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Clin Med I > OPthalmology x2 > Flashcards

OPthalmology x2 Flashcards

1
Q

Afferent nerve lesion

A

shine light in affected eye no pupillary reflex bilaterally

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2
Q

Efferent nerve lesion

A

shine line in either eye no pupillary constriction on affected side only.

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3
Q

Gluacoma primar component

A

Intraocular pressure increase - urgent >30mmHG

  • optic nerve damge
  • visual field loss
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4
Q

Gluacoma Angle Closure

A

acute rise on IO pressure du to outflow obstuction
Cause: primary (genetic) angle closure or secondary angle closure
Test: penlight test> look for cresent shadow

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5
Q

Angle closure glaucoma Pres

A 
decreased vison
halos around lights 
ciliary flsuh
steamy cloudy cornea
mid-dialated pupil 4-6mm 
- so it reacts poorly to light 
Narrow ant chamber 
Firm globe 
N/V 
severe eye pain
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6
Q

Angle closure glaucoma managment

A 
- refer immediatly 
Gonioscopy is standard for diagnosis 
Tx: Beta blocker or Alpha 2 agonist  ( ask opthamologist preference) 
- Mannitol ( osmotic agents)
- laser peripheral iridotomy 
- surgical trabeculectomy 
NO dialating drops
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7
Q

OPen angle gluacoma

A

Optic neuropathy and either increase aqueous production or decreased ouflow

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8
Q

OPen angle glaucoma presentation

A
  • increased intraocular pressure often
  • increase cup/disc ratio
  • may have afferent pupillary defect
  • early asymptomatic
  • later chronic vision loss - peripheral first
  • vision loss cannot be recovered onece it occurs
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9
Q

open angle glauc Tx

A 
OPthamologic referall 
topical ocular antihypertensive medication 
- beta blockers abd alpha 2 agonist 
laser trabeculoplasty 
surgical trabeculectomy
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10
Q

Cataracts

A

break down of clumping of eye proteins

risk: >60, poor nutrition, excessive exposure to sun, some medication, smoking, DM, HIV, trauma, congential

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11
Q

Cataracts pres

A

gradual chronic painess loss of vision
usualy bilateral symptom
usually difficulty with night driving may seem glare
decreased visual acuity
yellowing.opalescent changes of the lense

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12
Q

Cataracts management

A

Tx: Rx glasses for vision changes

no criteria for surgery> extracapsular cataract extraction and intraocular lens implant

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13
Q

Macular Degeneration cause/ risk

A

Age related
degen disease of macula
risks: > 50, smoke, heavy alch, diet, FH, Nitroglycerin, Beta blockers
Gen pres: gradual or cutley blurred vision, Metamorphopisa, central scotoma, amser grid distorsion

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14
Q

Dry AMrD

A

central scotoma, drusen deposits, pigment mottling, geographic atrophy, vison loss is gradual in one or both eyes

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15
Q

Wet ARMD

A 
subretianl neovascular 
subsequent degeneration-leaky vessels> subretinal fluid or blodd
Rapid vision distoreion
- metamorphopsia
- central scotoma
- mor common in one eye
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16
Q

Macular degen Tx

A 
VItamins (antiox/min/zinc/omega 3)
stop smoking
daily amsler
low vision aids
stop offending drigs 
wet: photcoagulation, photodynamic therapy, intravitreal steroid/ monoclonal antibodies
17
Q

Retinal Detatchment

A

serparation of the retinal from epithelia and choroid and can cause ischema of the photoreceptors
Risks: history of myopia, comp of cataracts surgery, current us of flouriquinolones, FH

18
Q

Rhegmatogenous RD

A

full thickness tear in the retina
- posterior vitreous detachment is most common cause
- with age the VH with shrink and liquifies with age
pulls away from retina resulting in tears
Traumatic RD: unccomon traumatic tear of retina followed by subretinal bleed of vitreous migration

19
Q

Nonreheg

A

caused by vitreous traction pulling on the retina and tearing
* associated with diabetes
fibrosis from neovascularization adherent between retina and vitreous

20
Q

RD presentation

A 
painless and can rapidly progress
- floaters/photopsias
-loss of vision 
- progrssion scotoma
- curtain like 
raised whitish retina 
* often bilateral 
rate of progression depended on size of retinal break 
- may have afferent pupillary defect
21
Q

RD managment

A 
without tx will progress 
urgent referall
laser photcoagulation
surgery
- scleral buckle 
-vitrectomy. replace VH with gas o silicone oil
22
Q

Hypertensive retinopathy presentation

A 
Often asymptomatic but some mild vision changes
Copper wiring 
silver wiring 
AV nicking 
cotton woll spots
retinal hemorrhages 
retinal and disn edema 
Tx: bp contol and laser potocoagulation if retinal hemorrhage
23
Q

Diabetic retinopathy non-ploiferative

A 
blurred vision
retinal hemorrhage 
retinal and macular edema 
cottom wool spots 
venous dialation 
hard exudates
24
Q

Diabetic retinopathy proliferattive

A 
neovasularization
preretinal and vitreous hemorrhage 
tractionall retinal detatchment 
retinal thickening 
macular edema
25
Q

Diabetic retinopathy tx

A

blood sugar control
opthalmology referal
laser phocoagulation
vitrectomy

26
Q

Central Retinal Artery Occulsion

A

Embolic
Risks
M>F, carotic arter atherosclerosis, hypertension, smoking, hyperlipidemia, DM

27
Q

Central Retinal vein Occlusion

A 
Thrombotic 
older
HTN
DM 
Smoking
obesity 
hypercoagulble 
glaucoma
28
Q

CRAO presentation

A 
acute total painless loss of vision
unilateral 
no light perception
afferent pupillary defect 
ischemic retinal whitening 
"cherry red spot"
29
Q

CRVO pres

A 
presentation 
acute varialbly painless loss of vision
unilateral 
scotoma w/blurred vision
may have visual field loss 
\+/- afferent pupilary defect 
"blood and thunder " retinal appearance
30
Q

CRAO and CRVO Tx

A

no effective treatment
prevent future strokes

CRVO

  • asprin, observation, tx for retinal edema
  • evaluate eitology if young
31
Q

Optic Neuritis

A

inflamatory demyelantation of optic nerve
age 20-40 women
monocular vision loss over 1-2 wks
- predictive MS

32
Q

OPtic Neuritis Prese

A 
PAINFUL 
central scotoma 
painful worse with EOMS 
\+/- abnormal vision color or photopsias 
optic disc edema 
optic nerve pale and shrunken
33
Q

optic neuritis managment

A

MRI brain and orbit with contrast
IV methylprednisione for severe vision loss > 2 white matter lesions on MRI
- more rapid recover but similar visual acuity at year one and may delay onset of MS
No tx: imprvement in 2-3 wks and there may be recurrence

Clin Med I (14 decks)

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