All Flashcards
Management of diabetic retinopathy?
Good diabetic control
Fenofibrate (50% red in diabetic retinopathy over 4yrs; delays progression)
Laser to reduce ischaemic stimulus
Anti-VEGF (intravitreal injection) = Bevacizumab
Lipid deposits around the eye
Xanthelasma
Mx: local surgical removal
Most common cranial nerve palsy in diabetics?
6th cranial nerve palsy
But can get diabetic 3rd cranial nerve palsy = SPARE THE PUPIL!!
- ptosis
- lateral deviation of the eye
- pupil normal (unlike posterior circulation aneurysm)
“No SPECS” for thyroid eye disease
Progression of thyroid eye disease:
No - no signs or symptoms; signs but no symptoms
S - soft tissue involvement
P - proptosis (prominent eyes)
E - EOM involvement (thickened medial rectus)
C - Corneal involvement from exposure
S - sight loss from involvement of optic nerves
- thickened medial rectus = can’t look straight ahead
- tendons are spared in thyroid eye disease vs infiltrative/lymphoma where muscles and tendons are involved
Pituitary field loss?
Bitemporal field loss
Retinal changes in hypertension?
Arterial narrowing Copper wiring Retinal vein occlusion (compression) Haemorrhages Cotton wool spots Exudate
Malignant HTN = swelling of optic disc
What is the difference between non-proliferative and proliferative diabetic retinopathy?
NPDR = no new blood vessels formed
- minimal = isolated microaneurysms only (12mo r/v)
- mild = microaneurysms and retinal haemorrhage (6mo r/v)
- moderate = haemorrhages and microaneurysms in >1/4 and cotton wool spots or venous bleeding (3-6mo r/v)
- severe = intraretinal micro vascular abnormalities in >1/4 and microaneurysms/haemorrhages in 4/4 (urgent r/v)
PDR = new blood vessel growth covering >1/3 disc with haemorrhage (urgent r/v)
Most common eye manifestation of RA?
Keratocinjunctivitis sicca (dry eyes)
In what conditions do you see Kaisler-Fischer rings?
Wilson’s disease**
Chronic active hepatitis
Primary biliary cirrhosis
