Ophthalmology Flashcards
Immediate and definitive management for acute angle closure glaucoma
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Immediate: Temporizing measures
- Timolol (halts further production of aqueous humor)
- Pilocarpine (induces ciliary muscle contraciton, opening the trabecular meshwork at the corneal angle)
- Apraclonidine (halts further production of aqueous humor, increases aqueous humor outflow)
- IV acetazolomide (halts further production of aqueous humor)
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Definitive:
- Laser iridotomy
In anyone who is on topical steroid eyedrops or systemic steroid therapy, you should suspect any vision change to be ___ until proven otherwise
In anyone who is on topical steroid eyedrops or systemic steroid therapy, you should suspect any vision change to be steroid-induced open angle glaucoma until proven otherwise
Clues to a diagnosis of open angle glaucoma
- Insidious loss of peripheral vision
- Increased cup:disk ratio on fundoscopic exam
- If steroid-induced, central vision bluriness due to corneal edema
Inferior rectus entrapment
- Diplopia on upward gaze following trauma is classic
Open globe injury
Closed angle glaucoma
When it comes to the eye. . .
- Activate alpha
- Block beta
- NEVER atropine
Corneal abrasion
With corneal abrasions, always treat before definitive diagnosis
Irrigate, THEN fluorescein exam, THEN consider whether or not surgery is necessary due to damage
Retinal detachment
If symptoms “come and go”, it is NOT retinal detachment. The retina doesn’t spontaneously reattach.
This indicates amaurosis fugax and possible impending retinal artery occlusion
“Cherry red spots on fovea”
Retinal artery occlusion buzzword
Treatment for retinal artery occlusion
Definitive: Intra-arterial tPA
Temporizing: Hyperventilation, global pressure (push on eyeball to try and induce vasodilation)
Macular degeneration
Myopia is a risk factor for. . .
. . . retinal detachment AND macular degeneration
