visual and sensory

Question 1

cataracts

Answer 1

cloudy lens
gradual onset of painless blurry vision, blindness if untreated
rf: old age, trauma, congenital risk, premies, DM, corticosteroids, smoke and OH

Question 2

cataracts: cm

Answer 2

painless
uni or bilateral change = blurry, halo around lights, altered color perceptions, glare issues at night, decreased accomodation

Question 3

retinopathy: DM - non proliferative

Answer 3

capillary microaneurysms, retinal swelling, hard exudate
macular edema - plasma leaks from macular blood vessels
capillaries rupture, leading to dot or blot hemorrhaging

Question 4

retinopathy: DM - proliferative

Answer 4

advanced retinopathy - same complications as non proliferative +
new blood vessels are fragile and leaky

Question 5

retinopathy: htn

Answer 5

high BP creates blockages in retinal blood vessels
initially no vision changes
sustained, sudden severe htn can cause sudden visual loss related to swelling of the optic disc and nerve
normal vision is restored with treatment of htn

Question 6

detached retina

Answer 6

tear or leak
vitreous humor flows behind retina
rapid, progressive detachment from choroid
usually spont: more likely with myopia (nearsidedness), >40, trauma to head (eye tumor, complication or hx of cataract sx)
cm: sudden unilateral vision loss, painless, floaters, flashes of light

Question 7

macular degeneration

Answer 7

age related
dry (non exudative) = drusen (yellow) buildup in retinal pigment epithelium
wet (exudative) = buildup of blood vessels and hemorrhage, blood vessels are leaky and in abn location

Question 8

macular degeneration: rf

Answer 8

fam hx, genetics, UV light, hyperopia (far sightedness), smoking, light colored eyes
dark green leafy veggies protective

Question 9

macular degeneration: cm

Answer 9

no s early on
later = blurred, dark vision, blind spots (scotomas), distorted vision (metamorphosia)
vision wont improve, tm limited - some meds injected into eye

Question 10

glaucoma

Answer 10

high IOP and vision change or optic nerve damage
chronic
usually bilateral

Question 11

glaucoma: open angle

Answer 11

rf = high IOP, OA, AA, fam hx, myopia, DM, htn, migraines
still have some flow
abn trabecular meshwork: reduced drainage of aqueous humor into canal of schlemm, imbalance btw inflow and outflow
results in increased IOP and vision problems
cm: usually none, progressive loss of sight, vague eye pain, halos, tunnel vision

Question 12

glaucoma: closed angle

Answer 12

aka acute angle closure glaucoma, narrow angle glaucoma
much less common
abn angle btw iris and later cornea
outflow blocked when pupil dilated
rf = asian american, F, hyperopia, fam hx, older age
emergency!: outcome based on time from onset to treatment, triggers = anticholinergic drugs
cm = usually unilateral (other eye is at risk), sever eye pain, n/v, blurry vision, halos, red eye, dilated pupil non reactive to light, cloudy cornea

Question 13

glaucoma: blindness

Answer 13

due to increased IOP -> more P on inner eye structures, decreased BF to optic nerve, nerve fiber death -> blind

Question 14

glaucoma: pharm

Answer 14

drugs decrease aqueous humor production, increase drainage, or both
sx for acute angle crisis
optic topical agents: keep localized with nasolacrimal P -> prevent systemic SE, hole P 2 min

Question 15

meniere disease

Answer 15

endolymphatic hydrops
episodic disorder of middle ear
20-40 yr
uni or bilateral
excessive endolymph and P in membranes disrupt vestibular (balance) and hearing function
cm = recurring episodes of vertigo (w/o n/v), hearing loss, ringing (tinitus), feeling of fullness, 1 ear or both
treat s (dizzy), usually need Na restriction