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Foundations II Exam 1 > Optic Nerve/Retina 1 > Flashcards

Optic Nerve/Retina 1 Flashcards

1
Q
  • Gradual OR acute painless vision loss unilateral OR bilateral
  • Metamorphopsia (wavy/distorted palm trees) - early sign of this condition
  • Central scotoma

Sxs of what eye condition?

A

Age-Related Macular Degeneration

*Metamorphopsia is early sign of Wet AMD

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2
Q

Leading cause of adult blindness in “industrialized countries”

A

Age-Related Macular Degeneration (AMD)

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3
Q
  • “Fleeting blindness”
  • Usually caused by retinal emboli from ipsilateral carotid disease
A

Amaurosis Fugax

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4
Q
  • Acute onset of monocular decreased vision
  • “curtain coming down” over eye
  • Cloudy/Smoky vision
  • “Floaters” or “flashes of light”
  • No pain/redness

Sxs of which eye condition?

A

Retinal Detachment

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5
Q

How is retinal detachment treated by the ophthomalagist?

A

Closing the tears w/ cryosurgery or laser surgery

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6
Q

In what position should a patient w/ retinal detachment be placed in during transport to ophtho for immediate referral?

A

Supine, w/ head turned to ipsilateral side to help retina fall back into place w/ aid of gravity

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7
Q
  • Characterized by growth of abnormal vessel into subretinal space
  • New vessels leak
  • Accounts for 80 - 90 % of blindness of this eye condition
  • May be acute onset
A

Wet AMD (age-related macular degeneration)

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8
Q

Venules are dilated and tortuous due to blood becoming backed up

A

Papilledema

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9
Q

Why would you obtain an EKG and echocardiography to diagnose Amaurosis Fugax?

A

Emboli from cardiac sources (atrial fibrillation) may be the cause

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10
Q

MRI of brain and orbits w/ gadolinium contrast is used to diagnose what eye condition?

A

Optic Neuritis, also assesses risk for MS

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11
Q

Which eye condition if suspected required URGENT ophtho referral / complete workup?

A

Papilledema

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12
Q

If you diagnose/suspicious of a pt w/ Optic Neuritis, who would you refer to? What must you rule in or out?

A

Ophtho/Neuro

MS

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13
Q
  • What is performed to diagnose Dry or Wet AMD?
  • Dx of Wet may require what?
A
  • Dilated fundus exam w/ ophthalmology

Wet:

  • Fluoroscein dye retinal angiography (to see where new vessels are created)
  • Optical coherence tomography (OCT)
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14
Q
  • Subretinal fluid or blood
  • Subretinal neovascular membrane
A

Wet AMD

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15
Q
  • Loss of color vision
  • Decreased visual acuity
  • RAPD - relative afferent pupillary defect
  • Optic nerve changes
A

PE findings of Optic Neuritis

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16
Q

Optic disk is swollen, w/ blurred margins, cup may be obscured due to swelling

A

Papilledema

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17
Q

Flame hemorrhages and infarctions (white cotton wool spots) in the nerve fiber layer, edema of surrounding retina

A

Papilledema

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18
Q

What are the first signs/sxs of papilledema?

A

Signs/sxs of elevated intracranial pressure

  • HA
  • N/V
  • Transient vision changes, or vision is normal
19
Q

What is the most common cause of Retinal Detachment? (RD)

A

Tear in retina. Vitreous fluid then goes under the retina causing detachment.

20
Q
  • Discrete yellow deposits
  • Central vision decreased due to atrophy of retinal pigment epithelium
A

Dry AMD, yellow spots are “retinal drusen”

21
Q
  • Most cases (2/3) are retro-bulbar (no changes in fundus)
  • Some cases (1/3) optic nerve is swollen w/ pallor and occasional flame-shaped peri-papillary hemorrhages
A

Optic Neuritis

22
Q
  • Non-invasive evaluation of carotids w/ duplex US and magnetic resonance angiography (MRA)
A

Diagnostic test for Amaurosis Fugax

23
Q

What is the goal of working up a patient w/ Amaurosis Fugax?

A

Determine cause of embolus

24
Q

What is the most common site of retinal detachment?

A

Superior temporal retinal area

25
Q

If visual acuity does not return after tx of Optic Neuritis, what must you rule out?

A

Compressive lesion or tumor

26
Q
  • +/- decreased visual acuity
  • Amsler grid distortion

Signs of which eye condition?

A

Age-Related Macular Degeneration

27
Q

What is the tx for Optic Neuritis?

A

IV methylprednisolone (steroids) for 3 days, then oral taper to accelerate vision recovery

28
Q
  • Visual loss described as, “curtain passing vertically” w/ complete monocular visual loss lasting a few minutes.
  • Similar curtain effect as episode passes after a few minutes
A

Amaurosis Fugax

29
Q
  • Afferent Pupillary Defect
  • Billowing or tent-like elevation of rugose retina on fundo exam
  • Elevated retina appears out of focus and gray
  • Vitreous hemorrhage

Signs of which eye condition

A

Retinal Detachment

30
Q
  • Drusen, pigmented mottling
  • Geographic atrophy
A

Dry AMD (age-related macular degeneration)

31
Q
  • Which eye condition may occur w/ viral infections such as meales, mumps, and influenza?
  • Common in women 20 - 40 yrs old
A

Optic neuritis

32
Q

How soon does visual acuity return after tx of Optic Neuritis w/ IV methylprednisone for 3 days w/ oral taper?

A

2 - 3 weeks

33
Q
  • Acute onset (hrs to days)
  • Monocular vision loss
  • Eye pain worse w/ EOMs
  • Visual field defects (central scotoma)
A

Optic Neuritis

34
Q
  • Causes loss of central vision
  • Incidence increases w/ each decade over 50 yrs old
A

Age-Related Macular Degeneration

35
Q
  • Which AMD has a better prognosis?
A

Dry AMD

36
Q

Swelling of optic nerve head, usually associated w/ what?

A

Papilledema, associated w/ elevated intracranial pressure

37
Q

What eye condition is strongly associated w/ Multiple Sclerosis (MS) and is the presenting factor in as many as 20% of MS patients.

A

Optic Neuritis

38
Q
  • Vitamins
  • Smoking cessation
  • Intravitreal anti-angiogenic injections (VEGF inhibitor)
  • Photodynamic therapy
  • Low vision aids

Tx for which eye condition?

A

AMD

Also Daily Amsler Grid and Ophtho referral

39
Q

What is the tx for Amaurosis Fugax?

A

Depends on the cause

40
Q

Inflammatory demyelinating condition, results in acute vision loss in one eye

A

Optic neuritis

41
Q
  • Age
  • Female gender
  • Smoking hx
  • Family hx
  • Complement factor polymorphism (genetic factor)

Risk factors for which eye condition?

A

Age-Related Macular Degeneration

42
Q

How do retinal tears occur?

A
  • Spontaneously
  • Secondary to traumatic events
43
Q

Areas of infarction associated w/ papilledema

A

Cotton Wool Spots

44
Q
  • Over 50 yrs old
  • Extreme myopia
  • Previous ocular surgery
  • Family hx
  • DM

Risk factors for which eye condition?

A

Retinal Detachment

Foundations II Exam 1 (25 decks)

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