ophtho Flashcards
pathway of aqueous humor through eye?
1) produced by ciliary epithelium 2) flows though posterior chamber 3) over lens, into anterior chamber 4) collected by trabecular meshwork 5) collected into canal of Schlemm
hyperopia vs myopia?
hyperopia: eye too short - light focuses behind retina myopia: eye too long - light focuses in front of retina
risk factors for cataracts?
age smoking ETOH excessive sunlight prolonged steroids classic galactosemia, galactokinase deficiency DM trauma infection
dz in eye on right?
glaucoma - pic is of cupping
elevated IOP and progressive peripheral visual field loss
causes of open angle glaucoma?
assoc with increased age, AfAm race, family hx
uveitis –> WBCs block trabecular meshwork
vitreous hemorrhage –> RBCs block meshwork
retinal detachment –> retinal elements block meshwork
pain red eye, sudden vision loss, halos, rock hard eye, H/A?
acute angle closure glaucoma
IOP pushes iris forward –> abrupt angle closure (chronic angle closure usually asx)
** NO EPI - midriatic effect
causes of angle closure glaucoma?
primary: enlargement or forward mvmt of lens agains central iris
secondary: hypoxia from retinal dz –> iris vasoproliferation –> contracts angle
what’s this? what is it associated with?
hypopyon!
assoc with uveitis
think systemic inflammatory d/os (sarcoid, RA, JRA, HLA-B27)
what dz?
age-related macular degen
distortion and loss of central vision
80% dry - drusen deposition, gradual decrease in vision; give multivitamin and antioxidants
20% wet - rapid due to bleeding, tx with anti-VEGF injections or laser
what dz?
diabetic retinopathy
hemorrhage and macular edema from damaged capillaries
non-proliferative –> sugar control, macular laser
proliferative –> peripheral photocoag, anti-VEGF
what dz?
retinal vein occlusion
pizza fundus!
2/2 compression from nearby arterial atherosclerosis
what dz?
retinal detachment
photoreceptor layer detaches from outer pigmented epithelium
2/2 etinal breaks, diabetic traction, inflammatory effusions
** more common in patients with high myopia; often preceded by post viterous detachment
what dz?
central retinal artery occlusion
acute painless monocular vision loss
cherry red spot at fovea
painless progressive vision loss starting with night blindness?
retinitis pigmentosa
rods affected first
bone spicule-shaped deposits around macula
what dz?
papilledema
usually 2/2 increased ICP
enlarged blind spot
pupillary light reflex pathway?
1) light –> CNII
2) pretectal nuclei (midbrain) –> B/L Edinger Westphal nuclei (CNIII)
3) EW –> ciliary ganglion
4) short ciliary nn –> pupillary sphincter mm
midriasis pathway?
3 neurons:
1) hypothal –> ciliospinal center of Budge (C8-T2)
2) exit at T1 –> superior cervical ganglion
3) ICA plexus, through cavernous sinus, long ciliary n in orbit to pupillary dilator mm
what are the visual field defects?
notes: Meyer loop - temporal lobe, loopw around inferior horn of lateral ventricle
dorsal optic radiation: goes via internal capsule
macular sparing b/c of B/L macular projection to occiput
