Opthalmology

Question 1

Glaucoma

Answer 1

Optic neuropathy
Elevated IOP
> 20 mmHg
Results in loss of vision

Question 2

Open-angle glaucoma

Answer 2

Most common type
DX: losing peripheral vision, high IOP, abnormal cup-to-disk ratio (>50%)
TX:
Non-selective BB (eg, timolol, levobunolol)
Topical adrenergic agonist (eg, epinephrine)
Topical cholinergic agonists (eg, pilocarpine, carbachol)
Topical carbonic anhydrase inhibitor (eg, dorzolamide, brinzolamide)

Question 3

Closed-angle glaucoma

Answer 3

MEDICAL EMERGENCY!

Impaired drainage of the anterior chamber angle, > 30mHg

1* cause: anatomic predisposition
2* cause: fibrovascular membrane formation/haemorrhage

SSX: eye pain, headahce, nausea, conjunctival injection, halos around lights, fixed, moderately dilated pupils. Check IOP

TX:
Contact ophthalmologist STAT!
TX:
Pilocarpine (for pupillary constriction) + timolol and acetazolamide (to decrease IOP) + laser iridotomy
Systemic tx: acetazolamide and mannitol

Question 4

Diabetic Retinopathy

Fundoscopic Findings
TX
Prevention

Answer 4

Asymptomatic, gradual vision loss - diabetic patients

Fundoscopic Findings:
Neovascularisation
Microaneurysm
Flame haemorrhages
Macular edema

TX
Laser photocoagulation surgery or vitrectomy - can treat/slow progression

Prevention
Diabetic patients - must have comprehensive ophthalmologic exams at least annually
Can slow progression - tight glucose and BP control

Question 5

Hypertensive Retinopathy

Answer 5

Question 6

Normal Fundus

Answer 6