Ophthalmology Clinical Correlation

Question 1

What are the Big 3?

Answer 1

cataracts
glaucoma
macular degeneration

Question 2

What is a cataract?

Answer 2

opacity of normally clear LENS

Question 3

What prompts cataract removal?

Answer 3

severity of visual loss

need to see back of eye

Question 4

What are the 2 types of macular degeneration?

Answer 4

dry (atrophic)

wet (neovascular/exudative)

Question 5

Macular degeneration causes what type of visual defect?

Answer 5

decreased central vision

Question 6

What builds up in Dry type macular degeneration?

Answer 6

drusen

Question 7

AREDS meds

Answer 7

Age Related Eye Disease Study recommended medications

Question 8

What are the AREDS?

Answer 8

antioxidancts + zinc

Question 9

Wet-type macular degeneration can cause what major problem?

Answer 9

hemorrhage, bleeding, and subsequent scarring

Question 10

Tx of wet macular degeneration?

Answer 10

anti-VEGF medications

Question 11

VEGF

Answer 11

vascular endothelial growth factor

Question 12

2 types of glaucoma

Answer 12

open-angle (progressive)

closed-angle (acute)

Question 13

What is the primary pathological entity in open-angle glaucoma?

Answer 13

trabecular network

Question 14

What is the primary pathological entity in closed-angle glaucoma?

Answer 14

iris occluding trabecular network/Schlemm’s canal

Question 15

Larger optic cup may be observed in which condition?

Answer 15

open angle glaucoma

Question 16

Physical finding of acute closed angle glaucoma?

Answer 16

hard eye

pressure > 40 mmHg

Question 17

Pain in closed-angle glaucoma?

Answer 17

severe

Question 18

Tx of closed angle glaucoma

Answer 18

pilocarpine (ACh agonist)
acetazolamide (CA inhibitor)
globe massage

Question 19

2 types of diabetic retinopathy

Answer 19

non-proliferative diabetic retinopathy (NPDR)

proliferative diabetic retinopathy

Question 20

What is big problem in diabetic retinopathy?

Answer 20

VEGF production and neovascularization/bleeding

Question 21

What is the difference between dry and wet diabetic retinopathy?

Answer 21

dry: no active bleeding
wet: active vitreous hemorrhage

Question 22

Tx of wet diabetic retinopathy

Answer 22

panretinal photocoagulation 1000-1500 spots
stops cells secreting VEGF
saves macular cells

Question 23

Diabetes referals

Answer 23

II: right away
I: 5 yr post diagnosis

Question 24

Silver wiring in which pathology

Answer 24

hypertensive retinopathy

Question 25

Amaurosis fugax

Answer 25

temporal artery insufficiency

Question 26

Retinal cholesterol emobli

Answer 26

bad

Question 27

Ophthalmic migraine

Answer 27

treat migraine

Question 28

Retinal detachment

Answer 28

may be asymptomatic until includes or occludes fovea

Question 29

What causes a cherry red spot on the macula?

Answer 29

central retinal artery occlusion

may also be partial

Question 30

What causes a “squashed tomato” appearance of the retina?

Answer 30

central retinal vein occlusion

Question 31

Temporal arteritis STAT tests

Answer 31

CRP and ESR

Question 32

Cerebrovascular accident

Answer 32

occipital cortex

bilateral hemianopsia

Question 33

Do not give this to patients with corneal abrasion

Answer 33

topical anesthetic

Question 34

Hyphema

Answer 34

bleeding into anterior chamber of eye

Question 35

Subconjunctival hemorrhage

Answer 35

laboring women

leave it alone

Question 36

Chemical irritants

Answer 36

mild: many
moderate: acidic
severe: alkaline (flush 1+ hr. with saline)