Hearing and Visual Disorders Flashcards
What are the potential causes of cataracts?
Ageing Trauma Previous ocular surgery or laser therapy Diabetes Hypertension Metabolic syndrome Renal impairment SLE Atopic dermatitis Down's syndrome Marfan's syndrome Wilson's disease Fabry's disease Rubella Smoking Steroids
Describe the clinical presentation of cataracts
Gradual onset blurred / cloudy vision - particularly obvious when reading or driving at night
Lens opacity - yellowish hue
Decreased richness of colours (particularly blues)
Near-sightedness
How are cataracts managed?
When there is functional impairment or other eye disease, surgery is used
Describe in general the pathophysiology of glaucoma?
Neurodegenrative disease with loss of retinal ganglia and decreased outflow of aqueous humour
Describe the clinical presentation of glaucoma?
Decreased peripheral visison
Increased intra-ocular pressure
How is glaucoma managed?
1st line - topical prostaglandin analogues, beta blockers, carbonic anhydrase inhibitors
2nd line - combination therapy
If eye drops are contraindicated / fail or if there is rapidly progressing disease - laser trabeculoplasty or surgery
What signs are seen on fundoscopy in mild/moderate non-proliferative diabetic retinopathy?
Microaneurysms
Intraretinal haemorrhages
Cotton wool spots
Lipid exudates
What signs are seen on fundoscopy in severe non-proliferative diabetic retinopathy?
Venous bleeding
Widespread intraretinal haemorrhage
What signs are seen on fundoscopy in proliferative diabetic retinopathy?
Neovascularisation
Vitreous haemorrhage
How is diabetic retinopathy managed?
Hypertensive and glycemic control
VEGF inhibitors for severe non-proliferative disease
Laser therapy or vitrectomy for proliferative disease
Mutation of which gene is associated with age-related macular degeneration?
Complement factor H
What changes will be seen on fundoscopy in age-related macular degeneration?
Drusen
Pigmentary changes
If neovascular - sub retinal haemorrhage, lipid exudates, cysts, retinal oedema and retinal pigment epithelial detachment
What investigation is used when there is neovascular age-related macular degeneration?
Optical coherence tomography
How is age-related macular degeneration managed?
Smoking cessation Decrease sugar in diet Address CV risk factors VEGF inhibitors If neovascular disease - thermal laser coagulation or photodynamic therapy
