The Eye in Systemic Disease Flashcards

1
Q

Describe the disease process that leads to ischaemia of the eye in diabetes?

A

Chronic hyperglycaemia-> Glycosylation of protein/basement membrane -> loss of pericytes -> microaneurysm-> leakage and ischaemia

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2
Q

What are the signs of non-proliferative retinopathy?

A

Microaneurysm/Dot and blot haemorrhages

Hard exudate

Cotton wool patches

Abnormalities of venous calibre

Intraretinal microvascular abnormalities

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3
Q

Describe the pattern of new vessel growth in diabetes?

A

Grow on disc

Grow in the periphery

Grow on iris if ischaemia is severe

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4
Q

What causes diabetic patients to lose vision?

A

Retinal oedema affecting the fovea

Vitreous haemorrhage

Scarring/tractional retinal detachment

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5
Q

Describe Classification 1: retinopathy

A
  • No retinopathy
  • Mild/moderate/ severe (non proliferative)
  • Proliferative
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6
Q

Describe Classification 2: Maculopathy

A
  • No maculopathy
  • Observable maculopathy
  • Referable maculopathy
  • Cliniccaly significant maculopathy
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7
Q

How is diabetic eye disease managed?

A

Glycaemic control

Laser

  • Panretinal Photocoagulation (PRP)
  • macular grid

Surgery
-vitrectomy

Rehabilitation

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8
Q

What does the appearance of the fundus correlate to in hypertension?

A

Severity of hypertension and the state of the retinal arterioles

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9
Q

What are the features of hypertensive retinopathy?

A
Attenuated blood vessels- copper or silver wiring
Cotton wool spots
Hard exudates
Retinal haemorrhage
Optic disc oedema
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10
Q

Describe accelerated hypertension

A

Particularly in young patients
Very dramatic fundal appearance
Can have decreased vision

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11
Q

What is the cherry red spot in CRAO?

A

Retinal nerve fibres become swollen apart from fovea (cherry red spot)

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12
Q

Define a rubeotic eye

A

Neovascularisation of the iris

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13
Q

Describe a branch retinal vein occlusion

A

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

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14
Q

What are the causes of non-infective uveitis

A

Sarcoidosis
HLA-B27
Juvenile arthritis
Bechet’s disease

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15
Q

What are the infective causes of uveitis?

A
TB
HZ
Toxoplasmosis 
Candidiasis 
Syphillis 
Lyme disease
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16
Q

What is GCA associated with?

A

Polymyalgia rheumatica

17
Q

What are the signs and symptoms of GCA?

A

Jaw claudication
Malaise
Raised plasma viscosity
Blinding condition

18
Q

What may be seen in extraocular thyroid eye disease?

A

Proptosis
Lid Signs
Restrictive myopathy

19
Q

What are the lid signs found in thyroid eye disease?

A

Retraction
Oedema
Lag
Pigmentation

20
Q

What may be seen in the anterior compartment in thyroid eye disease?

A

Chemosis
Injection
Exposure
Glaucoma

21
Q

What may be seen in the posterior compartment in thyroid eye disease?

A

choroidal folds

optic nerve swelling

22
Q

What characterises thyroid eye disease?

A

Swelling of extraocular muscles and orbital fat

23
Q

How should thyroid eye disease be managed?

A

Control of thyroid dysfunction

Lubricants

Surgical decompression

24
Q

What are the manifestations of SLE in the eye?

A

Ocular inflammation

25
What are the manifestations of rheumatoid arthritis in the eye?
Keratoconjunctivitis Sicca Scleritis Corneal melt
26
What is the triad of sjogrens disease?
Keratoconjunctivitis sicca Xerostomia Rheumatoid arthritis
27
What is an ocular manifestation of sjogrens disease?
Inflammation of lacrimal glands
28
What are some of the ocular manifestations of marfans syndrome
- dislocated lenses - retinal detachment - severe myopia - astigmatism - amblyopia - strabismus - glaucoma - pre-senile cataracts (before age 40) - flattened corneal curve - larger cornea - exophthalmos - difficult pupil dilatation
29
What is seen in stevens-johnson syndrome?
Symblepharon Occlusion of lacrimal glands Corneal ulcers
30
What is Symblepharon?
Adhesions