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OPHTHALMOLOGY > Systemic Disease and the Eye > Flashcards

Systemic Disease and the Eye Flashcards

1
Q

What signs can indicate non-proliferative diabetic retinopathy?

A
  • microaneurysms / dot + blot haemorrhages
  • hard exudate
  • cotton wool patches
  • abnormalities of venous calibre
  • Intra-retinal microvascular abnormalities
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2
Q

Where do new vessels commonly grow in diabetic retinopathy?

A

On the disc (NVD)
At the periphery (NVE)
On iris (if ischaemia = severe)

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3
Q

What is the name given to blood vessels growing on the iris?

A

rubeosis iridis

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4
Q

What are the 3 main reasons for diabetic loss of vision?

A
  • retinal oedema affecting the fovea
  • vitreous haemorrhage
  • scarring causing retinal detachment
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5
Q

How can diabetic maculopathy be treated?

A
  • Advice on tight glycaemic control
  • Laser (Pan retinal phototherapy PRP)
  • Surgery – vitrectomy
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6
Q

What does the fundus look like after end stage laser treatment?

A

Atrophy and melanin hypertrophy

Light and dark spots

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7
Q

If a young person presents with evidence of hypertensive retinopathy what condition should be suspected?

A

Malignant Hypertension

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8
Q

What features are normally present in hypertensive retinopathy?

A
  • cotton wool spots
  • hard exudates
  • retinal haemorrhage
  • optic disc oedema
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9
Q

Why does the retina appear pale on fundoscopy after a CRAO?

A

retinal nerve fibre layer becomes swollen (oedema)
=> cant see coloured choroid vessels through it
- except at fovea (cherry red spot)

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10
Q

What inflammatory condition that presents in the lungs is known to also cause uveitis?

A

Sarcoidosis

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11
Q

Aside from sarcoidosis, what other non-infective diseases can cause uveitis?

A

HLA-B27
Juvenile Arthritis
Behcet’s Disease

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12
Q

What biochemical markers are usually raised in giant cell arteritis?

A

Alk Phos
Plasma Viscosity
CRP

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13
Q

What is the indicator of proptosis in thyroid eye disease?

A

Sclera visible above or below the iris

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14
Q

What signs can be seen in the eyelid that would demonstrate thyroid eye disease?

A

retraction
oedema
lag
pigmentation

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15
Q

What eye conditions can be developed secondary to rheumatoid arthritis?

A

Dry eyes (Keratoconjunctivitis Sicca)
Scleritis
Corneal melt

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16
Q

Why are the eyes usually dry in sjogrens syndrome?

A

Infiltration of the lacrimal gland

17
Q

How far is the macula usually from the optic disc?

A

3mm

18
Q

Ischaemia in diabetic retinopathy drives what molecule to create new fragile blood vessels?

A

VEGF

Vascular endothelial growth factor

19
Q

New vessels develop at the periphery when ischaemia is local. TRUE/FALSE?

A

TRUE

20
Q

What part of the eye has become ischaemia when new vessels develop on the optic disc?

A

Indicates pan-retinal ischaemia

21
Q

What visual signs can distinguish new vessels from old vessels?

A

New vessels:

  • tortuous
  • double back
  • don’t look to be travelling in one particular direction
22
Q

Why is the peripheral retina “sacrificed” during laser treatment?

A

Decreases oxygen demand and leaves most acute part of vision intact

23
Q

Why is laser treatment used to kill off new vessels rather than an anti-VEGF injection?

A

Anti-VEGF doesnt last very long

24
Q

How is the degree of ischaemia determined after a CRVO?

A

Angiogram

25
Q

What sign can be seen on the cornea in sarcoidosis?

A

Keratotic precipitates (triangle shape)

26
Q

What are the infective causes of uveitis?

A 
TB
Herpes Zoster
Toxoplasmosis
Candidiasis
Syphilis
Lyme Disease
27
Q

Giant Cell arteritis only affects what type of blood vessel?

A

Blood vessels with an internal elastic lamina

28
Q

SLE causes what eye changes?

A

Ocular inflammation and necrosis of the sclera

29
Q

Marfan’s syndrome causes what problem in the eye?

A

Lens dislocation (UPWARDS)

normally lens dislocates downwards but Marfan’s is opposite

OPHTHALMOLOGY (12 decks)

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