high yield Flashcards
Patient presents with bilateral slowly progressive vision loss. On opthalmoscopic exam you see areas of RPE loss and pigment clumping and drusen formation. What is the dx?
dry type macular degeneration
peripheral vision is intact–patient will not become completely blind
-tx: vitamin supplements with zinc and antioxidants
patient presents with sudden onset of distorted and decreased vision. On opthalmoscopic exam you see blood, edema and exudates. Evidence of scarring is also present. dx?
- wet type macular degeneration
- cycles of hemorrhage and scarring
- tx: laser, angiogenesis inhibitors
- prognosis poor if fovea involved
- dry and wet forms can coexist and dry can progress to wet
most common cause of legal blindness in the elderly?
macular degeneration
open angle glaucoma
- usually asymptomatic
- good vision until late in the disease process
- mild to moderate elevation in pressure
- gradual visual field loss
- inc. cup:disc ratio
- progressing “cupping”: loss of rim of tissue of optic nerve
- tx: prostaglandin analogs, beta blockers, carbonic anhydrase inhibitor
closed angle glaucoma
- severe pain
- sudden onset
- red eye
- semi-dilated pupil, non-reactive
- dec. vision
- ground glass cornea
- very high IOP
- *ocular emergency
conjunctivitis
- Inflammation of the conjunctiva
- Some discharge
- NO PAIN
- No change in vision
- Pupils are normal
viral: Watery discharge/serous, clear
TENDER PREAURICULAR NODE!
Recent URI
allergic: itchy, stringy discharge
bacterial: purulent discharge
keratitis
- inflammation of the CORNEA
- May have discharge
- SO SO PAINFUL!
- Often change in vision
- Pupil may or may not be different
- Can use fluorescein to pick up discontinuity in epithelium – ie abrasion
If pt. wears contacts, be wary of pseudomonas infection!
-Fluoroquinolones cover a good amount of bacterial infections, incl. pseudomonas
Herpes Simplex Keratitis
- Dendritic pattern w/fluorescein stain
- Use topical &/or oral antivirals
iritis
- Can often see with systemic diseases – sarcoidosis, CT d/o, Reactive arthritis
- Also called UVEITIS
- LOTS OF PAIN
- Possible change in vision
- Pupils will be unequal between affected and unaffected eyes – because iris affects pupil size and in bad eye it will generally be fixed or at least sluggish
- No discharge
thyroid eye disease
- Autoimmune
- Antibodies go after extraocular muscles–> inflammation–>Proptosis
- Tendon sparing!!
- Treating thyroid problem won’t help eye
- Steroids can help, as can surgery
progressive supranuclear palsy
parkinson’s plus syndrome
- Early gait d/o –>falls
- SPEECH d/o
- dementia
- GAZE palsy
- nuchal rigidity
dementia with lewy bodies
Waxes & wanes w/ psychotic symptoms – especially vivid visual hallucinations
multiple system atrophy
parkinson’s plus syndrome
AUTONOMIC INSUFFICIENCY; INCONTINENCE; cerebellar ataxia
corticobasal degeneration
parkinson’s plus syndrome
Asymmetric limb apraxia plus rigidity and dementia
headache red flag signs
2SNOOP4 -Systemic symptoms Secondary Risk Factors -Neurologic Symptoms -Onset -Older -Prior History, Positional, Papilledema, Precipitants
What are the hallmarks of central retinal artery occlusion?
- sudden onset vision loss
- painless
- cherry red spot
