Multisystem diseases manifestations in ophthalmology

Question 1

what can be found in mild non-proliferative diabetic retinopathy 1

Answer 1

microaneurysms

Question 2

what can be found in moderate non-proliferative diabetic retinopathy 5

Answer 2

microaneurysms

blot haemorrhages

hard exudates

cotton wool spots

venous bleeding

Question 3

what can be found in severe non-proliferative diabetic retinopathy 3

Answer 3

blot haemorrhages + microanueuryssm in 4 quadrants

venous bleeding in 2 quadrants

intraretinal microvascualr abnormalitiy in any quadrant

Question 4

define intraretinal microvascular abnormalities (IRMA)

Answer 4

dilated and tortuous capillaries in the retina

act as shunt between arterial and venous vessels in the retina

Question 5

what is found in proliferative diabetic retinopathy 2

Answer 5

neovascularisation

vitreous haemorrhage

Question 6

what is found in diabetic maculopathy 2

Answer 6

macular oedema

ischaemic maculopathy

Question 7

complications of diabetic retinopathy 5

Answer 7

retinal detachment

vitreous haemorrhage (bleeding into vitreous humour)

rebeosis iridis (new blood vessel formation in the iris)

optic neuropathy

cataracts

Question 8

Mx of diabetic retinopathy 3

Answer 8

laser photcoagualtion

anti-vegf

vitreoretinal srugery -in severe disease

Question 9

complications of hypertension in ophthalmology 3

Answer 9

hypertensive retinopathy

choroidopathy

optic neuropathy

Question 10

what signs are seen in the retina to suggest hypertensive retinoapthy 6

Answer 10

cotton wool spots

hard exudates

retinal haemorrhage

papilloedema

Question 11

cause of silver wiring in retina

Answer 11

where the walls of arterioles become thickened and sclarosed causing increased reflection of the light

Question 12

cause of arteriovenous nipping

Answer 12

artieroles cause compression of veins where they cross
-again due to sclerosis and hardening of the arterioles

Question 13

cause of cotton wool spots

Answer 13

-caused by ischaemia and infarction

Question 14

cause of hard exudates

Answer 14

-caused by damaged vessels leaking lipids into retina

Question 15

cause of retinal haemorrhage

Answer 15

-caused by damaged vessels rupturing and releasing blood into the retina

Question 16

cause of papilloedema

Answer 16

-caused by ischaemia and optic nerve
-resulting in optic nerve swelling (oedema) and blurring of the disc margins

Question 17

what classification system is used for hypertenisve retinoapthy

Answer 17

Keith-Wagener classification

Question 18

define stage 1 hypertensive retinopathy

Answer 18

mild narrowing of the arterioles

Question 19

define stage 2 hypertensive retinopathy

Answer 19

focal constrcition of blood vessels and AV nicking

Question 20

define stage 3 hypertensive retinopathy 3

Answer 20

cotton wool patches

exudates

flame and blot haemorrages
-may collect around fovea resulting in a ‘macular star’

Question 21

define stage 4 hypertensive retinopathy

Answer 21

papilloedema

Question 22

Mx of hypertensive retinopathy

Answer 22

focused on controlling blood pressure and other risk-facotrs such as smoking and blood lipid levels

Question 23

HIV manifestations in ophthalmology in early stages 4

Answer 23

kaposi sarcoma

herpes zoster ophthalmicus

candidiasis

lymphoma

Question 24

HIV manifestations in ophthalomolgy in late stages 3

Answer 24

tuberculosis

toxoplasmosis

pneumocystosis

Question 25

HIV manifestationsin ophthalmology with profoundly low CD4 count 2

Answer 25

cytomegalovirus retinitis mycobacterium-avium complex disease

Question 26

define kaposi sarcoma

Answer 26

oppurtunisitic malignancy produced by HHV-8 infectoin

Question 27

ophthalmology manifestations of MS 6

Answer 27

optic neuritis -typically monocular painful vision loss that occurs over hours to days and lasts a few weeks change in visual acuity orbital pain -worse on extraocular movement dimished colour vision visual field loss papillitis

Question 28

ocular manifestiations of sarcoidosis 2

Answer 28

uveitis -most commonly bilateral anteior uveitis choroidal granulomas can lead to visual impariment if centrally located

Question 29

ocular manifestations of TB 8

Answer 29

scleritis phylectenulosis interstitial keratitis corneal infiltrates anterior chamber iris nodules granulomatous anterior uveitis

Question 30

ocular manifestations of RA 4

Answer 30

dry eye syndrome episcleritis scleritis PUK

Question 31

ocular manifestations of thyroid disease 6

Answer 31

mild -ocular irritation, lid retraction, lid lag sx of orbital infiltration -chemosis -proptosis -restirciton of ocular motiitli -corneal exposure -optic nevre compression

Question 32

ocular manifestations of stroke 3

Answer 32

unilateral loss of cision or dark area or shadow or loss of visual contrast and light sensitivity

Question 33

ocular manifestiatons of giant cell arteritis 2

Answer 33

acute unilateral vision loss typically secondary to optic nerve ischaemia (AAION)-arteritic anterior ischaemic optic neuropathy less commonly due to central retinal artery occulsion