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Ophthalmology > 3: Macular and Retinal Disease > Flashcards

3: Macular and Retinal Disease Flashcards

(51 cards)

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1
Q

What is the most common cause of blindness

A

ARMD

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2
Q

In which population does age-related macular degeneration occur

A

Elderly

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3
Q

What are the 2 types of ARMD

A

Wet and Dry

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4
Q

What is the most common type of ARMD

A

Dry (90%)

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5
Q

What is dry ARMD

A

Macular degeneration caused by accumulation of drusen

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6
Q

What is wet ARMD

A

Macular degeneration caused by choroidal neovascularisation - leading to leakage of serous fluid and blood loss

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7
Q

What are 4 risk factors for ARMD

A

FH
Smoking
Age
CVD - DM, HTN, dyslipidaemia

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8
Q

Is ARMD unilateral or bilateral

A

Bilateral

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9
Q

Explain presentation of ARMD

A
  • Good visual acuity
  • Difficultly making-out images due to failing contrast
  • Difficultly recognising faces
  • Difficultly with night vision and changing conditions
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10
Q

What is a never event in ARMD

A

Peripheral fields will never be affected

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11
Q

What is a feature of wet ARMD

A

Metamorphosia

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12
Q

What is metamorphosia

A

Distortion of straight lines

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13
Q

What causes metamorphopsia

A

Due to disruption of retinal layers by fluid

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14
Q

What is a classic presentation in wet ARMD

A

Window frames will appear wonky

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15
Q

How is wet ARMD tested for

A

Amsler grid testing

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16
Q

How will fundoscopy present in dry ARMD

A

drusen

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17
Q

How will fundoscopy present in wet ARMD

A

red patches - sub retinal or intra-retinal haemorrhages

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18
Q

what does drusen indicate

A

degeneration of the axonal head

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19
Q

over what time period does wet ARMD develop

A

months

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20
Q

over what time period does dry ARMD develop

A

years

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21
Q

what investigations are ordered for ARMD

Study These Flashcards
A

Slit lamp microscopy

Fluorescein angiography

Ocular coherence tomography

22
Q

when is fluorescin angiography indicated

Study These Flashcards
A

If suspect wet-ARMD

23
Q

what accompanies fluorescin angiography

Study These Flashcards
A

indocyanine green angiography - to look for changes in choroidal circulation

24
Q

What is the problem with dry ARMD

Study These Flashcards
A

Little treatment can be offered

25
What is given for dry ARMD
Vitamins
26
What 4 vitamins are given in dry-ARMD
Zinc Vitamin A Vitamin E Lutein (ZEAL)
27
What investigations are ordered in wet-ARMD
Fluorescein angiography. Results are reviewed in 4-6W with optical coherence tomography.
28
What is given for wet ARMD
anti-VEGF
29
Name an anti-VEGF
bevacizumab
30
How often is bevacizumab or ranibizumab given
monthly
31
When is laser photocoagulation indicated
proliferation
32
Why is screening indicated
to identify proliferation
33
How is screening for wet-ARMD performed
Amsler grid testing
34
What are 2 methods to prevent wet-ARMD
Smoking cessation | Green vegetables
35
Does wet or dry ARMD have a worse prognosis
Wet ARMD
36
What visual field defect will be present in ARMD and why
central scotoma
37
What time frame does dry ARMD present
gradual progressive visual field loss
38
What time frame does wet ARMD present
insidious over weeks-months
39
What is a vitreous haemorrhage
collection of blood in vitreous body
40
What are the two 'groups' of causes of vitreous haemorrhage
- due to rupture of neovascularisation vessels secondary to ischaemia - rupture physiological vessels
41
What are two causes of vitreous haemorrhage due to rupture of 'neovascularisation'
diabetic retinopathy | central retinal vein occlusion
42
What is the most common cause of vitreous haemorrhage
diabetic retinopathy
43
What are two causes of vitreous haemorrhage due to rupture of physiological vessels
PVD | Retinal tear
44
Describe symptoms of vitreous haemorrhage
- Sudden monocular vision loss - Some report 'red' colour before this - visual loss or floaters may be worse after sleep
45
Why are floaters or visual worse following sleep
as when lying down blood collects at the back of the eye covering the macula
46
What are two signs vitreous haemorrhage
No RAPID | No red reflex
47
What 2 investigations are ordered for suspected vitreous haemorrhage
Slit lamp microscopy | US Scan
48
What is slit lamp microscopy used for
Detect blood
49
What is US used for
Look for retinal tear
50
How does vitreous haemorrhage usually repair
Often blood reabsorbs - cause of watching and waiting
51
If a large vitreous haemorrhage what may be required
Vitrectomy

Ophthalmology (12 decks)

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