Ophthalmology Flashcards
What changes to the lens can be seen with aging?
Yellows: May affect color discrimination
Opacifies: Cataract
Hardens: Nuclear sclerosis
What is presbyopia?
The ciliary body/lens loses accommodative ability with age meaning there is a loss of near vision
What eye diseases are the following conditions associated with?
HTN
Arthritis
Diabetes
HTN- retinal vein occlusion
Arthritis- dry eye
Diabetes- glaucoma, cataracts, diabetic neuropathy
What are the 4 leading causes of vision loss in the aging eye?
- Age-related macular degeneration (AMD)
- Glaucoma
- Cataract
- Diabetic retinopathy
__% of Americans over 65 have some cataract formation
50
For individuals 65 years of age or older, asymptomatic, and without disease, the American Academy of Ophthalmology recommends a comprehensive eye examination every ...
1 to 2 years.
chronic inflammation of
the eyelid; burning, itching,
tearing, and crusting of the eyelid
blepharitis
What is Entropion?
inward turning of the
eyelids and lashes,
What is ectropion?
outward turning of the
eyelids and lashes
What is dermatochalasis?
with time and age the layers of the skin over the eyelid can their elasticity and droop
What is the most common eyelid malignancy?
basal cell carcinoma- 90% of
eyelid tumors, affect the lower lids more
commonly than the upper.
What is the most common condition affecting the
cornea in the aging eye?
poor tear
production
Dry eye tx
several times a day, as needed for comfort,
and can refer patients with refractory
symptoms for ophthalmic treatment that may include
occlusion of the lacrimal puncta to
preserve the tear film and topical
cyclosporine drops (Restasis [Allergan])
Herpes Zoster Ophthalmicus tx
oral acyclovir
or its derivatives often can reduce
symptoms and shorten the course of the
disease.
What is the most common cause of visual loss in
the elderly?
age-related macular
degeneration, or AMD.
Risk factors for AMD
Advanced age
FH of AMD
Smoking
CV disease
People who have already had vision loss in one eye from the advanced stage of AMD have about a \_\_\_% chance of developing vision loss from advanced AMD in the second eye within 5 years
50
What defines the advanced stage of AMD?
when the changes of AMD are
associated with loss of vision.
What is the difference between atrophic advanced stage (sometimes called “dry” AMD), and a neoneovascular stage of advanced AMD(sometimes called “wet” AMD)?
atrophic
advanced stage of AMD- associated with a gradual vision loss due to
atrophy of the photoreceptors overlying
retinal pigment epithelium and atrophy of
the underlying choriocapillaris, in the
central macular area.
neovascular
stage of advanced AMD- associated
with more sudden visual loss from the
ingrowth of new blood vessels, from the
underlying choriocapillaris through breaks
in Bruch’s membrane between the retina
and the choroid.; disc edema and disinform scar
What are the symptoms seen in intermediate vs advanced stage AMD?
Intermediate- no symptoms or slight difficulty reading, driving, etc due to atrophy not yet involving center of macula; straight lines may appear crooked
Advanced stage- central blind spot; peripheral vision usually remains intact
dx of advanced stage AMD
A fluorescein angiogram is performed to confirm the diagnosis of the advanced stage of AMD, especially the neovascular form. The angiogram also can determine if an individual with the neovascular form is a candidate for laser photocoagulation, photodynamic therapy, or other pharmacologic treatments aimed at inhibiting vascular endothelial growth factor (VEGF).
In the Age-Related Eye Disease Study, a
multicenter prospective trial, the risk of
progression from intermediate to advanced
AMD was reduced when patients took a
daily dietary supplement containing …
vitamin C (500 mg), vitamin E (400 IU), beta carotene (15 mg), and zinc oxide (80 mg).
tx for neovascular advanced stage AMD
laser
photocoagulation, photodynamic therapy
with verteporfin, and intraocular injection
therapy with anti-VEGF; all 3 can stabilize visual loss, and VEGF can
Risk factors for glaucoma
high
intraocular pressure (IOP), African racial
heritage, advanced age, and first-degree
relatives who have glaucoma.
Concurrent hypertension,
diabetes mellitus, and myopia may also be
associated with glaucoma risk.