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Ophthalmology > The Eye in Systemic Disease > Flashcards

The Eye in Systemic Disease Flashcards

1
Q

name the 5 signs of non proliferative retinopathy

A
  1. micro aneurysms - dot and blot haemorrhages
  2. hard exudate
  3. cotton wool patches
  4. abnormal venous calibre
  5. IRMA - intra-retinal microvascular abnormalities
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2
Q

loss of _________ results in microaneurysms

A

loss of PERICYTES results in microaneurysms

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3
Q

which 3 places can new vessels grow?

A
  1. disc (NVD)
  2. periphery (NVE)
  3. iris if ischaemia is severe
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4
Q

what is rubeosis iridis?

A

growth of new vessels onto the iris

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5
Q

name the 3 things that diabetic patients can lose vision from

A
  1. retinal oedema
  2. vitreous haemorrhage
  3. scarring and retinal detachment
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6
Q

name the 3 classifications of retinopathy

A
  1. no retinopathy
  2. non-proliferative retinopathy - mild, moderate and severe
  3. proliferative retinopathy
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7
Q

name the 4 classifications of maculopathy

A
  1. no maculopathy
  2. observable maculopathy
  3. referable maculopathy
  4. clinically significant maculopathy
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8
Q

name the management for diabetic retinopathy (4)

A

medical management
laser - PRP or macular grid
surgery
rehabilitation

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9
Q

cotton wool patches are seen in diabetic patients but also in patients with what condition?

A

hypertension

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10
Q

name the 5 features of hypertensive retinopathy

A
  1. attenuated blood vessels-copper or silver wiring
  2. cotton wool spots
  3. hard exudates
  4. retinal haemorrhage
  5. optic disc oedema
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11
Q

sudden painless loss of vision

cattle trucking of artery

very profound loss of vision

retinal nerve fibre layer becomes swollen except at fovea (cherry red spot)

rarely recovers

diagnosis?

A

central retinal artery occlusion

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12
Q

sudden painless visual loss

range of visual loss

need to determine degree of ischaemia

Ischaemia correlates to degree of reduced vision and fundal appearances

diagnosis?

A

CRVO

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13
Q

what does a robotic eye look like?

A

vessels surrounding pupil encroaching on the iris

google it

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14
Q
  1. common in Africa
  2. huge exudation on fundus
  3. bilateral hiliar lymphadenopathy on CXR

diagnosis?

A

sarcoidosis

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15
Q

name some infective and non-infective causes of uveitis

A

infective - TB, herpes zoster, toxoplasmosis…

non-infective - idiopathic, HLA-B27, juvenile arthritis, sarcoidosis

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16
Q
  1. enlarged temporal artery
  2. old pathient
  3. swollen optic nerve head

diagnosis?

A

giant cell arteritis

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17
Q

what condition is giant cell arteritis associated with?

A

polymyalgia rheumatica

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18
Q

name the symptoms of giant cell arteritis

A 
headache
jaw claudication
malaise
raised PV
blinding condition
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19
Q

name the main feature of thyroid eye disease

A

proptosis

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20
Q

name the important antibody in SLE that causes ocular inflammation

A

anti-DNA Ab

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21
Q

dry eyes (keratoconjunctivitis sicca), scleritis and corneal melt is seen in which inflammatory condition?

A

rheumatoid arthritis

22
Q

the following triad:

keratoconjunctivitis sicca
xerostomia
rheumatoid arthritis

is seen in which syndrome?

A

sjogren’s syndrome

lacrimal glands are also infiltrated

23
Q

lens displacement without trauma, long fingers and a high arched palate is seen in what condition?

A

marfans

24
Q

which way is the lens displaced in marfans syndrome?

A

UP!

25
Q

symblepharon
occlusion of lacrimal glands
corneal ulcers

dermatological diagnosis?

A

stevens-johnson syndrome

26
Q

what is the gold standard imaging technique to identify cause of eye disease?

A

MRI scanning

27
Q

name the following nerves:

(a) CN III
(b) CN IV
(c) CN VI

A

(a) CN III - oculomotor
(b) CN IV - trochlear
(c) CN VI - abducens

28
Q

what eye muscle does CN VI supply?

A

lateral rectus muscle

29
Q

what does the lateral rectus muscle do?

A

adduction of the eye

30
Q

name the main cause and other causes of VIth nerve palsy

A

main: raised ICP
other: microvascular, tumour and congenital

31
Q

what muscle does the IVth nerve supply?

A

superior oblique

32
Q

what actions does the superior oblique muscle perform

A

intorsion
depression in adduction
abduction (weak)

33
Q

what is seen in a patient with a IVth nerve palsy?

A

head tilt

right tilt if left IV palsy
left tilt if right IV palsy

34
Q

what is the main cause of IVth nerve palsy?

A

congenital decompensated (inability to fuse images together) and trauma

35
Q

what muscles do CN III innervate?

A

all the rest

medial rectus muscle
inferior rectus
superior rectus
inferior oblique
sphincter pupillae
levator palpebrae superioris
36
Q

what is the ocular position in a IIIrd nerve palsy?

A

down and out

37
Q

name the main and other causes of a IIIrd nerve palsy

A

main: aneurysm (circle of willis)
other: microvascular, tumour, MS and congenital

38
Q

what should you suspect in a painful IIIrd nerve palsy?

A

ANEURYSM!!!

39
Q

inter-nuclear ophthalmoplegia is seen in patients that have had what?

A

a stroke

40
Q

inter-nuclear ophthalmoplegia causes?

A

multiple sclerosis - demyelination is main and vascular is other

41
Q

name the most common pathology of the optic nerve

A

ischaemic optic neuropathy

42
Q

name the pathology of the optic nerve that is seen commonly in MS

A

optic neuritis

43
Q

optic nerve defects are ________ or abide the __________

A

optic nerve defects are COMPLETE or abide the HORIZONTAL

44
Q

progressive visual loss (unilateral)

pain behind eye, especially on movement

colour desaturation

central scotoma

gradual recovery over weeks - months

diagnosis?

A

optic neuritis

45
Q

name the most common pathology at the optic chiasm

A

pituitary tumour

also craniopharyngioma and meningioma

46
Q

what visual field is seen in pathology of the optic chiasm

A

bi-temporal field defect

47
Q

is visual loss reversed after a pituitary tumour is removed?

A

yes

48
Q

what pathology is seen in the optic tracts and radiation?

A

tumours
demyelination
vascular anomalies

49
Q

what visual field defect is seen in pathology of the optic tract?

A

homonomous defects
macula not spared
quadrantanopia
incongruous (non-symmetrical)

50
Q

what pathology is seen at the occipital cortex and what is the visual field defects enthuse patients?

A

pathology: vascular disease and demyelination
visually: homonomous defect, macular sparing and congruous (symmetrical)

Ophthalmology (13 decks)

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