Part III - Pt Ed Flashcards
GLAUCOMA - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
WHAT: eye dz where optic nerve is damaged
1) increased eye pressure compresses nerve fibers responsible for peripheral vision, eventually leads to blindness
2) PREVENTION: lowering eye pressure with gtts
DIAGNOSIS: visual fields, machines that measure ganglion cell density and number of nerve fibers
TREATMENT: eye DROPS to lower pressure, or LASERS or SURGERY to lower pressure
3) PROGNOSIS: GRADUAL VISION LOSS over many years; SPARES CENTRAL vision until end stage
F/U: usually every 3-6 months to monitor pressure/changes to ONH
–ANY OTHER QUESTIONS?
AMD - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
WHAT: eye dz that affects central vision due to damage to the retina / macula.
1) DRY form: cellular waste (drusen) builds up in area called macula, distorts central vision
WET form: MORE SEVERE, can cause blood vessels to leak fluid or blood in the macula
BOTH AFFECT CENTRAL VISION and cause distort faces, make it difficult to read
2) PREVENTION: VITAMINS rich in lutein / zeaxanthine, or a green leafy diet.
DIAGNOSIS: determined by observing either DRUSEN (dry) or BLEEDING/FLUID (wet) in the macular area of the retina
TREATMENT: DRY: stop smoking. Vitamins. WET: laser, or injected medication that stops/slows new BV growth.
3) PROGNOSIS: eventually will occur in everyone; WILL SPARE PERIPHERAL VISION and will not render you completely blind. Eventually may require LV devices to magnify objects esp when reading.
F/U: usually every 3-6 months to check vision and perform macular imaging.
CATARACTS - WHAT ARE THEY.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
WHAT: clouding of the lens
1) Due to UV damage, age, diet. BLOCKS light or DISTORTS light entering eye, making you more sensitive to bright lights, esp driving at night. May cause glare / halos. Can eventually cause decreased vision.
2) PREVENTION: sunglasses, antioxidants (A,C,E)
DIAGNOSIS: in microscope, glare testing
TREATMENT: surgical - high success rate.
3) PROGNOSIS: good, esp after surgery. PCO in 20-25% of cases (ONE in every 4-5 people).
F/U: 1 day / 1 week / 1 month P/O. Then annually if no complications.
DM RETINOPATHY - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
WHAT: condition of the eyes caused by leakage of blood vessels inside the retina due to diabetes.
1) Increased sugar in the blood damages blood vessels, may cause them to LEAK BLOOD / FLUID. May present as HEMORRHAGES / EXUDATES in eye, and can impact vision depending on location. Due to decreased oxygen inside the retina, NEW BLOOD VESSELS CAN ALSO GROW and are more prone to leaking. MAY ALSO CAUSE RETINAL DETACHMENT and permanent blindness.
2) PREVENTATIVE: BS control / BP and cholesterol cntrl.
DIAGNOSIS: in microscope
TREATMENT: LASER if new blood vessels grow in areas of decreased oxygen, otherwise, tight BS control.
3) PROGNOSIS: EVERYONE (type 1 and 2) is MORE LIKELY to have retinopathy depending on HOW LONG they’ve had the disease. That’s why ANNUAL DILATED EYE EXAMS are crucial for monitoring.
F/U: usually annually if no retinopathy observed, but can be every 2-3 months depending on severity.
DRY EYE SYNDROME - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
WHAT: a condition of the eyes in which the eye is UNABLE TO MAINTAIN HEALTHY LAYER OF TEARS.
1) Either caused by INCREASED EVAPORATION if oil glands are plugged or DECREASED TEARING. Can cause burning, redness, itching, INCREASED tearing, CL intolerance, irritation, CAN DECREASE VISION.
2) PREVENTION: 20/20/20 rule to increase blinking
DIAGNOSIS: dry eye tests to determine tearing and amount of inflammation in the tears that may be exacerbating dry eye symptoms
TREATMENT:
-WC BID x5-10 mins, ATs BID - QID, , OINTMENT AT NIGHT, LID SCRUBS
3) PROGNOSIS: usually good, IF YOU’RE AGGRESSIVE / COMPLIANT IN TREATING IT. IF NOT: can lead to decreased vision by compromising the cornea and potentially causing ULCERS / INFECTIONS.
F/U: usually every few weeks until controlled, then annually.
HORDEOLUM / CHALAZION - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
WHAT: small BUMP in eyelid usually caused by a clogged oil gland, most commonly a meibomian gland.
1) Eye has about 100 MGs, can cause TENDERNESS in an area of a clogged gland, PAINFUL SWELLING, REDNESS, SENSITIVITY TO LIGHT. If it’s been there long enough and there’s no active infection, a NODULE can remain but will not hurt when touched. Usually NO MAJOR EFFECT ON VISION unless excess tearing.
2) PREVENTION: Warm compresses, omega-3 supplements to maintain appropriate oil gland health/expression.
DIAGNOSIS: behind microscope, in addition to pt hx of tender area on lid
TREATMENT: Aggressive WCs BID - QID x 10-15 mins, BABY SHAMPOO / lid scrubs BID to clean lids.
STEROID INJECTION/lancing and DRAINING possible in non-clearing, non-infections event.
3) PROGNOSIS: usually excellent. F/U: annually.
PRESBYOPIA - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
Condition that causes near vision to slowly decline as we age.
1) LENS LOSES ABILITY TO FLEX/FOCUS on things up close - actually becomes more STIFF/RIGID. Usually begins to occur around 40-45 Y/O. It is NORMAL, and causes you to hold objects FURTHER AWAY until you eventually realize that READING GLASSES are necessary.
2) PREVENTION: nothing you can do. Affects EVERYONE. Just like getting wrinkles on your skin.
DIAGNOSIS: Based on pt hx, doc’s observations when checking reading visual acuity.
TREATMENT: reading glasses - WILL NEED TO INCREASE POWER AS YOU AGE AND EYES HAVE HARDER TIME FOCUSING, but WILL PLATEAU around 60-65 Y/O.
3) TREATMENT: Reading glasses, increasing in power until it plateaus.
F/U: annual eye exams when checking your prescription.
ASTIGMATISM - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
Natural refractive error of the eye.
1) Cornea not perfectly round in all directions - causes things to appear distorted / slanted. Can make it difficult to focus or see fine details, FAR AWAY AND UP CLOSE.
2) PREVENTION: nothing you can do to prevent.
DIAGNOSIS: usually diagnosed when finding prescription.
TREATMENT: GLASSES OR CONTACT LENSES that compensate for abnormal curvature. May not ned to treat if mild. REFRACTIVE SURGERY is optional for permanent resolution.
FLOATERS - WHAT IS IT.
1) Affects eyes / vision.
2) P/D/T
3) Prog / F/U?
WHAT: black or clear spots in vision that may appear as COBWEBS or FLIES moving around your vision seen in bright lights / backgrounds.
1) Vitreous jelly that fills YOUNG eye is gel-like consistency. With age, the jelly liquefies and the solid components separate from the liquid components. The solids clump together and float around inside your eye, and cast shadows on the retina, causing you to see flecks/spots moving around your vision.
2) PREVENTION: TYPICAL CONSEQUENCE OF AGING. In SOME cases, may be caused by TRAUMA to the eyes or a retinal HOLE or DETACHMENT.
DIAGNOSIS: microscope observation of the vitreous.
TREATMENT: usually NONE - risks outweigh benefits, UNLESS CAUSED BY RD - then a gas bubble is injected in to the eye to reattach the retina to the back of the eye. A scleral buckle is then used to keep the retina attached.
3) PROGNOSIS: can usually just be MONITORED at annual eye exams. Often BRAIN LEARS TO IGNORE when gravity pulls clumps of vitreous down and off to the side.
F/U: annually, UNLESS SUDDEN SHOWER / INCREASE in floaters or if accompanied by flashes / curtains / veils of light.
