Ocular Conditions Flashcards
What is Uveitis?
Uveitis is inflammation of the middle layer of the eye, called the uvea or uveal tract. It can cause eye pain and changes to your vision.
What are the symptoms of Uveitis?
aching, painful, red eye
small pupil, irregular outline.
blurred vision
eye looks cloudy
Headaches
Light sensitivity
What are the causes of Uveitis?
cause remains unclear
inflammation of the uvea (inside of eye) and/or iris
affects mainly children and young adults.
often associated with trauma or autoimmune response
Describe the typical therapy for Uveitis
Treatment for uveitis will depend on which areas of the eye are affected and what caused the condition.
Corticosteroid eye drops
(e.g. dexamethasone)
Corticosteroid injections
Mydriatic eye drops
(e.g. atropine sulfate)
Symptoms of Blepharitis?
itchy, sore red eyelids
eyelids stick together, problems opening eyes on waking
crusty eyelashes
burning, gritty sensation in the eyes,
photophobia
abnormal eyelash growth/eyelash loss
Symptoms of Blepharitis?
itchy, sore red eyelids
eyelids stick together, problems opening eyes on waking
crusty eyelashes
burning, gritty sensation in the eyes,
photophobia
abnormal eyelash growth/eyelash loss
Causes of Blepharitis?
Sebaceous glad dysfunction
leading to/caused by:
staphylococcal infection
infestation of lice or demodex mites
allergic reaction e.g. mascara
fungal infection
viral infection (rare)
Describe the typical therapy of Blepharitis
Most people experience repeated episodes, separated by periods without symptoms
Daily eyelid-cleaning routine can help control the symptoms
More severe cases may require antibiotics that are either applied topically, or taken orally.
What is a stye?
A small, painful lump on the inside or outside of the eyelid
Symptoms of stye?
swollen/’lumpy’ eyelid
redness
swelling and tenderness lasting several days
often a white ‘head’ in centre of swelling
Causes of stye?
acute staphylococcal infection of the sebaceous glands
in-growing eyelash
can be associated with blepharitis
recurrent in diabetics
positive correlation with stress
Typical therapy of stye?
Most styes get better without treatment within a few days or weeks.
Topical antibiotics
What is conjunctivitis?
Name the different types
An inflammation of the conjunctiva
- bacterial
- allergic
- chlamydial
Causes of conjunctivitis?
pollen (hay fever)
dust mites
make up
animal fur
eye drops
unclean contact lens
bacterial/viral
Typical therapy of conjunctivitis
Conjunctivitis often doesn’t require treatment as the symptoms usually clear up within a couple of weeks
Allergic conjunctivitis: azelastine hydrochloride eye drops
Infective conjunctivitis: chloramphenicol or fusidic acid
What is Keratitis?
inflammation of the cornea
Symptoms of keratitis
eyelid oedema
conjunctival inflammation
discharge
corneal ulceration
‘pink eye’
Causes of keratitis
bacterial (contact lenses, trauma)
viral (Herpes simplex)
fungal (Candida)
parasitic (Acanthamoeba) pools, hot tubs, contact lens solution
most common cause of blindness
Typical therapy of keratits?
Depending on the severity of the infection, an oral antibiotic may be prescribed along with an antibiotic ointment or eye drops
What is Ectropion
A condition in which the eyelid turns outward
Symptoms of Ectropion?
Permanently watery eye
Eyelid sags away from the eye
Exposure of conjunctival surface
Exposure of corneal surface
Decreased vision
Ocular surface pain
causes of Ectropion
weak muscles around the eyes (associated with old age)
Injury to the skin around the eyes
Bell’s palsy (also known as facial palsy)
Congenital (genetic) defect
typical therapy of Ectropion
Mild cases may not need any treatment
In more severe cases, an operation to correct the problem will probably be recommended
Define Exophthalmos (Proptosis)
Abnormal protrusion of the eyeball
Symptoms of Exophthalmos (Proptosis)
eyelids forced apart
staring expression
impaired eye movement
double/blurred vision
dry and itchy eyes
Causes of Exophthalmos (Proptosis)
increase in the volume of tissue behind the eyes
Associated with hyperthyroidism
Hereditary disease (Grave’s)
infection of the sinuses (in children)
protrusion of one eye likely caused by cyst, cancer, brain tumour or blood clot
What is a cataracts?
A clouding of the lens in the eye
Symptoms of cataracts?
Blurred, cloudy and/or misty vision
Gradual visual deterioration
Age- and environment-related
Discomfort in bright light
Colours appear faded
Reading, watching TV more difficult than used to be
Glasses becoming less effective
Causes of cataracts?
Protein aggregation in lens
Eye injury
Diabetes
Uveitis
Risk factors that can lead to cataracts?
Smoking
Overexposure to sunlight
Steroids for long time
Typical therapy?
Surgery is the only type of treatment that’s proven to be effective for cataracts
What is Keratoconjunctivitis sicca (dry eye syndrome)?
A decreased tear production or increased tear film evaporation
Symptoms of Keratoconjunctivitis sicca
ocular irritation (dryness, grittiness, soreness)
typically bilateral presentation
worsens through the day
redness of eyes
Complications: scarring, conjunctivitis, light sensitivity, corneal thinning
Causes of Keratoconjunctivitis sicca
concomitant illness
hormonal changes
ageing
loss of tear fluid (defects in: lacrimal gland, meibomian gland, eyelid, cornea, tear ducts
Typical treatment of Keratoconjunctivitis sicca
Ocular lubricants (e.g. eye drops with Carbomers® or hydroxyethylcellulose
Define Glaucoma
A group of eye diseases which result in damage to the optic nerve and vision loss
Symptoms of glaucoma
Largely asymptomatic due to slow onset, age-related
Impairment of peripheral vision
Hazy or blurred vision
The appearance of rainbow-colored circles around bright lights
Severe eye and head pain
Nausea or vomiting (accompanying severe eye pain
Sudden sight loss.
Causes of glaucoma
trigger(s) unknown
Glaucoma is related to the damage of the optic nerve usually associated with excessive pressure within the eye
This excessive intraocular pressure is caused by misbalance in production and drainage in the aqueous humour
trabecular meshwork progressively impaired/blocked
What are the types of glaucoma?
Open-Angle Glaucoma
Angle-Closure Glaucoma
Describe Open-Angle Glaucoma
most common
(~90 %);
slow clogging of the drainage canals;
develops slowly;
a lifelong conditionDescribe Angle-Closure Glaucoma
blocked drainage canals, resulting in a sudden rise in intraocular pressure;
develops very quickly
What are the risk factors for developing glaucoma?
Age: primary open angle glaucoma is more common with increasing age (over 40);
Blood pressure: people with low blood pressure have a greater risk;
Race: People of African or Afro-Caribbean origin are at increased risk of developing chronic open-angle glaucoma and people of Asian origin are at increased risk of developing acute angle-closure glaucoma
Family history: people with close relatives with glaucoma are at increased risk
Short sight or long sight: people who are short-sighted (myopia) are more likely to develop chronic open-angle glaucoma
Medical history: people with diabetes may be at increased risk of developing glaucoma
What are the typical therapies for glaucoma?
Prostaglandin analogues Beta-blockers Carbonic anhydrase inhibitors Sympathomimetics Miotics
How do
Beta-blockers work and give an example
(reduce intraocular pressure by slowing down the production of aqueous humour in your eye);
e.g. Timolol maleate
How do Carbonic anhydrase inhibitors work and give an example
(reduce the amount of aqueous humour produced in your eye, which reduces intraocular pressure
e.g. Brinzolamide
How do Sympathomimetics work and give an example
(reduce the rate of production of aqueous humour and increase the flow of aqueous humour out of the eyes);
e.g Brimonidine tartrate
How do Miotics work and give an example
Miotics work by opening up the blocked trabecular meshwork, which should improve the drainage of aqueous humour out of your eye)
e.g Pilocarpine hydrochloride
What are the symptoms of an acute injury? Foreign body/corneal scratch
Dry eye sensation
Sensation of “foreign body”
Appearance usually normal with some associated redness
Excessive tear production
What is Diabetic retinopathy? and what causes it
damage that occurs to the retina due to diabetes
Microvascular changes due to poor control of blood sugar lead to degeneration of vascular walls
Affects 80% of patients with diabetes for >10 years
90% of cases are preventable if monitored and treated correctly
symptoms of diabetic retinopathy
Few, if any, early warning signs
Early stages only detectable by fundus photography
Early stages: Non-proliferative diabetic retinopathy
Later stages: vessels proliferate and vision deteriorates
Typical therapies of diabetic retinopathy
laser treatment
intravitreal injections or intravitreal implant with
fluocinolone acetonide
(corticosteroid)
an operation to remove blood or scar tissue
What causes subconjunctival heamorrhage?
mild physical trauma
Symptoms of subconjunctival heamorrhage?
blood from burst blood vessel covers surface of the eyeball
Blood not in eyeball itself
Initial pain disappears quickly
No change in vision
Typical therapies for subconjunctival heamorrhage?
No treatment is needed in the absence of infection or significant trauma
What is age related macular degeneration (AMD)?
A painless eye condition that causes lose of central vision, usually in both eyes
Symptoms of AMD?
- reading becomes difficult
- colours appear less vibrant
- people’s faces are difficult to recognise
- AMDdoes not affect the peripheral vision
Typical treatments of AMD?
There’s currently no cure for either type of AMD;
Wet AMD can be treated with anti-vascular endothelial growth factor (anti-VEGF) medication - Ranibizumab (Lucentis)
What is Dry AMD?
Dry AMD develops when the cells of the macula become damaged by a build-up of deposits called drusen. It’s the most common and least serious type of AMD, accounting for around 9 out of 10 cases
What is Wet AMD?
Wet AMD – sometimes called neovascular AMD – develops when abnormal blood vessels form underneath the macula and damage its cells
What are the symptoms of Myopia (short sightedness)?
distant objects appear blurred
close objects seen clearly
30% UK are myopic
Manifests from childhood – 25 years old
Causes of Myopia (short sightedness)?
light not properly focussed on to back of the eye
eye too long from front to back
cornea too steeply curved
How to correct myopia/hyperopia?
Lenses (glasses or contact lenses) used
Contact lenses are thin transparent plastic discs that sit on the cornea and are held in place owing by eyelid pressure exerted and tear fluid surface tension
Lenses are shaped according to the correction necessary
Myopia: a concave lens or “minus”
Hyperopia: a convex lenses or “plus”
What are the different types of contact lens?
Rigid (hard or gas permeable)
Soft (hydrogel or silicone hydrogel)
What are the complications of wearing contact lens?
Papillary conjunctivitus
Ulcerative keratitis
Acanthamoeba keratitis (sight threatening parasite)
What are some rare eye conditions?
Cancer
Cicatricial pemphigoid - (autoimmune blistering)
Limbal stem cell deficiency
Corneal dystrophies
Keratoconus - (corneal degeneration)
