema:
* the fluid that escapes from damaged vessels can be well-circumscribed (focal) or more widespread and poorly demarcated in nature (diffuse).
Ischaemic maculopathy:
- patients will be symptomatic with defects in visual acuity due to ischaemia at the site of the macula. These areas are best visualised with fluorescein angiography.
Clinically significant macular oedema (CSMO):
- CSMO describes significant changes associated with retinopathy, such as hard exudates and retinal thickening, found within a certain distance to the fovea or greater than a certain size.
What is the name of this treatment for diabetic retinopathy? [1]
Pan-retinal photocoagulation (PRP)
Name a complication of diabetic retinopathy [1]
Diabetic retinopathy is one of several causes of neovascular glaucoma: a type of secondary glaucoma.
Neovascularization can occur within the iris and its trabecular meshwork (rubeosis) causing a narrowing and closure of the drainage angle and therefore increased intraocular pressure.
Name a complication of diabetic retinopathy [1]
Diabetic retinopathy is one of several causes of neovascular glaucoma: a type of secondary glaucoma.
Neovascularization can occur within the iris and its trabecular meshwork (rubeosis) causing a narrowing and closure of the drainage angle and therefore increased intraocular pressure.
What level of diabetic retinopathy does it suggest? [1]
New vessels on disc
- Proliferative DR
What level of diabetic retinopathy does it suggest? [1]
Microaneursym
- Non-proliferative DR
What level of diabetic retinopathy does it suggest? [1]
New vessels everywhere:
- PDR
What level of diabetic retinopathy does it suggest? [1]
Dot & Blot haemorrhages - NPDR
Diabetic maculopathy
Describe the 4 stages of hypertensive retinopathy [4]
Grade 4
Describe the difference in findings between central retinal artery occlusion and central retinal vein occlusion [+]
