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Neurology - Anatomy and Physiology > Ophthalmology - Pathology > Flashcards

Ophthalmology - Pathology Flashcards

1
Q

What visual deficit does cataracts cause?

A

Blurry/poor vision.

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2
Q

What is the pathogenesis of cataracts?

A

Painless, often bilateral opacification of lens.

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3
Q

What are the risk factors for cataracts?

A

Congenital: classic galactosemia, galactokinase deficiency
Acquired: Age. Smoking, etoh, excessive sunlight, prolonged corticosteroid use, DM (sorbitol), trauma, infection.

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4
Q

What visual defect does glaucoma cause?

A

Progressive peripheral vision loss

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5
Q

What is the pathogenesis of glaucoma?

A

Optic disc atrophy with cupping - thinning of outer rim of optic nerve head.

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6
Q

What are the two categories of glaucoma?

A

Open angle and closed/narrow angle

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7
Q

What are the risk factors and characteristics for open angle glaucoma?

A

Age, AA race, family history. More common in US. Painless.

Primary = cause unclear.

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8
Q

What are the causes of secondary open angle glaucoma?

A

Blocked trabecular meshwork from WBCs (uveitis), RBCs (vitreous hemorrhage), retinal elements (retinal detachment).

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9
Q

What is primary closed angle glaucoma?

A

Enlargement or forward movement of lens against central iris (pupil margin) –> obstruction of normal aqueous flow through pupil Ž fluid builds up behind iris, pushing peripheral iris against cornea and impeding flow through trabecular meshwork.

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10
Q

What is secondary closed angle glaucoma?

A

Secondary—hypoxia from retinal disease (e.g., diabetes mellitus, vein occlusion) induces
vasoproliferation in iris that contracts angle.

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11
Q

What is the presentation of chronic closure glaucoma?

A

Often asx with damage to optic nerve and peripheral vision.

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12
Q

What is the presentation of acute closed angle glaucoma?

A

Emergency!! IOP pushes iris forward, angle closes abruptly. Very painful, red eye, sudden vision loss, halos around lights, rock-hard eye, frontal-headache.

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13
Q

What medication is contraindicated in acute closed/narrow angle glaucoma?

A

Epi. Causes pupillary dilation.

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14
Q

What is the uvea?

A

Iris, ciliary body, and choroid

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15
Q

What is anterior uveitis vs. posterior uveitis? Associated sx?

A

Anterior uveitis: Iritis
Posterior uveitis: Choroiditis
- may have hypopyon, conjunctival redness

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16
Q

What is hypopyon?

A

Accumulation of pus in anterior chamber (associated w/ uveitis).

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17
Q

What is uveitis associated with?

A

Systemic inflammatory disorders: Sarcoidosis, RA, JIA, HLA-B27 conditions

18
Q

What is the visual defect in age-related macular degeneration?

A

Loss of central vision - scotomas.

19
Q

What are the two types of age-related macular degeneration?

A

Dry (80%), and wet - exudative(10-15%).

20
Q

What characterizes dry age-related macular degeneration?

A

Deposition of yellowish extracellular materal in and beneath Bruch membrane and retinal pigment epithelium: “drusen”.

21
Q

How can progression of age-related macular degeneration be prevented?

A

Multivitamin, antioxidant supplements.

22
Q

What characterizes wet age-related macular degeneration?

A

Rapid loss of vision due to bleeding secondary to choroidal neovascularization.

23
Q

How to treat wet age-related macular degeneration?

A

Anti-VEGF injections (eg ranibizumab) or laser.

24
Q

What are the two types of diabetic retinopathy?

A

Nonproliferative and proliferative

25
Q

What characterizes non-proliferative diabetic retinopathy?

A

Damaged capillaries leak blood. Lipids and fluid seep into retina. Hemorrhages and Macular edema.

26
Q

What is the treatment for non-proliferative diabetic retinopathy?

A

Blood sugar control, macular laser.

27
Q

What characterizes proliferative diabetic retinopathy?

A

Chronic hypoxia results in new blood vessel formation w/ resultant traction on retina.

28
Q

What is the treatment for proliferative diabetic retinopathy?

A

Peripheral retinal photocoagulation, anti-VEGF (bevacizumab).

29
Q

What does retinal vein occlusion look like?

A

Blockage of central or branch retinal vein due to compression from nearby arterial atherosclerosis causes retinal hemorrhage and venous engorgement + edema in affected areas.

30
Q

What is the presentation of retinal detachment?

A

Vision loss. Often preceded by posterior vitreous detachment - flashes/floaters, and eventual monocular loss of vision (curtain drawn down).

31
Q

What is the pathogenesis of retinal detachment?

A

Separation of neurosensory layer of retina (photoreceptor layer w/ rods and cones) from outermost pigmented epithelium (normally sheds excess light, supports retina). Causes degeneration of photoreceptors –> vision loss. Surgical emergency.

32
Q

What may retinal detachment be secondary to?

A

Retinal breaks, diabetic traction, inflammatory effusions.

33
Q

In patietns w/ what vision problems is retinal detachment more common?

A

Patients w/ high myopia.

34
Q

What are the fundoscopic findings of retinal detachment?

A

Splaying and paucity of retinal vessels.

35
Q

What does central retinal artery occlusion present as?

A

Acute, painless monocular loss of vision.

36
Q

What are the fundoscopic findings of central retinal artery occlusion?

A

Retina cloudy with attentuated vessels and cherry-red spot at fovea (center of macula).

37
Q

What is retinitis pigmentosa? What is the presentation?

A

Inherited retinal degeneration. Painless, progressive vision loss beginning with night blindness - rods affected first.

38
Q

What are the fundoscopic findigns of retinitis pigmentosa?

A

Bone spicule-shaped deposits around macula.

39
Q

What is the presentation of retinitis?

A

Retinal edema and necrosis leading to scar. (pizza hemorrhages).

40
Q

What are common etiologies of retinitis?

A

Viral - CMV, HSV, HZV. Associated with immunosuppression.

41
Q

What is papilledema?

A

Optic disc swelling, usually bilateral and due to increased ICP. Elevated optic disc with blurred margins seen on fundoscopic exam. Enlarged blind spot.

Neurology - Anatomy and Physiology (19 decks)

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