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Neuro B3 - WLB > Ophthalmology Key Points > Flashcards

Ophthalmology Key Points Flashcards

1
Q

What are cataracts?

A

Opacity of the normally clear lens caused by age, metabolic disorder, trauma, or heredity

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2
Q

What are the indications for cataract surgery?

A
  • severity of vision loss
  • functional needs of patient
  • need to improve view of posterior segment of the eye to care for ocular pathology
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3
Q

When does macular degeneration usually occur?

A

Anytime after age 50, usually >70 years old

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4
Q

What type of vision loss is present first in macular degeneration?

A

Central vision

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5
Q

What does eye exam show in minor Dry Macular Degeneration?

A
  • drusen
  • pigmentary changes
  • vision probably fine
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6
Q

What does eye exam show in more significant Dry Macular Degeneration?

A
  • drusen
  • pigmentary retinopathy
  • atrophy of the retina
  • vision probably diminished
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7
Q

What is the treatment for Dry Macular Degeneration?

A
  • Quit smoking
  • nutritional changes (dark, green vegetables)
  • manage systemic diseases (DM, HTN)
  • AREDS supplements - antioxidant vitamins (beta carotene, vitC, vitE), minerals (zinc, copper)
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8
Q

What does eye exam show in Wet Macular Degeneration?

A
  • Defects develop in deep retinal layers
  • Growth of blood vessels under/in retina
  • Edema
  • Hemorrhage
  • Eventual fibrosis/scarring
  • Serious loss of vision
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9
Q

What are the treatment options for Wet Macular Degeneration?

A
  • Dry recommendations
  • Conventional laser
  • Photodynamic therapy
  • Anti-VEGF drugs (Avastin, Eyelea, Lucentis, Macugen) injected intravitreally can dry up exudative changes
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10
Q

What is Glaucoma?

A

Increased ocular pressure causing optic nerve loss.

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11
Q

What causes blockage in Open Angle Glaucoma?

A
  • The trabecular meshwork is normally the main blockage
  • Aqueous humor cannot drain out as well
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12
Q

What are the symptoms of Narrow (Acute/Closed) Angle Glaucoma?

A
  • Acute onset
  • Severe pain with loss of vision
  • +/- nausea
  • red eye
  • cloudy cornea
  • photophobia
  • halo around lights
  • fixed/mid dilated pupil
  • extremely high IOP >40 mmHg
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13
Q

How do glaucoma medications decrease intraocular pressure?

A
  • Decreasing aqueous production
  • Increasing outflow
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14
Q

What three medications are suggested in the treatment of Acute Glaucoma?

A
  1. Pilocarpine (Q15min)
  2. Acetazolamid (Diamox IV/PO)
  3. Glycerine OR Isosorbide (PO)
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15
Q

What procedure do ophthalmologists perform to treat Acute Glaucoma?

A

Surgical or Lasor Peripheral Iridotomy

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16
Q

What are key eye exam findings in Nonproliferative Diabetic Retinopathy?

A
  • Blot Hemorrhages
  • Cotton Wool Spots
  • Microaneurysms
  • Macular Edema
  • Hard Exudates
17
Q

What is the treatment for Diabetic Retinopathy?

A

Panretinal Photocoagulaton (PRP)

  • ablate supporting retina
  • stops release of VEGF
18
Q

What are the 7 things that should be on your differential diagnosis for a patient with sudden visual loss?

A
  1. Amaurosis Fugax
  2. Migraine Scotoma
  3. Retinal Detachment
  4. Retinal Artery Occlusion
  5. Retinal Vein Occlusion
  6. Temporal Arteritis (Giant Cell Arteritis)
  7. Stroke
19
Q

What is the hallmark of Amaurosis Fugax?

A

Quick loss of vision in one eye

(lasts minutes)

20
Q

Who do you refer a patient with Amaurosis Fugax to?

A

Cardiology!

(Impending stroke until proven otherwise!)

21
Q

What is a Retinal Cholesterol Emboli a warning sign of?

A

Future disaster in vascular system.

(need Carotid US & Echocardiogram)

22
Q

What causes an Ophthalmic Migraine (aura w/ or w/o headache)?

A

Spasm of arteriole in occitpital cortex

23
Q

What are the clinical hallmarks of Retinal Detachment?

A
  • Sudden partial vision loss in one eye
  • Painless
  • Sustained, may be progressive
24
Q

What is the clinical hallmark on eye exam for Retinal Arterial Occlusion?

A

Cherry Red Spot

(indicates acute central retinal artery occlusion)

25
Q

What is the treatment for Acute Arterial Occlusion?

A
  • Rebreathing CO2
  • Timolol
  • Acetazolamide
26
Q

What is the clinical hallmark on exam for Central Retinal Vein Occlusion?

A

Squashed Tomato

27
Q

What are the clinical hallmarks for Temporal Arteritis (Giant Cell Arteritis)?

A
  • Headache (actually scalp tenderness)
  • Fever
  • Weightloss
  • Jaw claudication (spasm/cramp)
  • Vision loss
28
Q

What can Temporal Arteritis also present as?

A

Central Retinal Artery Occlusion

(cherry red spot)

29
Q

What do you do immediately after you suspect Temporal Arteritis?

A
  • Order STAT Sed rate and CRP
  • Start high dose systemic steroids immediately
30
Q

What should you not give when treating corneal abrasions? Why?

A

Topical anesthetics –> slows healing

Neuro B3 - WLB (11 decks)

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