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Ophthalmology > Medical Ophthamology > Flashcards

Medical Ophthamology Flashcards

1
Q

What is Diabetes Mellitus (DM) associated with in terms of ocular damage?

A

Diabetes Mellitus (DM) causes long-term damage to ocular structures, potentially leading to blindness.

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2
Q

Which types of diabetes mellitus exist and how do they differ in prevalence?

A

Type I accounts for 5-10% (autoimmune), and Type 2 for 90-95% (develops later in life).

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3
Q

What is a stye, and how is it treated?

A

A stye is a small abscess caused by acute staphylococcal infection; treated with hot compresses, antibiotics, and incision and drainage.

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4
Q

How does blepharitis present in patients with diabetes?

A

Blepharitis manifests as chronic staphylococcal infection of the lid margin, treated with lid hygiene and systemic tetracycline.

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5
Q

What causes chalazion, and what type of lesion is it?

A

Chalazion is a chronic, sterile granulomatous lesion caused by retained sebaceous secretions.

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6
Q

Why are cataracts more common in patients with diabetes?

A

Cataracts are more frequent due to metabolic abnormalities in diabetes.

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7
Q

What are the characteristic features of diabetic cataracts?

A

Diabetic cataracts often present with anterior cortical spokes or posterior subcapsular plaques.

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8
Q

What is the second leading cause of neovascular glaucoma?

A

Neovascular glaucoma develops due to angle closure from fibrovascular tissue.

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9
Q

What is rubeosis iridis and how is it related to DM?

A

Rubeosis iridis refers to abnormal blood vessel growth on the iris in diabetes.

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10
Q

What is diabetic retinopathy (DR), and why is it a significant cause of blindness?

A

Diabetic retinopathy is a leading cause of blindness due to microangiopathy affecting the retina.

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11
Q

What are the major risk factors for developing diabetic retinopathy?

A

Risk factors include poor glucose control, long duration of DM, hypertension, nephropathy, pregnancy, and anaemia.

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12
Q

Describe the pathogenesis of diabetic retinopathy.

A

Diabetic retinopathy results from capillary occlusion, leakage, and blood abnormalities.

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13
Q

What are the early-stage symptoms of diabetic retinopathy?

A

Early-stage diabetic retinopathy has no symptoms or presents with blurry vision.

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14
Q

Why is regular eye examination crucial for diabetics?

A

Regular eye exams are essential since early diabetic retinopathy is asymptomatic but treatable.

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15
Q

List the key signs of diabetic retinopathy.

A

Signs include hard exudates, cotton wool spots, retinal haemorrhages, and neovascularisation.

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16
Q

What is the significance of microaneurysms in diabetic retinopathy?

A

Microaneurysms are the earliest signs of diabetic retinopathy.

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17
Q

How do hard exudates manifest in diabetic retinopathy?

A

Hard exudates result from lipid deposits in the retina due to leakage.

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18
Q

What role do new blood vessels play in diabetic retinopathy?

A

New blood vessels are fragile and can rupture, causing vitreous haemorrhage.

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19
Q

How does retinal detachment occur in diabetic patients?

A

Retinal detachment occurs due to traction from new blood vessels.

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20
Q

What is vitreous haemorrhage, and how does it develop in diabetic retinopathy?

A

Vitreous haemorrhage occurs when neovascular fronds rupture.

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21
Q

Differentiate between non-proliferative and proliferative diabetic retinopathy.

A

Non-proliferative retinopathy lacks new vessels; proliferative involves neovascularisation.

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22
Q

What is diabetic maculopathy?

A

Diabetic maculopathy affects the macula, leading to central vision loss.

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23
Q

How is early treatment of diabetic retinopathy classified?

A

Early treatment includes classifying diabetic retinopathy into stages (mild, moderate, severe).

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24
Q

What management strategies are important in diabetic eye disease?

A

Management includes glucose control, blood pressure regulation, and laser therapy.

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25
Q

How does laser photocoagulation help in managing diabetic retinopathy?

A

Laser photocoagulation prevents progression by sealing leaking vessels.

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26
Q

What medications are used in the intravitreal treatment of diabetic retinopathy?

A

Anti-VEGF medications like bevacizumab reduce neovascularisation.

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27
Q

When is vitrectomy indicated in diabetic retinopathy?

A

Vitrectomy is required for vitreous haemorrhage or retinal detachment.

28
Q

How does public health enlightenment contribute to preventing diabetic retinopathy?

A

Public health efforts aim to increase awareness and screening.

29
Q

Why is hypertension associated with diabetic retinopathy?

A

Hypertension exacerbates diabetic retinopathy by damaging blood vessels.

30
Q

What is hypertensive retinopathy and how does it affect ocular health?

A

Hypertensive retinopathy involves vascular changes due to sustained elevated blood pressure.

31
Q

What are the major factors influencing the development of hypertensive retinopathy?

A

Severity and duration of hypertension influence retinopathy risk.

32
Q

Explain the pathogenesis of hypertensive retinopathy.

A

Vasoconstriction and increased permeability cause haemorrhages and exudates in hypertensive retinopathy.

33
Q

Describe the stages of the Kieth-Wegner classification for hypertensive retinopathy.

A

The Kieth-Wegner classification outlines four stages of hypertensive retinopathy.

34
Q

What are the features of Grade 1 hypertensive retinopathy?

A

Grade 1 presents with mild arteriolar narrowing.

35
Q

How does Grade 2 hypertensive retinopathy present?

A

Grade 2 shows more marked arteriolar narrowing and focal attenuation.

36
Q

What is the Bonnet sign, and in which grade of hypertensive retinopathy does it occur?

A

Bonnet sign is the tapering of veins near arteriolar crossings in Grade 2 retinopathy.

37
Q

What are the clinical features of Grade 3 hypertensive retinopathy?

A

Grade 3 presents with copper wiring, flame-shaped haemorrhages, and cotton wool spots.

38
Q

Describe the Gunn and Salus signs in hypertensive retinopathy.

A

Gunn and Salus signs indicate arteriovenous crossing changes in hypertensive retinopathy.

39
Q

What characterises Grade 4 hypertensive retinopathy?

A

Grade 4 shows silver wiring and bilateral disc swelling, indicating severe retinopathy.

40
Q

What are the consequences of malignant hypertension on the eye?

A

Malignant hypertension can cause severe ocular complications, including optic neuropathy.

41
Q

How does ocular ischaemic syndrome present in hypertensive patients?

A

Ocular ischaemic syndrome leads to severe vision loss from restricted blood flow.

42
Q

What role does laser therapy play in treating hypertensive retinopathy complications?

A

Laser therapy treats retinal neovascularisation and haemorrhages in hypertensive retinopathy.

43
Q

How is retinal vascular occlusion managed in hypertensive retinopathy?

A

Retinal vascular occlusion is managed through blood pressure control and anti-VEGF injections.

44
Q

What similarities exist between the retinal and cardiovascular systems in hypertension?

A

Retinal changes mirror systemic cardiovascular issues, aiding in diagnosis.

45
Q

Why is sickle cell disease significant in the context of eye health?

A

Sickle cell disease causes significant visual loss due to vascular complications.

46
Q

What genetic mutation causes sickle cell disease?

A

A point mutation in the β-globin gene on chromosome 11 causes sickle cell disease.

47
Q

Describe the haemoglobin structure affected by sickle cell disease.

A

Haemoglobin S leads to reduced oxygen transport and abnormal red blood cell shapes.

48
Q

What is the global epidemiology of sickle cell disease?

A

Sickle cell disease affects over 400,000 children annually, mostly in sub-Saharan Africa.

49
Q

What percentage of the Nigerian population is affected by sickle cell disease?

A

In Nigeria, 150,000 children are born annually with HbSS.

50
Q

How does sickle cell disease affect the eyes?

A

Sickle cell disease leads to occlusion of small retinal vessels, causing ischaemia.

51
Q

Describe the pathophysiology of sickle cell retinopathy.

A

Vascular proliferation in sickle cell disease results in unstable blood vessels that can rupture.

52
Q

What are the clinical features of sickle cell eye disease?

A

Early stages cause mild blurry vision, while advanced stages lead to blindness.

53
Q

What distinguishes non-retinal from retinal lesions in sickle cell disease?

A

Non-retinal lesions include conjunctival issues, while retinal lesions cause vision loss.

54
Q

How does vascular proliferation lead to eye damage in sickle cell disease?

A

Vascular proliferation in sickle cell disease leads to vitreous haemorrhage.

55
Q

What are the stages of retinal lesions in sickle cell retinopathy?

A

Retinal lesions are divided into non-proliferative and proliferative stages.

56
Q

Why is the retina considered an accessible organ for hypertension monitoring?

A

The retina’s microcirculation makes it a window into hypertension’s effects.

57
Q

What is the significance of fundoscopic examination in diabetic and hypertensive patients?

A

Fundoscopy allows visualisation of retinal blood vessels to detect hypertension-related changes.

58
Q

How does haemoglobin S affect the shape and function of red blood cells?

A

Sickle haemoglobin causes red blood cells to become rigid and sticky.

59
Q

What systemic complications arise from sickle-shaped red blood cells?

A

Sickle-shaped red blood cells can block blood flow, causing pain and organ damage.

60
Q

How is sickle cell retinopathy managed?

A

Sickle cell retinopathy is managed through regular eye exams and treatment of neovascularisation.

61
Q

What is the role of oxygen therapy in managing sickle cell-related eye complications?

A

Oxygen therapy helps prevent retinal hypoxia in sickle cell patients.

62
Q

What preventative measures are recommended for diabetic retinopathy?

A

Diabetic retinopathy can be prevented with regular eye exams and tight glucose control.

63
Q

What is the relevance of anti-VEGF drugs in diabetic eye disease?

A

Anti-VEGF drugs reduce new blood vessel growth in diabetic retinopathy.

64
Q

How can early diagnosis of hypertensive and diabetic retinopathy prevent blindness?

A

Early diagnosis and treatment prevent blindness in hypertensive and diabetic retinopathy.

65
Q

What are the systemic implications of untreated retinopathy in hypertensive and diabetic patients?

A

Untreated retinopathy can cause systemic complications like stroke and heart disease.

Ophthalmology (5 decks)

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