OPTHAL 2 Flashcards
hypertensive retinopathy in who
symptoms/signs
young people
attenuated blood vessels - copper/silver
cotton wool spots. hard exudates. retinal haemorrhage. optic disc oedema. dramatic fundal appearance. can have decreased vision
diabetic retinopathy macuopathy is what
risk factors
what worse with new vessel growth
commonest treatable cause of blindeness is DM
duration of DM, type 2 DM, htn, pregnancy
new vessels in disc worse than new vessels elsewhere. vessels growing in iris rubeosis iriditis - can get secondary glaucoma
diabetic retinopathy stages
management
none.
non proliferative mild, mod, severe
proliferation
R0 prescreen in 12 months
R1 1 dot haem/microaneurysm. 12 months
R2 4 or over blot haem in one half only. 6 months
R3 4 or over blot haem in bot inferior and superior hemifieleds or venous beading or IRMA refer
R4 new vessels or nitrous haem refer urgently
laser - damage retina - reduce metabolic load - can cause night blindeness
diabetic maculopathy stages
none
observable exudates between 1 and 2 disc dm circle of the centre fovea 6 months
referable - any blot haem or hard exudates within 1 disc dm. refer
SJS
occlusion of lacrimal glands, corneal ulcers
horners syndrome is what
cause
paralysis of sympathetic supply to eye, mild mitosis, contracted pupil which does not dilate, ipsilateral reduced sweating
pan coast tumour, carotic/aortic aneurysms, lesions of neck, congenital, idiopathic
third nerve cranial palsy
ptosis. down and out.
MR, SR, IR, IO, sphincter papillae, levator palpabele superioris
microvascular - pupil sparing, trauma, tumours, congenital, aneurysms - painful
4th nerve palsy
congenital, tumours, trauma, microvascular
supériorité oblique. intorsion, depressed in adduction, weak abduction
head tilt - in cycle torsion weak
trauma
torsion, chin depressed
6th nerve palsy
LR weakness
weakness of abduction. horizontal double vision when looking into the distance. papilloedema
vascular. acoustic neuroma. increased ICP. congenital
internuclear opthalmeplegia
MI, vascular
loss of small print
ptosis
anisocona
oscillopsia
droopy eyelid
different sized pupils
looks like things are moving
new born VA 1m 6m 2-3y 4y
6/240 2/90 6/18 6/6 6/9.5
ametropic
strabismic
anisometropic
stimulus deprevation
bilateral uncorrected refractive error
squinting eye is suppressed
unequal refrective error
congenital cataracts/ptosis
brown’s
superior oblique is being pulled down so can’t pull eye up
ESO
EXO
hyper
hypo
outward movement
inward
eye higher
eye lower
latent phonia
sym corneal reflections
binocular vision
underlying deviation in both eyes
manifest trophia
assym reflections
no/poor binocular vision
squint in 1 eye at a time
occlusion therapy
total - patching
partial - 1% atropine dilates pupil - can’t accommodate
management of adult squint
prism glasses
orthoptic exercises
botox if can’t have surgery
EOM surgery - function, cosmetic
children visual system develops by when
convergent squints
by 6yo
corrected w glasses
amblyopia cause
management
squint, refractive error, obstruction to visual axis - cataracts, ptsosi
occlusion treatment to good eye
squint cause
management
congenital. long sighted. CNP. muscle pathology. blow out fracture
correct refractive error. treat amblyopia
squint surgery recession: reattach muscle posterior to insertion weakens muscle
resection: excise segment - strengthens
baby with red reflex
retinoblastoma, coloboma
cataract
retinoblastoma/retinal detachment or dysplasia
alteration in colour - pale yellow
opacity
no/black reflex
sticky eyes in infants cause
symptoms
ix
management
congenital nasolacrimal duct
sticky and watery
delayed flueoresene dye dissapearecne
bathe and massage. most revolve by 1y. if not - string and probing 12-18m
