Lecture XII Flashcards
What happens to the eyes in pregnancy? (3)
- Refractive error changes
- Dry eyes
- Transient loss of accommodation
What is a retinal complication from pregnancy?
Pregnancy induced HTN leads to retinopathy
What can happen with DM retinopathy with pregnancy?
Progresses
Should you change the glasses prescription or contact lens prescription in pregnancy?
No–will change too fast
What causes the exophthalmos with Grave’s disease?
EOM hypertrophy 2/2 Ab stimulating
What are the histological findings of the thyroid with grave’s disease?
Scalloping of the colloid
What is the most common cause of unilateral or bilateral exophthalmos in the adult?
Grave’s disease
How well does the severity of exophthalmos with serum thyroid levels in grave’s disease?
Not very
True or false: Thyroid ophthalmopathy can progress even after thyroid function is normal
True
What may happen to the optic nerve with Grave’s disease?
Pressure on the nerve
What are the three major non-surgical treatments for thyroid ophthalmopathy?
- Tear substitutes
- Corticosteroids
- Orbital irradiation
What is the major symptoms of iritis? Others?
- Photophobia
- Decreased vision
- Miotic pupil
- Pain
What must be r/o with iritis?
Trauma
What are the three major clinical exam findings of iritis?
- White cells in the anterior chamber
- Hypopyon
- Keratic precipitates
What are the ophthalmologic complications of Sarcoidosis? (4)
- Anterior uveitis (iritis)
- Posterior uveitis
- Retinitis
- Dry eye syndrome
What is the great mimic of Sarcoidosis?
Histoplasmosis
What are the exam findings of sarcoidosis in the eye? (cornea, retina)
- Granulomatous uveitis (“mutton fat”)
- Candlewax drippings in the choriditis
What are the ocular complications from RA?
- Dry eyes
- Episcleritis
- Scleritis
- Corneal ulcers
Perforations of the ciliary body = ?
RA
What is the major complication from RA corneal ulcerations?
Perforation of the cornea
What is the major ocular findings from JRA? What is characteristic about the joint issues with JRA?
Iritis that is often asymptomatic and chronic
Usually pauciarticular
What may happen if iritis in JRA goes unrecognized? (3)
- Cataracts
- Glaucoma
- Corneal calcification
What are the ocular manifestations of SLE?
- Dry eyes
- Scleritis
- Peripheral corneal ulcers
- Retinopathy and optic neuropathy
What are the s/sx of CT diseases in the eyes?
- Dry eyes
- Burning
- FB sensation
- Photophobia
- Tears
What medications can cause dry eyes?
- antidepressants
- Diuretics
What syndrome may cause tear deficiency?
Steven-Johnson syndrome
What is the treatment for ocular surface disease? (3)
- Artificial tears OTC
- Omega 3
- Lid hygiene
What are the s/sx of ischemic optic neuropathy?
- HA
- Scalp TTP
- Jaw claudication
What is the systemic symptoms of giant cell arteritis?
Polymyalgia rheumatica
What is the treatment for giant cell arteritis?
- IV steroids
- Bx of the temporal artery
What is the timeframe in which the bx for giant cell arteritis will not be affected by the steroids given for treatment?
1 week
What are the three classic lab elevations with Giant cell arteritis?
- Platelets
- ESR
- CRP
What are the ocular s/sx of migraines? (3)
- Scintillating scotomas
- Transient cortical blindness
- Homonymous hemianopia
What medications should chronic migraine sufferers avoid?
Oral BCP
What is the long term treatment for migraines?
-Examine for visual loss
What is amaurosis fugax?
-Temporary arterial obstruction, causing sudden and transient visual loss
What are the organ system that affects amaurosis fugax?
- CVD
- Cerebrovascular
- Ophthalmologic
What can mimic occlusion with amaurosis fugax?
Migraine vasospasm
What is the treatment for CRAO? (2)
- Digital massage
- Glaucoma meds
What are the fundus characteristics after CRAO?
blind eye with a pale disc
What are the two classic malignancies that affect the optic nerve?
Leukemia
Lymphoma
True or false: most of the malignancies involving the eye are secondary
True
What are the complications of radiation to the eye?
Cataracts
Retinopathy
What chemotherapeutic agent can cause superficial keratitis?
Cytosine arabinoside
What chemotherapeutic agent can cause optic neuropathy?
Vincristine
What chemotherapeutic can cause CRAO?
Carmustine
True or false: pregnancy can cause serous retinal detachment
True
What is the role of corticosteroids in the treatment of exophthalmos 2/2 Grave’s disease?
Reduces the antibody production. However, this is only a temporizing measure.
What type of injection characterizes iritis?
-Circumcorneal injection
What is the treatment for iritis?
Cycloplegic agents (antimuscarinics to cause dilation of the pupil)
What type of pupil do patients with iritis have: miotic or mydriatic?
Miotic
What causes the “snowglobe” appearance of irits?
Keratic precipitates
Which disease is characterized by the following:
- Granulomatous uveitis (“mutton fat”)
- Candlewax drippings in the choroiditis
Sarcoidosis
