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Ophthalmology > The Eye in General Disease > Flashcards

The Eye in General Disease Flashcards

1
Q

What occurs in diabetic retinopathy?

A

Chronic hyperglycaemia causes glycosylation of protein/basement membrane

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2
Q

What does the loss of pericytes due to glycosylation in diabetic retinopathy cause?

A

Microaneurysms = may leak or cause ischaemia

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3
Q

What are the signs of non-proliferative diabetic neuropathy?

A

Microaneurysms, dot/blot haemorrhages, cotton wool patches, hard exudate, abnormalities of venous calibre, intra-retinal microvascular abnormalities (IRMA)

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4
Q

Where can new vessels grow in diabetic retinopathy?

A

On the disc (NVD), in the periphery (NVE) or on the iris (if ischaemia is severe)

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5
Q

Why do diabetic patients ultimately loss their vision?

A

Retinal oedema affecting the fovea, vitreous haemorrhage, scarring/tractional retinal detachment

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6
Q

What is the classification of retinopathy?

A

No retinopathy
Mild retinopathy
Moderate and severe = non-proliferative retinopathy
Proliferative retinopathy

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7
Q

What is the classification of maculopathy?

A

No maculopathy
Observable maculopathy
Referable maculopathy
Clinically significant maculopathy

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8
Q

What are the management options for diabetic retinopathy?

A 
Laser = PRP, macular grid
Surgery = vitrectomy 
Rehabilitation = blind/partial sighted
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9
Q

What part of the eye correlates the severity of hypertension and the state of the retinal arterioles?

A

The appearance of the fundus

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10
Q

How does age affect how hypertension impacts the eye?

A

Young people can have extensive retinopathy

Elderly patients with arteriosclerotic vessels often have minimal changes

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11
Q

What are some features of hypertensive retinopathy?

A

Attenuated vessels (copper/silver wiring), cotton wool spots, hard exudates, retinal haemorrhage, optic disc oedema

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12
Q

What are some features of accelerated hypertension?

A

Particularly affects young patients, very dramatic fundal appearance, can have decreased vision

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13
Q

What are some features of central artery occlusion?

A

Sudden painless loss of vision, profound visual loss, retinal nerve fibre layer except fovea (cherry red spot), rarely recovers

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14
Q

What are some features of central vein occlusion?

A

Sudden painless visual loss, range of visual loss, need to determine degree of ischaemia

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15
Q

What does the ischaemia that occurs due to central vein occlusion correlate to?

A

The degree of reduced vision and fundal appearances

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16
Q

What are some symptoms of branch vein occlusion?

A

Painless disturbance in vision, may be asymptomatic, may be aware of loss of part of visual field

17
Q

What are some infective causes of uveitis?

A

TB, herpes zoster, toxoplasmosis, candidiasis, syphilis, lyme disease

18
Q

What are some non-infective causes of uveitis?

A

Juvenile arthritis, idiopathic, sarcoidosis, Behcet’s disease, HLA-B27

19
Q

What is giant cell arteritis?

A

Inflammation of medium sized arteries associated with polymyalgia rheumatica

20
Q

What are some features of giant cell arteritis?

A

Headache, jaw claudication, malaise, raised PV, may cause blindness

21
Q

What are some extra-ocular symptoms of thyroid eye disease?

A

Proptosis, restrictive myopathy

Lid involvement = retraction, oedema, lag, pigmentation

22
Q

What are some ocular features of thyroid eye disease?

A

Anterior segment = chemosis, injection, exposure, glaucoma

Posterior segment = choroidal folds, optic nerve swelling

23
Q

What characterises thyroid eye disease?

A

Swelling of the extra-orbital muscles and orbital fat

24
Q

What is the underlying mechanism behind thyroid eye disease?

A

Autoimmunity = spectrum of severity, potential blinding complications

25
Q

What is the most common cause for unilateral and bilateral proptosis?

A

Thyroid eye disease

26
Q

How is thyroid eye disease managed?

A

Control of thyroid dysfunction, lubricants, surgical decompression

27
Q

What are some features of SLE?

A

Multi-system autoimmune disease, anti-DNA antibodies, ocular inflammation

28
Q

How does rheumatoid arthritis affect the eye?

A

Dry eyes (keratoconjunctivitis sicca), scleritis, corneal melt

29
Q

How does Sjogren’s syndrome affect the eyes?

A

Keratoconjunctivitis sicca, xerostomia, rheumatoid arthritis, infiltration of lacrimal glands

30
Q

What are some dermatological conditions that affect the eyes?

A

Erythema multiforme (Stevens-Johnson), hypersensitivity to drugs/food, maculopapular rash, stomatitis, conjunctivitis

31
Q

How does Stevens-Johnson syndrome affect the eyes?

A

Symblepharon, occlusion of lacrimal glands, corneal ulcers

32
Q

What vision problems are characteristic of Marfan’s syndrome?

A

Severe myopia, astigmatism

Ophthalmology (20 decks)

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