Basic Eye Disorders 1

Question 1

Cataracts affects which population?

Answer 1

1 in 2 elderly

Question 2

Cataract is due to _____ damage to the lens proteins that reduce _____.

Answer 2

• oxidative
• solubility

(insoluble OPACITIES form in otherwise transparent tissue)

Question 3

In cataract, ________ w/in lens causes clouding of vision and progressive vision loss.

Answer 3

protein clumping (coagulation and crystallization)

Question 4

Senile cataracts is _______ (unilateral/bilateral) and has a ______ appearance.

Answer 4

• unilateral or bilateral
• radial

Question 5

Cataracts has 3 main pathophysiologic causes*** (***different than risk factors; see chronic vision loss)

(other than idiopathic)

Answer 5

1. congenital/viral
2. chromosomopathy (trisomy 21)
3. inborn error of metabolism

Question 6

First dx test done if you suspect cataracts

Answer 6

pin hole

Question 7

pin hole test

Answer 7

visual acuity chart through a pin hole, if it improves then nothing wrong w/ macula or retina.

Question 8

How is cataracts dx?

Answer 8

Examining fundus: reduced or obstructed red reflex

Question 9

Diabetic retinopathy occurs in almost all ______ patients and the majority of _____ patients

Answer 9

• DMT1
• DMT2

Question 10

Diabetic retinopathy affects 1 in _____.

Answer 10

2,500

Question 11

______ are particularly affected by increased blood sugar and lose the ability to auto-regulate.

Answer 11

Vascular pericytes

Question 12

hemorrhage over the macula will lead to _______.

Answer 12

sudden vision loss

Question 13

What causes cotton-whool spots?

Answer 13

retinal capillaries infarct → hypoxia

(possibly infarct of neuron → mitochondrial accumulation at the swollen ends)

Question 14

neovascularization (diabetic retinopathy) is the result of _______.

Answer 14

ischemia

Question 15

What is the main difference in proliferative vs. non-proliferative diabetic retinopathy

Answer 15

neovascularization

(proliferative can hemorrhage→visualized with green slit)

Question 16

diabetic retinopathy occurs 10-15 years after dx, and chronic retinal problems can lead to ________.

Answer 16

retinal detachment → sudden vision loss

(TQ!!)

Question 17

visual acuity in patients with diabetic retinopathy depends on ______.

Answer 17

involvement of the macula

Question 18

Non-proliferative diabetic retinopathy is treated with _______; proliferative is treated with ________.

Answer 18

• surgery (temp. improvement)
• anti-VEGF

Question 19

How do you measure the anterior chamber depth

Answer 19

ophthalmoscopy: measure the distance between the iris reaction and the cornea

Question 20

a shallow anterior chamber indicates ________.

Answer 20

glaucoma

Question 21

3 Most common causes of red eye

Answer 21

1. Keratoconjunctivitis
2. uveitis
3. Acute Glaucoma (side of face hurts, medical emergency)

Question 22

Who does closed angle glaucoma affect (2)

Answer 22

1. asians
2. pts w/hyperopia

Question 23

MC cause of viral conjunctivitis and kerititis

Answer 23

adenovirus

(also HSV & VZV)

Question 24

Cobblestoning of the conjunctiva, watery discharge and an abrupt onset indicates ________.

Answer 24

viral conjunctivitis

Question 25

***_Eosinophils_*** are found in _____ (allergic/bacterial) conjunctivitis and keratitis; ***_neutrophils_*** are found in ________ (allergic/bacterial).

Answer 25

* allergic * bacterial

Question 26

herpes keratoconjunctivitis usually affects which population?

Answer 26

1. children 2. neonates

Question 27

Hutchinson sign

Answer 27

lesions on nose, related to herpes zoster conjunctivitis and keratitis

Question 28

\_\_\_\_\_\_\_\_ (microbe) seen in patients who use tap water to clean their contacts

Answer 28

acanthamoeba

Question 29

MC cause of vision loss in the elderly?

Answer 29

dry macular edema | (1 in 40 white females)

Question 30

Macular degeneration is always ______ (unilateral/bilateral)

Answer 30

bilateral

Question 31

How are drusen visualized on fundoscopic exam?

Answer 31

green light filters out red, blue filters out yellow

Question 32

Dry macular degeneration presents with ______ (slow/sudden) vision loss

Answer 32

slow

Question 33

Dry form of macular degeneration is due to idiopathic \_\_\_\_\_\_\_\_\_.

Answer 33

disintegration of retinal pigment epithelium & loss of overlying photoreceptors

Question 34

Wet form of macular degeration is \_\_\_\_\_\_\_\_(slow/sudden)

Answer 34

can be either progressive or sudden

Question 35

Patient states, “I see worse in the middle of my vision.” What do you suspect?

Answer 35

Wet form of macular degeneration

Question 36

Lack of visual acuity w/pinhole indicates _______ involvement.

Answer 36

retina (seen in wet form of macular degeneration)

Question 37

Optic neuritis is strongly associated with _______ (diz)

Answer 37

MS | (precedes MS by a few years)

Question 38

optic neuritis may simulate \_\_\_\_(diz).

Answer 38

glaucoma

Question 39

optic neuritis presents with ____ (2) due to inflammation of the optic nerve.

Answer 39

1. papilledema 2. pale white disc where margin is obscured

Question 40

A woman comes in with numbness in her arm, a headache and has papilledema. Dx?

Answer 40

optic neuritis

Question 41

Head MRI of a patient with optic neuritis may reveal \_\_\_\_\_\_.

Answer 41

optic nerve demyelination