HEENT Portion Flashcards
Glaucoma
what is this?
what are the 2 types?
1 RF?
eye conditions that cause progressive optic nerve damage, leading to irreversible loss of vision
Types:
- open angle
- closed angle
RF:
elevated intraocular pressure
Closed angle glaucoma
what is this caused by? IOP?
5 key sxs?
3 tx options?
2
3
1
acutre rise in IOP due to the trabecular meshwork being occluded with IOP over 50
SXS:
PAINFUL
STEAMY CORNEA
FIX MID DILATED PUPIL
NAUSEA AND VOMITING
INFLAMMED EYE
TX: get pressure down ASAP
- Decrease aqueous production WITH BB or barconic anhydrase inhibitor
2. increase outflow with Prostaglandin, cholinergi, epi
***ALPHA AGONISTS DO BOTH OF THESE***
- Ultimately need laser (YAG periphreal iridotomy**)
Open angle glaucoma
what is this?
3 ways to dx?
3 tx options?
most often asymptomatic and chronic with IOP over 22, but can still have damage less than 22
DX:
- tonometry: tells IOP
- optic nerve eval through dilated pupil
- pachymetry: measure central corneal thickness
TX:
- pharmocological first then consider surgery
A. BB or carbonic anyhdrase inhibitor
B. Laser Trabeculoplasty
secondary glycoma
7 causes
- inflammation
- hyphema-blood in the anterior chamber
- angle recession-caused by blunt trauma to the TM
- neovascular- complication of diabetic retinopathy or vascular occlusion, BV can grow into the angle
- phacolytic
- pseudoexfoliation syndrome-white flakey material from the anterior surface clogs the TM
- pigment disruption-part of the iris flakes off and clogs the TM
Cataract
what is this?
patho?
3 sxs
3 types
opacity of the lens caused by insoluble protein caused by age, medication, illness, sun exposure
Patho: the lense is make of proteins arranged in a certain fashion but over time they can clump together and cloud the lense
SXS:
- gradual loss of vision
- increased glare
- decreased color preception
Types:
nuclear sclerosis
cortical
posterior subscapular
Nuclear sclerosis cataract
ellow or brown discoloration
of the central lens; even distribution;
distance vision blurred myopic shift (second sight)
cortical cataract
radial or spoke like opacities
posterior subscapular cataracts
plaque-like opacities
on the posterior aspect of the lens. Greater affect
on acuity and often in younger patients
whta are the reasons for doing cataract surgery?
- increase activitis of daily living
- prevent secondary glaucoma
- permit fundus visulization
what is a secondary cataract that is a complication of cataract surgery?
-The posterior capsule can become opacified
of varying degrees, weeks to months later.
-The symptoms can range from blurring vision
to glare -similar to the initial cataract.
Txed with YAG laser in office procedure
presbyopia
what is this?
fix it?
age?
The natural loss of accommodation
due to thickening of the lens
secondary to age.
Typically occurs after age 40
Corrected with near reading rx
Dry Macular degeneration
what is this?
age?
2 key findings?
tx considerations? 3 things
painless and progressive CENTRAL vision loss, OVER 50
FINDINGS:
- drusen-small yellow deposits lead to degenerative changes and atrophy
- changes on amsler grid
TX:
AREDS trial-tx with high antioxidants plus zinc can reduce up to 25%
(b-caretene, vit C, E, zinc)
Wet macular degeneration
what are the two things the contribut to this?
patho?
2 findings?
1 tx?
neovascular (new growth) and exudative (hemmorage), 10% of those with macular dengen but 90% of blindness
patho: subretinal fluid accumulation from neovascularization or fragile vessels that rupture
FINDINGS:
- metamorphopsia-hemmorage causing wavy and distorted vision with paracentral scotomas “blind spots”
TX: ANTI-VEGF (vascular endothelial growth factor), 9/10 stabilize
Sensory presbycusis
what causes this?
3 characterisitcs?
1 tx?
Loss of sensory hair cells in basal end of cochlea
1. Slowly progressive loss
- beginning with higher frequencies
- Difficulty hearing in presence of background noise
Treatment: amplification..assisted listening or hearing aids
strial presbycusis
what is this?
what is lost?
1 tx?
A metabolic form of hearing loss
Cochlear dysfunction; atrophy of ≥30% of the stria vascularis
- Mild to moderate hearing loss in most frequencies
Treatment: amplification…assisted listening or hearing aids
