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OPSC211 - EYE HEALTH > Outcome 3 - Recognize Ocular Pathologies - Concept one: Internal layer > Flashcards

Outcome 3 - Recognize Ocular Pathologies - Concept one: Internal layer Flashcards

1
Q

Retinal Detachment (RD)

A

Separation of inner neurosensory retina and outer retinal pigment epithelum (RPE)

  • Space between fills w/ sub-retinal fluid
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2
Q

RPE

A

Retinal Pigment Epithelum

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3
Q

RD

A

Retinal Detachment

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4
Q

Most Common Detachment

A

Rhegrmatogenous Detachment

- caused by tear/hole in retina

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5
Q

What happens if retina tears?

A

Vitreous seeps thru opening

  • Fluid accumulates underneath retina, retina peels away from back of eye
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6
Q

What is vitreous?

A
  • Gel-liked fluid that fills the eye

- Full of tiny fibers that attach to the retina

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7
Q

Risk factors of Retinal Detachment

A
  • Aging
  • Having cataract surgery
  • Thinning of outer retina (lattice degeneration)
  • High myopia
  • Head trauma
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8
Q

Macula-on detachment

A
  • Macula had not detached yet

- Still attached to underlying RPE

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9
Q

Macula-off detachment

A
  • Detached from RPE

- Macula peeled away from underlying RPE

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10
Q

Symptoms of Retinal Detachment

A
  • Most common: shadow spreading across vision on one eye, blank spot, curtain or cob-web vision
  • Light flashes
  • Floaters
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11
Q

Retinal Detachment seen w/ opthalmoscope

A
  • Detached area: gray/brownish green

- Can have horseshoe-shaped tear in affected eyes

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12
Q

What is lattice degeneration?

A

Occurs when areas in peripheral atrophy or deteriorate in lattice pattern

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13
Q

What is atrophy?

A

Waste away, especially as result of degeneration of cells

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14
Q

Lattice Degeneration is common in…

A

Moderate to high myopia

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15
Q

What is Central Retinal Pathology?

A

Cone cells located in macula regions allow most detail central vision used in:

  • Reading
  • Sewing
  • Observing facial features
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16
Q

What is degenerative myopia?

A

More severe than other forms of myopia - changes within central retina

*potential in severe vision lost

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17
Q

Progressive elongation of the eye happens with…

A

Degenerative myopia

  • Thinning of choroid and retina’s pigment epithelum of the macula
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18
Q

What happens to the retinal tissue in degenerative myopia?

A

The retinal tissue develops cracks cause by breaks in Bruch’s membrane

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19
Q

Degenerative myopia commonly occurs in…

A

Young adulthood and people with higher myopia (they’re are greater risk)

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20
Q

Causes of degenerative myopia?

A
  1. Biochemical abnormalities

2. Hereditary factors

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21
Q

RP

A

Retinitis Pigmentosa

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22
Q

Retinitis Pigmentosa

A

Group of diseases that affect the retina - causes degeneration of tissue and diminishes vision

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23
Q

Is Retinitis Pigmentosa hereditary? And what happens?

A

Yes.

  • Causes cell death of rod and cones and the eventual atrophy of several retinal layers
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24
Q

Symptoms of Retinitis Pigmentosa?

A
  • Night blindness
  • Tunnel vision
  • Increases overtime, peripheral diminishes and only a small central area of vision remains
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25
Q

People are considered legally blind when they have…

A

Retinitis Pigmentosa

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26
Q

What is Central Serous Retinopathy (CSR)?

A

Swelling that reduces or distorts vision

  • caused by a small, round, shallow swelling of the retina
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27
Q

What is edema?

A

Swelling/Inflammation

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28
Q

Initial stages of Central Serous Retinopathy?

A
  • Vision suddenly becomes blurred/dim
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29
Q

Are reoccurrences common in Central Serous Retinopathy?

A

Yes, can affect 20-50% of people.

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30
Q

When does Central Serous Retinopathy tend to occur?

A
  • Personal/Work-related stress
  • People who have “type A” personality
  • Prolonged use steroid medication
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31
Q

If Central Serous Retinopathy frequently occurs, what happens?

A

Possible permanent vision loss

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32
Q

What is a Macular hole?

A

When multiple layers of the central retina are destroyed

  • caused by vitreous body pulling away from tissues surrounding macula area
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33
Q

Who commonly gets macular holes?

A

The elderly, typically is it unilateral

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34
Q

Macular hole central vision changes in early stages show:

A

Straight lines look wavy on Amsler grid

35
Q

Macular hole central vision changes in late stages show:

A

Small blank patches on Amsler grid

36
Q

What is the leading cause of irreversible vision loss in western world?

A

Age related macular degeneration (ARMD)

37
Q

ARMD

A

Age related macular degeneration

38
Q

TWO FORMS OF ARMD ARE:

A
  1. Exudative aka Neovascular aka WET ARMD

2. Nonexudative ARMD aka DRY ARMD

39
Q

Most is the most severe ARMD?

A

Wet

40
Q

When is DRY ARMD diagnosed?

A

When drusen begins to accumulate in/around macula

41
Q

Early stages of DRY ARMD result in?

A
  • Aging

- Thinning of macular tissues and/or deposits of pigment in the macula

42
Q

Symptoms of DRY ARMD?

A
  • Gradual vision loss (not as severe as WET ARMD)

- progress to late stage of geographic atrophy > gradual deterioration of retinal cells > severe vision loss

43
Q

What is WET ARMD?

A

New blood vessels grow beneath the retina and leak blood and fluid.

Leakage causes permanent damage to light-sensitive retinal cells which cause them to die off and create blind spots in central vision

44
Q

What is Choroidial neovascularization (CNV)?

A

The underlying process of causing WET ARMD

45
Q

Wet macular degeneration falls into two categories:

A
  1. Occult

2. Classic

46
Q

What is OCCULT in WET ARMD?

A
  • Occurs w/ new blood vessel growth behind the retina
  • Vessels not as pronounced and leakage is less evident
    !! produces less critical vision loss
47
Q

What is CLASSIC in WET ARMD?

A
  • Blood vessel growth and scarring have very clear outlines that can be observed beneath the retina
  • referred to classical choroidial neovascularization (cnv)
    !! produces MORE damage = vision loss
48
Q

Symptoms of WET ARMD?

A
  • difficulty reading w/o extra light and magnification
  • blindspot in center vision
  • inability to see detailed features
  • distorted or blurring of objects in colour, size or shape
  • difficulty seeing to read or drive
49
Q

Stages of ARMD are defined by?

A

The size and number of drusen under the retina

50
Q

Early ARMD

A
  • diagnosed by presence of medium drusen (width of human hair)
  • people with early ARMD don’t experience vision loss
51
Q

Intermediate ARMD

A
  • typically large drusen
  • pigment changes in retina
  • only detected in eye exam
  • may cause vision loss
52
Q

Late ARMD

A
  • in addition to drusen, people have vision loss from damage to the macula
53
Q

Two types of late ARMD:

A
  1. Geographical atrophy in DRY ARMD

2. Neovascular ARMD

54
Q

What is Geographical DRY ARMD?

A
  • A type of late stage of ARMD
  • caused by gradual breakdown of the light sensitive cells in the macula that convey visual images to brain
  • interruption of supporting tissue beneath macula
55
Q

What is Neovascular WET ARMD?

A
  • type of late stage of ARMD
  • abnormal blood vessels grow underneath retina
  • can leak fluid and blood = swelling and damage to the macula
56
Q

Is it possible to have geographic atrophy and neovascular ARMD in the same eye?

A

Yes, either condition can appear first

57
Q

Everyone with early ARMD will develop late ARMD, true or false?

A

False. approx. 5% of patients who have early ARMD and no signs of ARMD in the other eye will develop advanced ARMD within the next ten years

14% who have early ARMD in both eyes will develop late
ARMD in at least one eye after approx. 10 years

58
Q

Risk factors of ARMD?

A
  • Age *major risk factor
  • Smoking *doubles risk
  • Family history *high risk
  • Race *common in Caucasians
  • Unprotected exposure to UV
59
Q

Does macular degeneration produce pain?

A

No, neither type does.

60
Q

Does macular degeneration result in complete blindness?

A

No, almost never results in total blindness. People have enough peripheral vision to get around and be somewhat independent.

61
Q

How do you detect ARMD?

A
  • Use an Amsler grid

- Eye exam

62
Q

What is Vascular Retinal Disease?

A

Systems in the body having to do with blood vessels and blood supply

63
Q

What is Diabetic Retinopathy?

A

Has a few visual or opthalmic symptoms until serious vision loss develops

64
Q

What should a diabetes patient do?

A
  • Treated early in diagnosis
  • Annual dilations
  • Early diagnosis
65
Q

Types of diabetes?

A

Type 1 - body producing not enough insulin

Type 2 - body does produce some insulin but not a sufficient amount to use

66
Q

Type one diabetes is common in?

A
  • Children, teenagers or adults under 30

- People who have latent autoimmune diabetes in adults (LADA) *immune response related to loss of pancreatic cells

67
Q

How is type one diabetes controlled?

A

Primarily controlled by insulin injections

68
Q

Type 1s are referred to as…

A

Insulin Dependant Diabetes

69
Q

Type two diabetes in controlled by….

A

combination of diet, exercise and/or medication

70
Q

Ocular complications of diabetes?

A
  • cataracts
  • glaucoma
  • diabetic retinopathy
71
Q

What is Branch Retinal Vein Occlusion (BRVO)?

A

Painless, decrease in vision.

*Hazy/distorted vision

72
Q

If veins that cover larger area are blocked, what happens? (BRVO)

A

New abnormal vessels may grown on the retinal surface which results in *hemorrhaging into the vitreous

73
Q

BRVO

A

Branch Retinal Vein Occlusion

74
Q

What is Central Retinal Vein Occlusion? (CRVO)

A
  • Common vascular disorder within retina w/ potentially blinding complications.
  • patient will have painless, sudden vision loss!!
  • similar to BRVO
75
Q

What causes CRVO?

A
  • Central vein is blocked, the central vein usually drains out blood from retina. If blood flow is interrupted, it leaks into the retina. = edema in macular region
76
Q

What causes BRVO?

A

Small retinal veins are blocked and if the veins that nourish the macula are blocked, it causes some central vision loss.

77
Q

What is Central Retinal Artery Occlusion (CRAO)?

A

Centra artery is blocked

78
Q

CRVO

A

Central Retinal Vascular Occlusion

79
Q

CRAO

A

Central Retinal Artery Occlusion

80
Q

Common cause of CRAO?

A
  • Abnormal blood clot (thrombosis)
  • Also can be caused by embolus (a clot that breaks off from another area of the body and is carried to the retina by blood stream)
81
Q

First signs of CRAO?

A
  • sudden and painless vision loss

* barely can count fingers or determine light and dark

82
Q

What is common associated with Arteriosclerosis?

A

CRAO

83
Q

What is Arteriosclerosis?

A

Carotid disease found in almost half of patients with CRAO

84
Q

Risk factors of BRVO and CRAO?

A
  • hypertension
  • diabetes
  • carotid artery disease
  • coronary artery disease
  • transient ischemic attacks (TIAs)
  • cerebral vascular accidents (Strokes)

OPSC211 - EYE HEALTH (1 decks)

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