Lecture 4 - ocular conditions

Question 1

What are the causes and symptoms of uveitis?

Answer 1

It is the inflammation of the uvea or iris which is associated with trauma or immune response. It is most common in young adult or children.
Its symptoms are:
-painful, red eye
-small pupil, irregular outline
- headache
- light sensitivity
-blurred vision
-eye look cloudy

Question 2

List the treatment of uveitis

Answer 2

This depends on what area is affected. Corticosteroid eye drops or injections.

Question 3

What is the cause and symptoms of blepharitis?

Answer 3

It is a sebaceous gland dysfunction  caused by staph infection, infestation of lice, allergic reaction, fungal infection or viral infection. 
It presents itself as:
-itchy sore eyelids
-eyelids stick together when waking
-crusty eyelashes
-burning, gritty sensation in the eye
-photophobia
-abnormal eyelash growth or loss.

Question 4

What is the treatment for blepharitis?

Answer 4

The typical therapy is daily cleaning of the eyelid will result in reduction of symptoms. In severe cases, topical or oral antibiotics may be given.

Question 5

What is the cause and symptoms of stye?

Answer 5

It is a small, painful lump on the inside or outside of the eyelid. It can be caused by a staph infection of sebaceous glands or ingrown eyelashes. It is commonly associated with blepharitis and with stress. It is recurrent in diabetes patients.
It symptoms are:
-swollen, lumpy eyelid
-redness
-swelling
-white in centre of swelling

Question 6

What are the treatment for stye?

Answer 6

They resolve after a few days. Can also use topical antibiotics.

Question 7

What is the cause and symptoms of conjunctivitis?

Answer 7

It is an inflammation of the conjunctiva. It can be caused by pollen, dust mites, make up, animal fur, eye drops, unclean contact lens, bacterial or viral.
The symptoms are:
-unilateral/bilateral
-sudden onset(seasonal)
-reddening of eyes
-itchy eyes
-swollen eyelids
-watering eyes
-soreness

Question 8

What are the treatment for conjunctivitis?

Answer 8

The symptoms normally clear itself after 1-2 weeks.
If it is a allergic conjunctivitis azelastine hydrochloride is given.
If it is a bacterial conjunctivitis chloramphenicol or fusidic acid is given.

Question 9

What is keratitis? List the symptoms

Answer 9

It is an inflammation of the cornea. It is normally caused by bacterial, viral, fungal, parasitic. It is the most common cause of blindness. 
The presenting symptoms are:
-eyelid oedema
-conjunctival inflammation
-discharge
-corneal ulceration
-pink eyes

Question 10

List the treatment available for keratitis?

Answer 10

An oral antibiotic can be prescribed along with an antibiotic eye drop or ointment.

Question 11

What is ectropion and list the symptoms.

Answer 11

It is a condition where the eyelid turn outward. It may be caused by weak muscles around the eyes, injury to the skin around the eye, Bell's palsy or congenital defect.
The symptoms are:
-permanently watering eye
-eyelid sags away from the eye
-exposure of corneal surface
-exposure of conjunctival surface
-decreased vision
-ocular surface pain

Question 12

What are the therapies available for ectropion?

Answer 12

Mild cases do not require treatment. Severe cases is normally treated with surgery.

Question 13

Give the cause and symptoms of exophthalmos.

Answer 13

It is an abnormal protrusion of the eyeball. It can be caused by extra growth of tissue behind the eyeball, associated with hyperthyroidism, Grave's disease, infection of the sinuses.
Symptoms are:
-eyelids forced apart
-staring expression
-impaired eye movement
-double/blurred vision
-dry and itchy eyes.

Question 14

What are cataract and how are they caused?

Answer 14

It is a clouding in the lens of the eye. It can be caused by an aggregation in lens, an eye injury, diabetes or uveitis.. There are certain risk factors such as smoking, overexposure to sunlight and steroids for long time.
The symptoms are:
-blurred, cloudy vision
-gradual vision deterioration
-age and environmental related
-discomfort  in bright light
-colours appears faded
-reading and watching tv is more difficult
-glasses become less effective

The only treatment option is surgery

Question 15

What are the causes and symptoms of glaucoma?

Answer 15

Glaucoma is a disease where the optic nerve is damage and individual suffer from vision loss.
The trigger of this disease is unknown but it is associated with excessive intraocular pressure which might be from a misbalance between production and drainage of aqueous humour.
Glaucoma is asymptomatic due to slow onset and age related. It causes impairment of vision, appearance of rainbow around bright lights, severe head and eye pain, sudden sight loss and nausea and vomiting.

Question 16

State the two types of glaucoma and the difference between them.

Answer 16

1. Open angle glaucoma(Most common, slow clogging of drainage canals, develops slowly, lifelong)
2. Angle-closure glaucoma (blocked drainage canals resulting in a sudden rise in intraocular pressure, develops very quickly)

Question 17

What are the risk factors of developing glaucoma?

Answer 17

Age
Low blood pressure
Race (afro-carribean more likely to get open angle glaucoma and asian more likely to get angle closure glaucoma)
Family history
Diabetes
Short sight or long sight

Question 18

List the available therapies for glaucoma

Answer 18

1. prostaglandin analogue - increase the flow of fluid (latanoprost)
2. Beta-blockers - decrease production of aqueous humour (timolol)
3. Carbonic anhydrase inhibitors - reduce production of aqueous humour (Brinzolamide)
4. Sympathomimetics - Reduce rate of production of aqueous humour and increase drainage (Brimonidine tartrate)
5. Miotics - improve drainage of fluid (pilocarpine hydrochloride)

Question 19

What is diabetic retinopathy and what are the symptoms?

Answer 19

It is damage caused to the retina due to diabetes. The microvascular changes due to poor control of blood sugar lead to degeneration of vascular walls. It affects 80% of patients with more than 10 years of diabetes. It can be treated if it is monitored.
The treatment options are laser treatment, intravitreal injection or implant with fluocinolone acetonide(corticosteroid). Can also do surgery to remove blood or scar tissue.

Question 20

What is age related macular degeneration?

Answer 20

It is a painless eye condition that causes loss of vision, usually in both eyes. It becomes harder to read, colour becomes less vibrant and harder to recognise people’s faces. There are currently no treatment for AMD.

Question 21

List the 2 types of AMD.

Answer 21

1. Dry AMD - deposits of drusen

2. Wet AMD - due to blood vessels underneath macula

Question 22

What is myopia?

Answer 22

It is short sightedness due to the cornea being to steeply curved.

Question 23

How to correct myopia or hyperopia?

Answer 23

Myopia can be corrected by concave lens

Hyperopia can be corrected by convex lens