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Unit 2- Clin Med > Vision Loss > Flashcards

Vision Loss Flashcards

1
Q

components of eye exam that pertain to vision loss

A

visual acuity, visual fields, pupils (PERRLA), tonometry, slit lamp/ pen light, dilated fundus

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2
Q

amsler grid

A

tests changes in vision

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3
Q

acute angle closure is rare/ common

A

rare

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4
Q

acute rise of IOP due to outflow obstruction (aqueous outflow)

A

acute angle closure

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5
Q

IOP

A

intraocular pressure

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6
Q

acute angle closure has a ____ mechanism than open angle glaucoma

A

different

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7
Q

which is more common, acute angle closure or open angle glaucoma

A

open angle glaucoma

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8
Q

glaucoma with acute narrowing of angle, inc IOP, optic nerve damage

A

acute angle closure glaucoma

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9
Q

glaucoma with chronic narrowing of angle, optic neuropathy, IOP not always significantly elevated, optic nerve damage

A

open angle glaucoma

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10
Q

crescent shadow occurs

A

because chamber is shallow, light cant pass through

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11
Q

crescent shadow might indicate

A

acute angle closure glaucoma (because of inc IOP)

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12
Q

ACUTE decresed vision, halos around lights, headache, N/V, severe eye pain, feeling of “pressure” (inc IOP)

A

acute angle closure

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13
Q

decreased vision, circumlimbal injection/ ciliary flush, steamy cornea, mid-dilated pupil, narrow anterior chamber, firm globe

A

acute angle closure

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14
Q

acute angle closure is a

A

ophthalmologic emergency

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15
Q

acute angle closure tx

A

topical ocular HTN meds (beta blockers, alpha 2 agonists), oral/IV osmotic agents (mannitol), laser peripheral iridotomy, surgical trabeculectomy, NO MYDRIATICS

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16
Q

early presentation of open angle glaucoma is

A

asymptomatic

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17
Q

late presentation of open angle glaucoma is

A

chronic painless visual field loss (1st peripheral, then central)

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18
Q

increased IOP, inc cup:disc (optic nerve), no AV nicking, no exudates

A

seen in open angle glaucoma exam

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19
Q

tx for open angle glaucoma

A

topical ocular HTN meds (beta blocker, alpha 2 agonists), laster trabeculoplasty, sx trabeculectomy

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20
Q

1 cause of central legal blindness in western world

A

macular degeneration

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21
Q

lens opacity (age related, congenital, traumatic), gradual, CHRONIC & PAINLESS loss of vision, “foggy vision”, glare at night, dec visual acuity, clouding/ opalescent changes to lens

A

cataracts

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22
Q

cataracts tx

A

glasses, sx (extracapsular cataract extraction, intraocular lens implant)

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23
Q

the prognosis for cataracts is

A

excellent

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24
Q

macular degeneration is caused by

A

aging (ARMD- Age Related Mac Degeneration) or toxic drug effects

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25
Q

gradual/acute blurred vision, metaorphopsia, central scotoma, +/- decreased vision, amsler grid distortion

A

macular degeneration

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26
Q

metamorphopsia

A

wavy/ distorted vision

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27
Q

central scotoma

A

blind spot

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28
Q

drusen bodies

A

lipid deposits

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29
Q

drusen bodies, pigment mottling, geographic atrophy, vision loss slow/ gradual, uni or bilateral

A

Dry ARMD

30
Q

subretinal neovascular degeneration, subretinal fluid or blood, fibrosis/ scarring, rapid vision distortion, loss of central vision, usually unilateral

A

Wet ARMD

31
Q

macular degeneration tx

A

vitamins (antiox, zinc, omega 3’s), smoking cessation, daily amsler grid changes, photocoagulation, photodynamic therapy, intravitreal steroids/monoclonal antibodies, low vision aids, stop the offending drugs

32
Q

separation of retina from underlying epithelial layer

A

RD

33
Q

RD

A

retinal detachment

34
Q

posterior vitreous detachment, traumatic RD

A

rhegmatogenous RD

35
Q

traction RD (associated with DM), exudative (extremely rare)

A

nonrhegmatogenous RD

36
Q

painless, rapidly progresses, floaters, photopsias, complete/partial vision loss, curtain like vision loss, may be peripheral only, raised whitish retina, bilateral 20% of the time

A

retinal detachment

37
Q

photopsias

A

light flashes

38
Q

curtain like vision loss is from ___ to __

A

top to bottom

39
Q

emboli in artery, edema in the retina, the only place the retina does not line is fovea

A

cherry red spot

40
Q

worry about thrombotic events more in pts with

A

HTN

41
Q

tx of RD

A

Surgery: laser/cryo/ scleral buckle/ vitrectomy

42
Q

retinal vascular changes due to systemic HTN

A

hypertensive retinopathy

43
Q

asymptomatic, arteriolar narrowing, arteriolar sclerosis, AV crossing changes, nerve fiber layer infarcts, retinal hemorrhages, retinal edema/ exudates, disc edema

A

hypertensive retinopathy

44
Q

arterial narrowing looks like

A

copper wiring

45
Q

arteriolar sclerosis looks like

A

silver wiring

46
Q

AV crossing changes looks like

A

AV nicking

47
Q

nerve fiber layer infarcts look like

A

cotton wool spots

48
Q

hypertensive retinopathy tx

A

systemic BP control

49
Q

severe hypertensive retinopathy can cause

A

associated visual loss

50
Q

2 classifications of diabetic retinopathy

A

nonproliferative and proliferative

51
Q

blurred vision, retinal hemorrhage, retinal edema, macular edema, cotton wool spots, venous dilation, microaneurysms

A

nonproliferative diabetic retinopathy

52
Q

microaneurysms seen as

A

hard exudates

53
Q

neovascularization, preretinal and vitreous hemorrhage, subsequent fibrosis, traction retinal detachment, macular edema

A

proliferative diabetic retinopathy

54
Q

macular edema

A

retinal thickening and edema involving the macula

55
Q

preretinal and vitreous hemorrhage can cause ___ and subsequent ___

A

preretinal and vitreous hemorrhage can cause sudden blindness and subsequent fibrosis

56
Q

diabetic retinopathy tx

A

blood sugar control, laser photocoagulation, vitrectomy

57
Q

when you think about IOP also think about

A

hyphema and hypophyon

58
Q

central retinal artery occlusion is

A

embolic

59
Q

central retinal vein occlusion is

A

thrombotic

60
Q

CRAO

A

central retinal artery occlusion

61
Q

CRVO

A

central retinal vein occlusion

62
Q

acute TOTAL painless loss of vision, “black as night”, “no light perception”, afferent pupillary defect, whitening of retina, cherry red spot

A

CRAO

63
Q

acute VARIABLE painless loss of vision, variable vision, +/- afferent pupillary defect, “blood and thunder” retinal appearance

A

CRVO

64
Q

CRAO tx

A

no effective tx, eval etiology to prevent future strokes (carotid plaques, cardiac thrombi)

65
Q

CRVO tx

A

aspirin, observation, tx retinal edema/ischemia, eval etiology if young (severe HTN, hypercoagulable)

66
Q

acute inflammatory demyelination of the optic nerve

A

optic neuritis

67
Q

monocular vision loss over hours to days, central scotoma, painful, +/- abnromal color vision, +/- flashes of light, 1/3 visible papillitis with disc swelling

A

optic neuritis

68
Q

optic neuritis tx

A

MRI brain and orbits, IV methylprednisolone for severe loss or 2+ white matter lesions on MRI, no tx (improves in 2-3 weeks, typically 20/40 vision by one year)

69
Q

IV methylprednisone has a ____ recovery and ____ long term vision fxn in the tx of optic neuritis

A

IV methylprednisone has a MORE RAPID recovery and DOES NOT IMPACT long term vision fxn in the tx of optic neuritis

70
Q

when doing a history, think ___ and ___

A

when doing a history, think ACUTE and CHRONIC

71
Q

perform a careful eye exam and do not forget

A

vision

72
Q

when performing an eye exam, go from ___ to ___

A

outside to in

Unit 2- Clin Med (6 decks)

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