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Ocular Pharmacology > Optometric Practice 2 > Flashcards

Optometric Practice 2 Flashcards

1
Q

FUNDUDS ANOMALIES

A

Diseases of the:

OPTIC NERVE
CHOROID
RETINA
MACULA

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2
Q

3 Diseases of the Optic Nerve

A

A. Optic Neuritis
B. Papilledema
C. Optic Atrophy

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3
Q

3 Diseases of the Choroid

A

A. Choroiditis
B. Posterior Uveities
C. Malignant Melanoma of the Choroid

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4
Q

8 Diseases of the Retina

A
  1. Retinal Tear
  2. Retinal Detachment
  3. Hypertensive Retinopathy
  4. Diabetic Retinopathy
  5. Circinate Retinopathy
  6. Retinal Hemorrhages
  7. Retinitis Pigmentosa
  8. Retinoblastoma
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5
Q

8 Diseases of the Macula

A
  1. Senile or Age-related Macular Degeneration
  2. Angioid Streaks
  3. Hole in the Macula
  4. Glaucomatous Cupping
  5. Myopic Degeneration
  6. Fundus in Leukemia
  7. Toxoplasmosis
  8. Fundus in AIDs
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6
Q

2 Types of Optic Neuritis

A

Papillitis and Retrobulbar Neuritis

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7
Q

Degeneration, demyelinization, inflammation or infection of the optic nerve

A

Optic Neuritis

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8
Q

Papillitis is also known as:

A

Intraocular Optic Neuritis

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9
Q

Optic Nerve Head is involved and there are visible changes in the disk

A

Papillitis

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10
Q

Inflammation occurs behind eyeball therefore disk changes are slight or even absent, diagnosis based on symptoms

A

Retrobulbar Neuritis

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11
Q

SYMPTOMS OF PAPILLITIS

A

great disturbance of vision & usually unilateral
pain around the eye or on movement of the eyeball
globe tender to palpation

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12
Q

PAPILLITIS OPHTHALMIC SIGNS

A

Very Early Stage:
The optic disc shows signs of congestion.
The disc’s edges blurry or have (stripes).

Fairly Established Condition:

The optic disc becomes swollen and takes on a whitish or grayish color.
The center of the disc may appear reddish.
Striations and white spots are often present.
Hemorrhages (bleeding) may occur.
Arteries look thin, while veins appear distended and twisted (tortuous).

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13
Q

surrounding retina involved & edema may accumulate in the macula to produce radiating streaks, described as

A

MACULAR STAR

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14
Q

most common cause of papillitis

A

SYPHILIS

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15
Q

Less frequent causes:

(LOVEUMMF)

A

Lead poisoning
Orbital Inflammation
Vascular disease
Encephalitis
Uveities
Meningitis
Multiple Sclerosis
Focal Infection

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16
Q

Prognosis of Papillitis

A

if unchecked, vision is finally much impaired or lost

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17
Q

TREATMENT OF PAPILLITIS

A

Directed against the cause and LOCALLY, rest the eye and from light

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18
Q

Involves the orbital or intracranial portion of the optic nerve

A

RETROBULBAR NEURITIS

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19
Q

SYMPTOMS OF RETROBULBAR NEURITIS

VETH

A

Headache on one side of the head.
Eye pain that gets worse when moving the eye or pressing it backward.
Vision problems that are getting worse quickly.
The pupil (the black part in the center of the eye) may not react quickly to light.

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20
Q

OPHTHALMIC SIGNS OF RETRO

A

first none, later slight hyperemia, disk margins haziness and sometimes, diminishsed caliber of retinal vessels

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21
Q

most common cause of Retro

A

MULTIPLE SCLEROSIS

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22
Q

less frquent causes:

A

syphilis, rheumatism or diabetes
acute infectious diseases (influenza
septic foci/poisons

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23
Q

PROGNOSIS OF RETRO

A

In multiple sclerosis, involvement of optic nerve rarely leasds to COMPLETE BLINDNESS

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24
Q

TREATMENT OF RETRO

A

cause should be attacked
large doses if VITAMIN B COMPLEX

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25
Q

A noninflammatory swelling of the optic nerve head resulting from increased intracranial pressure of some interference of the optic nerve circulation, particularly venous drainage

A

PAPILLEDEMA

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26
Q

SYMPTOMS OF PAPILLEDEMA

A

Early stages - nothing
ENLARGED BLINDSPOT
Later - reduction in vision to blindness IF INTRACRANIAL PRESSURE IS NOT REDUCED

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27
Q

OPHTHALMOSCOPIC SIGNS OF PAPILLEDEMA

A

in early stages, slight edema of the disk
later examination shows great swelling & protrusion of the disk
distortion & tortuosity of the retinal veins
hemorrhages upon & near the edematous papilla

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28
Q

Most frequent cause of Papilledema:

A

BRAIN TUMOR

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29
Q

LESS FREQUENT CAUSE:

BMIS

A

Brain abcess
Meningitis
Intracranial hemmorhage
Syphilis & malignant hypertension

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30
Q

PROGNOSIS OF PAPILLEDEMA

A

more or less permanent loss of vision associated with secondary optic atrophy

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31
Q

TREATMENT OF PAPILLEDEMA

A

vision restored if intracranial pressure is reduced in time removal or treatment of lesion

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32
Q

2 CLASSIFICATION OF OPTIC ATROPHY

A
  1. Simple or Primary Atrophy
  2. Secondary or Postneuritic or Secondary Inflammatory Atrophy
33
Q

SYMPTOMS OF OA

A

reduction in the acuteness of vision
diminution in the light sense
color blindness
when atrophy is complete, pupils are dilated & immobile

34
Q

OPHTHALMOSCOPIC SIGNS (SIMPLE ATROPHY)

A

disk is white, grayish or bluish white
edges of the disk are sharply defined and regular
size of disk is diminished & presents saucer- shaped excavation
minute vessels have disappeared
arteries are diminished in caliber

35
Q

OPHTHALMOSCOPIC SIGNS (SECONDARY ATROPHY)

A

disk is dense white or grayish in color
margins are irregular & hazy
minute vessels are lost retinal arteries are narrow
arteries & veins enclosed by white lines

36
Q

CAUSE OF SIMPLE ATROPHY

A

cerebrospinal diseases multiple sclerosis systemic syphilis malaria
diabetes
excessive hemorrhage
arteriosclerosis
certain poisons(arsenic, wood alcohol)
choroiditis retinitis glaucoma

37
Q

CAUSE OF SECONDARY ATROPHY

A

papilledema
optic neuritis
tumors of the optic nerve

38
Q

PROGNOSIS OF OA

A

simple atrophy occurs in middle life; the course is slow extending over many months & prognosis is unfavorable, the condition progessses to absolute blindness

secondary atrophy, prognosis is better & depends upon extent optic nerve has escaped from destructive influences

39
Q

TREATMENT OF OA

A

control the cause
scleral or extraocular muscle surgical transplantation have been tried to initiate scleral vascularization which may induce choroidal & retinal neovascularization

40
Q

inflammation of the choroid classified as ACUTE OR CHRONIC

A

CHOROIDITIS

41
Q

Under Acute Choroiditis:

A

exogenous and endogenous

42
Q

due to perforating wounds of the eyeball

A

EXO Acute Choroiditis

43
Q

caused by infection localized elsewhere in the body

A

ENDOGENOUS ACUTE CHOROIDITIS

44
Q

Occurs as an ocular manifestation of some internal disease such as syphilis or tuberculosis

A

CHRONIC CHOROIDITIS

45
Q

6 CLINICAL VARIETIES OF POSTERIOR UVEITIES

(DDCJAC)

A

Diffuse Choroiditis
Disseminated Choroiditis
Circumscribed Choroiditis
Juxtapapillary Choroiditis
Anterior Choroiditis
Central Choroiditis

46
Q

patches of exudation, each gradually shading into the surrounding portions of the choroid

A

DIFFUSE CHOROIDITIS

47
Q

numerous round or irregular yellowish spots with fluffy borders scattered over the fundus

A

DISSEMINATED CHOROIDITIS

48
Q

single patch of yellowish color with fading edges is seen near the macula

A

CIRCUMSCRIBED CHOROIDITIS

49
Q

form of circumscribed choroiditis which is adjacent to the disk, its shape is usually oval

A

JUXTAPAPILLARY CHOROIDITIS

50
Q

presents foci of exudation similar to those found in disseminated choroiditis but limited to the periphery of the choroid

A

ANTERIOR CHOROIDITIS

51
Q

A form of circumscribed choroiditis situated in the macular region

A

CENTRAL CHOROIDITIS

52
Q

SYMPTOMS OF CENTRAL CHOROIDITIS

A

severe reduction or loss of central vision but peripheral vision is preserved
seeing a black spot & distortion of
objects
flashes of light, sparks of bright circles before the eyes

53
Q

OPTHALMOSCOPIC SIGNS

A

gray or white spot, usually about half the size of the disk, either mottled or uniform in color, with
more or less pigmentation scattered in irregular deposits or forming a border

choroidal vessels seen on surface

lesion found in the macular area

54
Q

CAUSES OF CENTRAL CHOROIDITIS

A

tuberculosis - most common cause

syphilis

Infection resulting from a perforating injury

acute infectious diseases of childhood

55
Q

PROGNOSIS OF CENTRAL CHOROIDITIS

A

dependent upon position of patches of exudation with subsequent atrophy

a single patch involving the macular region will seriously impair vision

56
Q

TREATMENT OF CENTRAL CHOROIDITIS

A

removal of etiologic factor
atropine may be indicated to rest the eyes

57
Q

always primary and involves ONE EYE ONLY - occurs in adults between 40-60

A

MALIGNANT MELANOMA OF THE CHOROID

58
Q

SYMPTOMS OF MALIGNANT MELANOMA of the CHOROIDITIS

A
  1. Insidious Stage - no symptoms & only sign may be discovered by chance; a brown or black, flat or slightly elevated, circumscribed mass in the choroid which slowly increases in size; tumor may exist for a long time without causing symptoms
  2. Stage of Clinical Symptoms
    defect in visual field or diminution in vision is the initial symptom, depending upon the location of the tumor
    definite elevation of the tumor but remains circumscribed, yellowish brown, brown or black
    area around tumor becomes detached
  3. Stage of Secondary Glaucoma tumor continues to increase in size
    & produce inflammatory signs as a result of glaucoma & of release of irritating necrotic products
  4. Stage of Extraocular Extension or Metastasis - tumor grows out of the globe; metastasis frequently occurs in the liver
59
Q

OPHTHALMOSCOPIC SIGNS OF MALIGNANT MELANOMA

A

Round or spindle-shaped cells, usually pigmented

Begins as a flat disk-shaped mass in the outer layers of the choroid

Later, it perforates the lamina vitrea(Bruch’s membrane) & forms mushroom-shaped mass pushing the retina forward & drusen

60
Q

cause of malignant melanoma

A

unknown although found in 10% of eyes blind from injury of inflammation

61
Q

PROGNOSIS OF MALIGNANT MELANOMA

A

when enucleated early, cure results in about 1/2 of the cases;even after removal , death results from metastasis

62
Q

TREATMENT OF MALIGNANT MELANOMA

A

enucleation is indicated as soon as diagnosis is established, cutting the optic nerve back, but it is necessary to remove the entire contents of the orbit if the growth has broken through the globe

tumors located in anterior portion may be removed by a resection of the sclera

63
Q

Torn by mechanical force, usually vitreous traction

A

RETINAL TEAR

64
Q

A separation of the retina occuring between the layer of pigment epithelium and the layer of rods and cones. DARK CLOUD BEFORE THE EYE

A

RETINAL DETACHMMENT

65
Q

A disease of the retina associated with essential or malignant hypertension (where blood pressure is severely high)

A

HYPERTENISVE RETINOPATHY

66
Q

4 CLASSIFICATIONS OF HYPERTENSIVE RETINOPATHY

A

GRADE 1, 2 ,3 AND 4.

67
Q

arterioles are reduced from ¾ to
½ of the corresponding vein & no hemorrhages, patches or edema are seen

A

GRADE 1

68
Q

further reduction of arteries from
½ to 1/3 of the corresponding vein & no hemorrhages or patches seen

A

GRADE 2

69
Q

aside from arteriole constriction, there are flame-shaped hemorrhages and/or cotton-wool patches & edema residues

A

GRADE 3

70
Q

onset of papilledema with partial or complete star-shaped figure of edema residues at the macula(macular star)

A

GRADE 4

71
Q

5yr. Survival rate of patients in group 1 is 70%; group 4 is 1%
Adequate control of hypertension improves the prognosis

A

PROGNOSIS:

72
Q

Associated with diabetes mellitus(where tissues are unable to utilize the available or deficient insulin coming from the pancreas which results in the inability to utilize glucose)
It is always bilateral

A

DIABETIC RETINOPATHY

73
Q

OPHTHALMIC SIGNS OF DM

A

Earliest sign is venous dilatation (because of obstruction of venous drainage)

Numerous small round red spots are seen which are small hemorrhages in the deeper layer of the retina

Small clusters of red dots at end of vascular twigs

74
Q
A
74
Q

CIRCLE AROUND THE MACULAR

A

circinate retinopathy or retinitis circinata

74
Q
A
74
Q
A
74
Q
A
75
Q
A

Ocular Pharmacology (3 decks)

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