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1 P Seg II > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

The vitreous makes up how much of the ocular volume

A

75%

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2
Q

Is the vitreous considered a CT

A

Yes

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3
Q

Make up of the vitreous

A
  1. 99% water
  2. Collagen, type 2. AKA Vitrosin.
  3. GAGs, help keep spacing
    - Hyaluronic acid (gel)
    - Chrondroitin sulfate
  4. A few cells, inorganic salts, and soluble proteins.
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4
Q

Another name for collagen

A

Vitrosin

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5
Q

Attachment of the vitreous to the back of the lens

A

Weigers adhesion/ligament is the attachment at the back of the lens in a circle. Creates eggers line on the posterior capsule.
Directly behind the lens, in front of the vitreous, is bergers space

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6
Q

Strong to weak attachemnts

A
  1. Vitreous base
  2. Posterior lens
  3. Optic disc
  4. Macula
  5. Vessels
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7
Q

The vitreous is __x as viscous as water

A

4

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8
Q

Combination of which 2 things causes elasticity in the vitreous

A

Collagen and Hyaluronic acid

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9
Q

Vitreous liquefaction/synchysis seniles occurs when what happens ?

A

Hyaluronic acid depolymerizes- less gel, more water (lacunae) uneven spacing between collage – > aggregation makes visible bundles of fibers

Begins in the center.

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10
Q

Vitreous liquefaction/synchysis seniles before age 50 and after age 80. How much liquid?

A

Before age 50, 25% liquid

After age 80, 62% liquid

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11
Q

Syneresis

A

Shrinkage of the vitreous as solids and liquids separate

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12
Q

Fibriliary degeneration

A

Liquefaction and syneresis

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13
Q

Vitreous condensation

A

collagen fibers are drawn together

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14
Q

Essention phenom of coloquets

A

Dynamic. Have pt look up and then down. Can see it moving due to liquefaction.

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15
Q

Liquefaction starts earlier in what type of patients

A

Myopes and those with thin retinas

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16
Q

PVD commonly occurs in what age and gender

A

Females older than 45

17
Q

Causes of PVD

A

Age
High myopia
Trauma
Inflammation - speeds up fibrillation process
Aphakia - no more anterior attachment to lens
Cataract surgery
Vitreoretinal degeneration

18
Q

How to differentiate complete and incomplete PVD

A

Complete- presence of weiss ring

19
Q

Tobacco dust/Schafers sign

A 
RPE pigment due to liquefied vitreous disrupting bonds. Know there was a retinal break. 
Should not occur with PVD unless there is a break 
Always document (-) in chart

When present, 52x more likely to have retinal break

20
Q

Complications of PVD

A
  1. VMT–> Edema –> Hole
  2. Vitreous hemorrhage
    - If a PVD causes a vitreous hemorrhage, there is 75% chance it also caused a retinal break
  3. Retinal break
    - Tobacco dust/shafers (when present, 52x more likely to have a retinal break)
    - 1/3 of symptomatic retinal breaks progress to RD
  4. Retinal hemorrhage
21
Q

What causes flashes and how many people report this when they have a PVD?

A

Traction causes physical stimulation of the photoreceptors.

22
Q

If a PVD causes a vitreous hemorrhage, there is 75% chance it also caused

A

a retinal break

23
Q

___ of symptomatic retinal breaks progress to RD

A

1/3

24
Q

f/u schedule

  1. No retinal break or heme?
  2. No break but mild vitreous heme or peripheral hemes are present
  3. No break but significant vitreous heme or tobacco dust present
A
  1. See back in 3 weeks, 3 months, 6 months
  2. Repeat in 1 week, 3 weeks, 3 months, 6 months
  3. Refer to retina
25
Q

marfan syndrome ocular findings

A 
ST subluxation 
Axial myopia 
Small k diameter 
Increased risk of retinal detachment 
Vit degen
26
Q

Syndrome that has a mutation in the fibrillan genes

A

Marfans

27
Q

Ehlers Danlos ocular findings

A 
High myopia
Micro K --> Glaucoma 
Angiod streaks 
Lattice (vitreoretinal degeneration) 
Ptosis 
Strab
28
Q

Anterior vitreous detachment is usually due to?
Associated with what else?
How to manage?

A
  • Trauma or lens dislocation.
  • Associated with retinal break due to high degree of trauma
  • Look for tears or dialysis. If no break, follow up in 1 year.
29
Q

Asteroid hyalosis incidence in the pop?

What is it?

A

1%
Calcium, phosphorous, oxygen, and lipid suspensions- adherent to the vitreous framework. Suspended throughout the collagen fibrils.

30
Q

Asteroid hyalosis differential

A

Synchysis Scintillans - cholesterol crystals. Occurs in severely blind eye.

Settles after movement, reflective, may cause pseudo hypopyon.

1 P Seg II (9 decks)

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