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Introduction to Eye Disease - Year 2 > Hypertensive Retinopathy > Flashcards

Hypertensive Retinopathy Flashcards

1
Q

What is high blood pressure?

A

•BP > 140/90mmHg –> On at least two occasions

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2
Q

For what conditions is high blood pressure a major risk factor?

A

•Major risk factor for heart disease, stroke, renal problems and visual impairment

[Changes at the back of the eye may be the first indication that a patient has high blood pressure].

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3
Q

What is malignant hypertension?

A

This is incredibly high blood pressure (its very rare).

Systolic > 200mmHg

Diastolic > 140mmHg

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4
Q

What are risk factors for high blood pressure?

A
  • Age
  • Family history
  • Obesity
  • Smoking
  • African-Caribbean race
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5
Q

What are ocular complications of raised blood pressure?

A
  • Cranial nerve palsies
  • Sub-conjunctival haemorrhages
  • Hypertensive retinopathy
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6
Q

Is hypertensive retinopathy visible on fundoscopy?

A

Yes

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7
Q

True or false - early signs or hypertensive retinocpathy are easily overlooked?

A

True - early signs of hypertensive retinopathy are easily overlooked.

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8
Q

Do systemic dieases such as diabetes present unilaterally or bilaterally?

A

Bilaterally - i.e. signs are present in both eyes.

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9
Q

True or false - there are different grades of hypertensive retinopathy.

A

True - the higher you go the more severe the hypertensive retinopathy

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10
Q

What occurs in grade 1 hypertensive retinopathy?

A
  • Arteriosclerosis => hardening or loss of elasticity of small blood vessel walls
  • Mild to moderate narrowing or sclerosis of the retinal arterioles
  • Vasospasm of arterial walls

ØNormal A/V ratio reduced

•Increased venous tortuosity may also be seen

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11
Q

What is the optometric managment for grade 1 hypertensive retinopathy?

A

Refer to Gp if not already being treated for hypertension

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12
Q

What will be seen in grade 2 hypertensive retinopathy?

A

•Moderate to marked narrowing of the arterioles

–>Local and or generalised

  • Arteriovenous crossing changes (shown in the image with the black arrows)
  • Increase in the light reflex (from copper wire)
  • Nipping or Gunn’s sign
  • Copper Wire
  • Reduced AV ratio
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13
Q

What is nipping or Gunn’s sign?

What is copper wire?

A
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14
Q

What is the optometric management for grade 2 hypertensive retinopathy?

A

Refer to GP if not already being treated for hypertension.

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15
Q

What presents with grade 3 hypertensive retinopathy?

A
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16
Q

What are cotton wool spots and how do they form?

A
17
Q

How many cotton wool spots can you see?

A
18
Q

With hypertensive retinopathy what shape do haemorrhages tend to be?

A

Flame shaped

(These are superficial and follow the nerve fibre layer).

19
Q

How many flame shaped haemorrhages can you see?

A
20
Q

True or false - vascualr leakage results in retinal oedema?

A

True

21
Q

Why is retinal oedema better viewed via slit lamp Binocular indirect ophthalmoscopy?

A

Because it provides a stereoscopic view.

22
Q

What can be used to detect macular oedema other than slit lamp BIO?

A

An OCT

(Often used to detect subtle macular oedema).

23
Q

How can hard exudates form?

A

From vascular leakage

24
Q

What are hard exudates and what do they look like on the fundus?

A

Lipo proteins that have been released ( from vascualr leakage).

They have a yellow waxy appearance on the fundus.

25
Q

Where are hard exudates are present in this picture?

A
26
Q

What does chronic macula oedema result in?

A

A macular star

27
Q

What is the optometric managment for grade 3 hypertensive retinopathy?

A

•Rapid referral to GP for cardiovascular check

28
Q

What presents in grade 4 hypertensive retinopathy?

A
29
Q

What symptoms may a px with grade 4 hypertensive retinopathy present with?

A

Headaches and visual symptoms such as a reduced VA.

30
Q

What is the optometric managment for grade 4 hypertensive retinopathy and why?

A

ØRefer to A&E as there is a Risk of ocular, cardiac, renal and cerebral damage

Introduction to Eye Disease - Year 2 (40 decks)

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