Systemic disease and the eye Flashcards
Hypertensive retinopathy pathophysiology:
Problems with autoregulation of blood flow in the precapillary and capillary lead to ischemia.
Hypertensive retinopathy grading:
0-4
Hypertensive retinopathy grade 0 finding:
No change
Hypertensive retinopathy grade 1 finding:
Minimal arterial narrowing (segmental or the entire vessel)
Hypertensive retinopathy grade 2 finding:
Venous narrowing at AV crossing
Hypertensive retinopathy grade 3 finding:
DBP of 110
Retinal bleeding (dot, Blot, Flame)
Cotton wool spot
NO microaneurysms.
Hypertensive retinopathy grade 4 finding:
DBP 130, SBP 200
Swollen disc
Contrary to diabetic retinopathy, there are no_____ in Hypertensive retinopathy.
no microaneurysms.
changes in ____ grades are due to chronic hypertension, and changes in _____grade are due to acute hypertension
changes in 1-2 grades are due to chronic hypertension, and changes in 3-4 grades are due to acute hypertension
______ Blood pressure is more important for RF
DBP
In the 3-4 hypertensive retinopathy grades there is _____ involvement, that can lead to ______
Choroidal, RD due to fluid escaping (serotic)
Can VA remain damaged after signs have passed?
Yes, especially damage to ON, macula, RPE
Graves ophthalmopathy - the percentage of hypo, EU, and hyper thyroidsim.
5% - EU
1% - hypo
Above 90% - hyper
Graves ophthalmopathy - There is a correlation between the degree of thyroid disease and the degree of ophthalmopathy. True/False?
False! There is NO correlation between the degree of thyroid disease and the degree of ophthalmopathy.
Graves ophthalmopathy - ocular involvement can be remembered through _____.
NO SPECS:
N - no signs
O - Only signs
S - Soft tissue P - Proptosis E - Extraocular muscles involvement C - Corneal damage S - sight loss
Graves ophthalmopathy - What is the soft tissue involvement?
Lids: lid lag, lid swelling
Conjunctiva: not diffuse (at the insertion of the muscles)
Graves ophthalmopathy - Extraocular muscles involvement is progress in what pattern?
Starts at the IR and continues in a counter-clockwise fashion.
Graves ophthalmopathy - Extraocular muscles involvement pathology?
May lead to?
Spindle hypertrophy and doesn’t involve the tendons, and may lead to diplopia.
Graves ophthalmopathy - Corneal damage pathophysiology?
Exposure keratopathy (SPK is usually seen)
Graves ophthalmopathy - sight loss is due to _____
Pressure on the ON
Graves ophthalmopathy - therapy:
דרדס
דמעות
רדיולוגי
דה-קומפרסיה
סטרואידים
RA ophthalmopathy - ocular involvement can be remembered through _____.
Dry CURVES
Dry - kertocunjictivitis sicca C - Choroiditis U - Ulceration R - RD V - Vasculitis E - Episcleritis S - Scleritis
Kertocunjictivitis sicca - Dx?
Schirmer dry eye test - <5mm in 5 minutes
Kertocunjictivitis sicca - Tx?
Tear replacement, Punctum plug
Episcleritis vs Scleritis finding?
The 5 P's - Scleritis presents with: P - Pain P - Purple (red-purple) P - Photophobia P - profound (deep) vessel involvement P - Phenyephrine test positive
Scleritis can be seen with?
WIPS: W - Wegner I - IBD P - PAN S - SLE