Systemic Disease and the Eye Flashcards
What signs can indicate non-proliferative diabetic retinopathy?
- microaneurysms / dot + blot haemorrhages
- hard exudate
- cotton wool patches
- abnormalities of venous calibre
- Intra-retinal microvascular abnormalities
Where do new vessels commonly grow in diabetic retinopathy?
On the disc (NVD)
At the periphery (NVE)
On iris (if ischaemia = severe)
What is the name given to blood vessels growing on the iris?
rubeosis iridis
What are the 3 main reasons for diabetic loss of vision?
- retinal oedema affecting the fovea
- vitreous haemorrhage
- scarring causing retinal detachment
How can diabetic maculopathy be treated?
- Advice on tight glycaemic control
- Laser (Pan retinal phototherapy PRP)
- Surgery – vitrectomy
What does the fundus look like after end stage laser treatment?
Atrophy and melanin hypertrophy
Light and dark spots
If a young person presents with evidence of hypertensive retinopathy what condition should be suspected?
Malignant Hypertension
What features are normally present in hypertensive retinopathy?
- cotton wool spots
- hard exudates
- retinal haemorrhage
- optic disc oedema
Why does the retina appear pale on fundoscopy after a CRAO?
retinal nerve fibre layer becomes swollen (oedema)
=> cant see coloured choroid vessels through it
- except at fovea (cherry red spot)
What inflammatory condition that presents in the lungs is known to also cause uveitis?
Sarcoidosis
Aside from sarcoidosis, what other non-infective diseases can cause uveitis?
HLA-B27
Juvenile Arthritis
Behcet’s Disease
What biochemical markers are usually raised in giant cell arteritis?
Alk Phos
Plasma Viscosity
CRP
What is the indicator of proptosis in thyroid eye disease?
Sclera visible above or below the iris
What signs can be seen in the eyelid that would demonstrate thyroid eye disease?
retraction
oedema
lag
pigmentation
What eye conditions can be developed secondary to rheumatoid arthritis?
Dry eyes (Keratoconjunctivitis Sicca)
Scleritis
Corneal melt
Why are the eyes usually dry in sjogrens syndrome?
Infiltration of the lacrimal gland
How far is the macula usually from the optic disc?
3mm
Ischaemia in diabetic retinopathy drives what molecule to create new fragile blood vessels?
VEGF
Vascular endothelial growth factor
New vessels develop at the periphery when ischaemia is local. TRUE/FALSE?
TRUE
What part of the eye has become ischaemia when new vessels develop on the optic disc?
Indicates pan-retinal ischaemia
What visual signs can distinguish new vessels from old vessels?
New vessels:
- tortuous
- double back
- don’t look to be travelling in one particular direction
Why is the peripheral retina “sacrificed” during laser treatment?
Decreases oxygen demand and leaves most acute part of vision intact
Why is laser treatment used to kill off new vessels rather than an anti-VEGF injection?
Anti-VEGF doesnt last very long
How is the degree of ischaemia determined after a CRVO?
Angiogram
What sign can be seen on the cornea in sarcoidosis?
Keratotic precipitates (triangle shape)
What are the infective causes of uveitis?
TB Herpes Zoster Toxoplasmosis Candidiasis Syphilis Lyme Disease
Giant Cell arteritis only affects what type of blood vessel?
Blood vessels with an internal elastic lamina
SLE causes what eye changes?
Ocular inflammation and necrosis of the sclera
Marfan’s syndrome causes what problem in the eye?
Lens dislocation (UPWARDS)
normally lens dislocates downwards but Marfan’s is opposite
