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Y4 Opthalmology > Gradual loss of vision > Flashcards

Gradual loss of vision Flashcards

1
Q

What is a cataract?

A

Lens of the eye becomes cloudy and opaque

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2
Q

What are the risk factors for a cataract?

A
  • Age
  • Smoking
  • UV radiation
  • Hyperglycaemia
  • Steroids
  • Hypocalcaemia
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3
Q

What conditions are associated with cataracts?

A
  • DM
  • Metabolic disorders (galactosaemia, hypocalcaemia, Fabry disease)
  • Myotonic dystrophy
  • Atopic dermatitis
  • Systemic syndromes (Down’s, Lowe’s)
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4
Q

What are the symptoms of a cataract?

A
  • Painless, slow loss of vision
  • Blurring of vision
  • Colours becoming more brown/yellow
  • Starbursts around lights, especially at night
  • Glare
  • Change in refraction
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5
Q

How do you diagnose a cataract?

A
  • Fundoscopy
    o Cataract appears black against the red reflex
  • Slit-lamp
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6
Q

What is glaucoma?

A

Damage to the optic nerve due to raised IOP

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7
Q

What is open angle glaucoma?

A

Increased resistance through trabecular meshwork

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8
Q

What are the symptoms of open angle glaucoma?

A
  • Painless loss of vision
  • Tunnel vision
  • Halos at night
  • Headaches
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9
Q

What are the risk factors for open angle glaucoma?

A
  • Family Hx
  • Having a thin cornea
  • Race – afro-Caribbean
  • DM
  • Old age
  • Being short-sighted (myopia)
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10
Q

How do you diagnose open angle glaucoma?

A

Tonometry
- >21mmHg

Slit-lamp
- Cup-to-disc ratio >0.7

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11
Q

What is the management for open angle glaucoma?

A
  • Lantoprost (prostaglanin analogue drops)
  • Laser
  • Surgery
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12
Q

What is closed angle glaucoma?

A

Iris bulges forwards and seals off trabecular meshwork from the anterior chamber, preventing aqueous humour from draining

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13
Q

What are the symptoms of closed angle glaucoma?

A
  • Painful loss of vision
  • Halos around lights
  • Watery eye
  • Systemic symptoms
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14
Q

What are the risk factors for closed angle glaucoma?

A
  • Age
  • Females>males
  • Family Hx
  • Chinese and East Asian
  • Shallow anterior chamber
  • Hypermetropia
  • Adrenergic medications: noradrenalin
  • Anticholinergic medications: oxybutynin
  • Tricyclic antidepressants: amitriptyline
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15
Q

How do you diagnose closed angle glaucoma?

A
  • > 21mmHg
  • Cup-to-disc ratio >0.7
  • Tender and hard eye
  • Cloudy cornea
  • Mild-dilated unreactive pupil
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16
Q

What is the management of closed angle glaucoma?

A
  • Pilocarpine
  • Acetazolamide
  • Analgesia
  • Antiemetic
17
Q

What are the symptoms of dry ARMD?

A
  • Difficulty with reading, fine detail, seeing faces clearly
  • Flickering or flashing lights
  • Scotoma
  • Gradual loss of central vision (peripheral vision is sparred)
18
Q

What are the symptoms of wet ARMD?

A
  • Difficulty with reading, fine detail, seeing faces clearly
  • Flickering or flashing lights
  • Scotoma
  • Rapid loss of vision
  • Demarcated red patches
19
Q

What are the risk factors for ARMD?

A
  • Female gender
  • Smoking
  • HTN
  • Previous cataract surgery
  • Family Hx
20
Q

How do you diagnose dry ARMD?

A
  • Visual acuity - May be reduced
  • A black patch affecting the central field of vision (scotoma)
  • Amsler grid - straight lines appear wavy
  • Fundoscopy - Drusen
21
Q

How do you diagnose wet ARMD?

A
  • Visual acuity - May be reduced
  • A black patch affecting the central field of vision (scotoma)
  • Amsler grid - straight lines appear wavy
  • Fundoscopy - fluid and/or blood in retina and choroidal neovascularisation
22
Q

How do you manage dry ARMD?

A

• High-dose antioxidant vitamins and zinc

23
Q

How do you manage wet ARMD?

A

• Anti-VEGF injections

24
Q

What is diabetic maculopathy?

A

hard exudates and other ‘background’ changes on macula

25
Q

What is pre-proliferative diabetic retinopathy?

A
  • cotton wool spots (‘soft exudates’ - represent areas of retinal infarction)
  • > 3 blot haemorrhages
  • venous beading/looping
  • deep/dark cluster haemorrhages
26
Q

What is proliferative diabetic retinopathy?

A

retinal neovascularisation

Y4 Opthalmology (5 decks)

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