Ophthalmology Clinical Flashcards

1
Q

Age related, any time after age 50, usually greater than 70. Presents with decreased central vision. What are the two types?

A
  • Dry macular degeneration (Nutritional recommendations, AREDS supplements; antioxidants, luteine)
  • Wet macular degeneration (growth of blood vessels under/in retina, edema and hemorrhage, eventual fibrosis and scarring; anti-vegf drugs and lasers)
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2
Q

Increased ocular pressure causes optic nerve loss. What are the two main types?

A

Glaucoma

  • Open angle (trabecular meshwork goes bad)
  • Narrow angle (acute/closed angle); medical emergency! Pilocarpine 15 minutes and azetazolamide and then laser iridotomy

*treatment is to lower eye pressure (medical, surgical, laser). Check the cup/disc ratio! Larger cup over time can indicate worsening of glaucoma, asymmetry is common in glaucoma.

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3
Q

How does diabetic retinopathy occur?

A

Increased glucose damages blood vessel walls, causing VEGF to be released. Fluid leaks into retina, causing visual damage.

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4
Q

What are the three clinical stages of diabetic retinopathy?

A
  • Nonproliferative diabetic retinopathy (NPDR): blot hemorrhages, cotton wool spots, micro aneurysms, macular edema, hard exudates
  • Preproliferative diabetic retinopathy: more significant; intraretinal vascular abnormalities and venous beading
  • Proliferative diabetic retinopathy (PDR): neovascular vitreoretinopathy, vitreous hemorrhage

*treat with pan-retinal photocoagulation (laser)

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5
Q

How often do diabetics need eye exams?

A
  • Type II at diagnosis and annually thereafter

- Type I annually after 5 yrs of disease duration, more freq if develop retinopathy.

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6
Q

Narrowing and sclerosis of arterioles, flame hemorrhages, cotton wool spots, optic nerve edema in severe cases.

A

Hypertensive retinopathy. Treat by keeping BP down.

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7
Q
  • Sudden loss of vision in one eye
  • Generally lasts only minutes
  • Painless
  • Embolic material within retinal arteriole (Hollenhorst plaque)
A

Amaurosis fugax. Usually temporary vascular insufficiency, req cardio workup first and optho eval second.

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8
Q

Hallmark is scintillating scotoma

  • painless and temporary
  • involves both eyes causing temporary hemianopsia
  • Lasts 20-30 minutes
  • kind of looks like heat waves
A

Opthalmic migraine: spasm of arteriole in the occipital cortex.

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9
Q
  • Sudden partial vision loss in one eye
  • Painless
  • May be progressive, always sustained (does not resolve spontaneously)
  • Often accompanied by floaters and photopsias (flashes)
  • Higher frequency in myopia
  • Usually spontaneous
A

Retinal detachment. Refer to optho for surgery.

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10
Q
  • Sudden severe loss of vision in one eye
  • Painless
  • Vision loss usually perm, may recover if treated rapidly
  • Cherry red spot
A

Retinal arterial occlusion. Can breathe into paper bag to inhale carbon dioxide and dilate vessels.

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11
Q

Squashed tomato look

A

Central retinal vein occlusion

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