Ocular Manifestations of Systemic Dis Flashcards
What are the ocular manifestations of DM?
Refractive error changes
Cataracts
Retinopathy most important
What aspects of Diabetic Retinopathy correlates with worse disease?
Duration of disease
HTN
High HbA1C
SMoking
What is the Pathogenesis of Diabetic Retinopathy?
Inc Glucose => VEGF => Inc Cap permiability/ abn vasoprolif.
What are the subgroups of Diabetic Retinopathy?
Proliferative
Non-proliferative
WHat are the charicteristics of NP Diabetic Retinopathy?
Retinal BV leak Leakage into macula => reduce vision Microaneurisms Leakage of IV fluids Hemorrhages Retinal Ischemia (Cot Wool spot)
WHat causes neovascularization?
Tissue Hypoxia
What are the symptoms of Vitreous Hemorrhage?
Shower of floaters or cobwebs
Sudden loss of vision
Refer!
What are the 2 causes of NPDR Visual Loss?
Ischemic Maculopathy
Macular Edema
What are the goals of Photocoagulation?
Prevents further neovasc
Reduce risk of vitreous hemorrhage
Reduce traction retinal detachment
How can we protect from Retinopathy?
Proteinuria is a RF for macular edema
Diuresis and BP control
ACE/ARB
Serum lipids
What are the Treatment options for retinopathy?
Laser Photocoagulation
Vitrectomy
What are the signs of worsening HTN effects in eye?
Arteriolar narrowing
Hard Exudates, Hemorrhage
Disc Edema
What are the ocular manifestations seen in pregnancy?
1) Refractive Changes
2) Dry Eyes
3) Loss of Accomodation
4) Preggo induced HTN
5) Retinal Detch
6) Prog of Diabetic Retinopathy
What are the clinical features of Thyroid Disease?
Enl of EOM, Lid Retraction, Lid Lag, Exopthalmos, Conjunctival Congestion
Thyroid Levels unreliable
What is the Tx of Thyroid Opthamopathy?
Tear Subs, Corticosteroids
EOM Surgery
Orbital Irradiation
Surgical Decompression
What are the symptoms of Iritis?
Photophobia, Dec Vision, Miotic Pupil, Pain
What are the Ocular Signs of Sarcoidosis?
Ant/Post Uveitis
Retinitis, hemorrhage, peripheral NV
Dry Eye Syndrome
Neurosarcoidosis
What are the ocular signs of Rheounatoid Arthritis?
Dry Eyes
Episcleritis
Scleritis
Corneal Ulcers
What are the ocular traits of Juvenile RA?
Iritis in 10% of Pts
Can lead to Cataracts, Glaucoma, or corneal Calcification
What are the ocular Manifestations of SLE?
Dry Eyes
Scleritis
Peripheral corneal ulcers
Retinopathy and optic neuropathy
What are the ocular symptoms of Connective tissue Disorders
Burning
Foreign Body sensation
Photophobia
Tearing.
What are causes of Tear Deficiency States?
Aging, RA, Systemic Meds, Steven-Johnson Syndrome
What is the Treatment of Ocular Surface disease?
Arteficial tears Lubricating Ointment at night Omega 3 Lid Hygeine Topical Anti inflammatory Punctal occlusion Doxycycline vs Azasite
What is the Tx of Giant Cell Arteritis?
High Dose Steroids IMMEDIATELY
What are the visual symptoms of a migraine?
Scintillating Scotoma Amaurosis Fugax Transient cortical blindness Homonymous Hemianopia Classic or Opthalmic
What are the types of Migraine?
With Headache: Classic
Without Headache: Acephalic
What is the Tx of Migraine?
Prevent freq attacks
Examine for visual loss
Consider taking off oral contraceptives
What are the Ocular manifestations of AIDS?
Cotton Wool Spots: Ag-Ab Complexes
CMV retinitis
Kaposi’s Sarcoma: eyelids
What is the Tx of CMV retinitis?
Oral/IV Gancyclovir
IV Foscarnet
IV Cidofovir
Intravitreal Gan
What are the S and S of Herpes Zoster Opthalmicus?
Intense Pain/discomfort
Itching
Photophobia
Vesicles, crusting w/exudate, spares midline, conjunctivitis
What is the Tx of HZO?
Acyclovir
