Sensory Flashcards
Cataracts
cloudy lens, gradual painless blurriness; if untreated, can go blind
Risk for cataracts
old (almost all will get), eye trauma (babies get premature cataracts), congenital risk, DM, steroid use, smoke and alc
Cataract manifestations of vision
-Painless
- Uni- or bilateral vision changes
- Blurry
- Halo around lights
- Altered color perceptions
- Glare issues at night
- Decreased
accommodation
Cataracts tx
laser eye tx
- no pharm
Retinopathy most common type
diabetic retinopathy (40% over 40 have it)
Nonprolific retinopathy
- Capillary microaneurysms, retinal swelling, hard exudate
- Macular edema- plasma leaks
from macular blood vessels - Capillaries rupture, leading to “dot or blot” hemorrhaging
Proliferative retinopathy
- All patho of nonproliferative plus advanced retinopathy
- New blood vessels are fragile and leaky
Hypertensive retinopathy
- Etiology: high blood pressure creates blockages in retinal bloodvessels
- no initial chx
- sustained, severe HTN can cause sudden visual loss related swelling of the optic disc and nerve–ischemia
- exudative and hemorrhage like with diabetic retinopathy
Retinal detachment
- retinal has tear or leak
- vitreous humor flows behind retina
- rapid, prog detach from choroid (spontaneous)
Risks for detached retina
Myopia, over 40, trauma to eye like eye tumor and complication of cataract surgery
CM of detached retina
SUDDEN, unilateral
vision loss
Painless
May see floaters
Flashes of light
Macular degneration
Most common irreversible vision loss over 60
Dry MD
- most common, 90%
- yellow deposits in retinal pigment epithelium
Wet (exudative) MD
- 10%
- more hemorrhagic
- grow new leaky (hemorrhagic) BVs in abnormal part of retina
Protection for MD
Dark green, leafy vegetables protective
Risk factor for MD
Family history, genetics, UV light,
hyperopia, smoking, light-colored eyes
CM for MD and tx
Early on– usually no symptoms
Later:
Blurred, darkened vision
Blind spots (scotomas)
Distorted vision (metamorphopsia)
Vision does not improve, treatment
is limited
Medications are injected into the eye
Glaucoma
inc IOP plus vision change or optic nerve damage
- chronic
- usually bilateral
Open angle risk for glaucoma
- still some flow
Elevated IOP
Age- older
Race: African-Americans 3-4x higher
risk
Family history
Myopia
Diabetes, HTN, migraines
Open-angle glaucoma patho
- Abnormal trabecular meshwork
- Reduced drainage of aqueous humor into canal of Schlemm
- Imbalance between inflow and outflow
- Results in increased IOP and vision problems
Open angle glaucoma CM
None usually
Progressive loss of sight
Vague eye pain
Halos around lights
Tunnel vision
Closed angle glaucoma
- Much less common
- Abnormal angle between the iris and later cornea
- Outflow is blocked when the pupil is DILATED
- Aka acute angle-closure glaucoma
(AACG) or narrow-angle glaucoma
Acute angle closure glaucoma is an
EMERGENCY - sudden complete closure - outcome based on time of tx
Closed angle glaucoma risks
- Asian American ethnicity
- Females
- Hyperopia
- Family history
- older age
What triggers acute angle closure glaucoma
Anticholinergic drugs
Acute closed angle glaucoma CM
Typically UNILATERAL but other eye is at risk
SEVERE eye pain
Nausea and vomiting
Blurry vision, halos
Reddened eyes
Dilated pupil– non-reactive to light
Cloudy cornea
Glaucoma and blindness
Due to the increased
IOP
More pressure on
inner eye structures
Decreased blood
flow to optic nerve
Nerve fiber death
blindness
Pharm for glaucoma
Drugs that DECREASE
aqueous humor
production
INCREASE aqueous
humor drainage
Or both
How to use eye drops
use nasolacrimal pressure for 2 min to prevent from spreading systemically
Drugs that dec AH prod
beta blocker, alpha adrenergic agonist
Drugs that inc AH drainage
prostaglandin analogs, alpha 2 adrenergic agonist (maybe)
Meniere disease
Endolymphatic hydrops
- unilateral or bilateral excessive endolymp and pressure in membranes disrupt vestibular and hearing fxn
Meniere CM
Recurring episodes of vertigo [usually with nausea & vomiting], hearing loss, ringing in the ears (tinnitus), and feeling of fullness
Meniere tx
Symptomatic - diet change (lower salt), caffeine, alc, stress, MSG, allergies
When does Meniere start
age 20-40 usually
HTN retinopathy tx
- normal vision can be restored with HTN tx
- no pharm
- meet with dr regularly to control progression
Etiology for macular degneration
Retinal aging
Tx for acute open angle glaucoma
Surgical intervention
What drug might you give with Meniere’s
Ones that help with dizziness
