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Foundations of Clinical Practice II > Retina and Optic Nerve > Flashcards

Retina and Optic Nerve Flashcards

1
Q

What is Optic Neuritis?

What is another concern for this condition?

A

Inflammatory demyelinating condition of the Optic nerve.

Can be linked to MS since it is a demyelination disease

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2
Q

Clinical presentations of Optic Neurits

A

Acute onset of condition (hrs - days)

Monocular vision loss

Painful EOMs

Central scotoma “blurry central vision”

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3
Q

Symptoms of Optic Neuritis

A

Loss of visual acuity

Color vision loss

  • Relative Afferent Pupillary Defect
  • Pupill is unable to stay constricted during swinging light test
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4
Q

How is the Optic nerve affected during Optic neuritis

A

Swollen, pallor optic nerve

Flame shaped, peri-papillary hemorrhages

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5
Q

How is a Optic neuritis diagnosed?

A

Refer urgently to ophthalmologist

Perform MRI on brain and orbits

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6
Q

How is Optic Neuritis treated?

A

IV methylprednisolone for 3 days and taper off to allow recovery

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7
Q

What is Papilledema

A

Swelling of the optic n. due to inter cranial pressure

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8
Q

Ddx or possible signs of a Papilledema

A
  1. Tumors

2. Cerebral edema (encephalopathy)

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9
Q

Clinical presentations of Papilledema

A
  1. Swollen optic n.
  2. Margins of disk are obscure/not sharp
  3. Venules are dilated and twisted
  4. Cotton wool spots = flame hemorrhages and infarctions
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10
Q

Treatments of Papilledema

A

Immediate ophthalmologist

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11
Q

What is Age Related Macular Distention

A

Degenerative loss of the macula (central retina)

Leading cause of adult blindness

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12
Q

What are the 2 types of AMD?

A
  1. Dry AMD
    - Retinal drusens are yellow deposits
    - Retinal pigment endothelium atrophy causing a loss of central vision
  2. Wet AMD
    - Growth of new abnormal vessels that leak
    - Main cause of blindness in AMD
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13
Q

What are the symptoms and signs of Age Related macular Distention

A
  1. Loss of central vision
  2. Metamorphopsia (wavy vision)
  3. Central scotoma
  4. Amsler grid distortion
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14
Q

What happens during a Retinal Detachment

A

Retina tears and it allows fluid works its way underneath the retina

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15
Q

Symptoms of Retinal Detachment

A
  • Curtain coming down in one eye
  • Cloudy vision
  • Floaters or flashes of lights
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16
Q

How is a Retinal Detachment clinically presented?

A

Fundoscopy exam will show a bulging tent like retina

May also see a vitreous hemorrhage

17
Q

Treatment for Retinal Detachment

A

Immediate Ophthalmology referral

Have the patient supine and turn head towards effected eye to allow retina to fall back in place

18
Q

How is Amaurosis Fugax presented?

A
  • Fleeting blindness

- Episodes of curtain falling causing temporary blindness lasting for a few minutes

19
Q

What is the cause of Amaurosis Fugax and how is it treated?

A

Cause: retinal emboli potentially from carotid disease

Treatment: Depends on cause

Perform an ultrasound or Magnetic Resonance Angiography (MRA)

EKG to find heart abnormality

20
Q

What are the classic findings of a Central Renal Artery occlusion?

A
  • Painless, loss of vision

- Cherry red spot (cherry red spot”

21
Q

Treatment for Central Retinal Artery Occlusion

A

Ophthalmology referral immediately

22
Q

What are classical findings for Central Vein Occlusion?

A
  • Blood and thunder fundus
  • Venous dilation and tortuosity
  • Multiple hemorrhages
23
Q

Symptoms of Retinal Vein occlusion?

A

Painless vision lost

Noticed first thing while walking up

24
Q

How is Central Retinal vein occlusion treated?

A

Referral to Ophthalmology

Aspirin to help with occlusion

If young pt evaluate for HTN and hyper coagulability

25
Q

What are the recommendations for an eye exam for diabetics

A

Yearly, dilated exams for:

  1. Type 1 dibetes for more than 5 years
  2. Type 2 dabetics at their first diagnosis
  3. If ocular symptoms develop or there are signs of Retinopathy
26
Q

Signs/Findings in Non-Proliferative Diabetic Retinopathy

A
  1. Micro aneurysms
  2. Dot blot hemorrhages
  3. Cotton wool spots
27
Q

Findings in Proliferative Diabetic Retinopathy

A
  1. Same findings as non-proliferative
  2. Neovascularization
  3. Vitreous hemorrhages
28
Q

Macular Edema findings

A
  1. Retinal thickening
  2. Micro aneurysms
  3. Hard Exudates
29
Q

Arteriolar Narrowing + Arteriolar Sclerosis

A

Group 1 HTN Retinopathy

30
Q

Group 2 HTN Retinopathy includes?

A

Group 1 plus

A:V crossing changes (AV nicking)

31
Q

Group 3 HTN retinopathy

A

Group 2 plus

Cotton Wool spots
Retinal hemorrhages
Retinal edema/exudates

32
Q

Group 4 HTN retinopathy

A

Group 3 plus

Disk edema (papilledema)

33
Q

Treatments for Diabetic Retinopathy

A

Blood sugar Control

  • Daily glucose <120
  • A1C < 7

Foundations of Clinical Practice II (23 decks)

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