Cardiovascular Disease: Name three cardiovascular related causes of eye disease/damage?
- Diabetes - Hypertension - Vascular Occlusion
Describe the effect of diabetes on the eyes?
Causes diabetic retinopathy Microvascular changes due to poor glucose control There is proliferative of new vessels which can bleed causing cloudy vision and destruction of the retina
Symptoms of diabetic retinopathy?
Microaneurysms (Dot and Blot Haemorrhages) Cotton Wool Spots Hard Exudates
What does this picture show?
Cotton Wool Spots
What does this picture show?
What does the picture show?
Dot and Blot Haemorrhage
What does the red arrow show?
Affect of diabetic retinopathy on vision?
Blurred/Cloudy Vision Vision Loss Blindness
Describe the categories of diabetic retinopathy?
- No retinopathy - Mild } - Moderate } Non-Proliferative Retinopathy - Severe } - Proliferative Retinopathy
Treatment for diabetic retinopathy?
- Laser Treatment - Eye Injections (Anti-VGEF) - Surgery (Removal of some vitreous)
Describe affect of hypertension on the eyes? Who does this affect most?
Hypertension can cause damage to the eyes and retinopathy More damaging in young than in elderly (elderly have atherosclerotic retinal vessels)
Signs of hypertensive retinopathy?
- Silver or copper wiring - Cotton wool spots - Hard exudates - Retinal Haemorrhage - Optic Disc Oedema
What is accelerated hypertension?
This is seen in young patients Rapid acceleration in hypertension Causes damage to the retina and loss of vision
Describe central retinal artery occlusion? Symptoms and Signs?
Blockage of the main artery of the retina This is sudden loss of vision - Profound loss - Painless - Cherry Red Spot
If you saw a cherry red spot, what would you think?
Central Retinal Artery Occlusion
What is this?
Central Retinal Artery Occlusion - Notice the cherry red spot
Describe central retinal vein occlusion? Symptoms and signs?
Blockage of the main vein of the retina This causes sudden visual loss - can range from mild to severe May or may not cause ischaemia Symptoms: - Blurred vision - Loss of vision - Painless - Floaters Signs: - Extensive Haemorrhages
What is this? Cause?
Extensive Haemorrhage Caused by central retinal vein occlusion
Describe branch retinal vein occlusion?
Painless loss in vision caused by the occlusion of a branch of the vein that supplies the retina Patients may notice part of their visual field lost or may be asymptomatic
Name three inflammatory diseases that can affect the eye?
- Granulomatosis Disease - Giant Cell Arteritis - Thyroid Disease
Describe the link between sarcoidosis the eyes?
Sarcoidosis can cause inflammatory eye disease Causes anterior uveitis
Causes of anterior uveitis?
Infective - Herpes Simplex - Herpes Zoster - TB Non-Infective - Sarcoidosis - Idiopathic - Rheumatoid Arthritis
What is giant cell arteritis? Symptoms?
This is inflammation of the large and medium sized arteries Also called temporal arteritis Symptoms include headache, jaw claudication, visual loss and malaise
Describe Thyroid Eye Disease? Symptoms of thyroid eye disease?
This is thyroid disease (systemic) having local effects on the eye. Symptoms - Proptosis (Protruding eyes) - Lid Lag - Chemosis of anterior segment Can cause glaucoma
What characterises Thyroid Eye Disease?
Swelling of extra ocular muscles and orbital fat
What is the most common cause of bilateral and unilateral proptosis?
Thyroid Eye Disease
Treatment of thyroid eye disease?
- Treat underlying thyroid disease - Ocular Lubricants (Dry Eyes) - Surgical Decompression
Describe connective tissue diseases that affect the eye?
SLE Rheumatoid Arthritis Marfans
Describe SLE and the eye? What immunological tests do you do to confirm SLE?
SLE is a multi-systemic immunological disease ANA and Anti-dsDNA Causes ocular inflammation
Describe rheumatoid arthritis and the eye?
Causes keratoconjunctivitis sicca (dry eye) May also lead to scleritis and corneal melt