Common Causes of Vision Impairment Flashcards
(38 cards)
1
Q
which visual acuity scores are indiciative of
- no / mild visual impairment?
- moderate visual impairment?
- severe visual impairment?
A
- mild to none: 20/30 - 20/50
- moderate: 2/70 or worse
- severe: 20/200 or rose
2
Q
following an eye complaint, a physician should complete what examinations before consulting a specialist?
A
- Visual acuity testing of each eye individually
- Confrontation visual field testing
- Extraocular motility
- Pupillary reaction
- Tonometry (pressure)
- Ophthalmoscope
3
Q
corneal abrasian
- causes
- clinical presentation
- workup
- treatment
A
- causes: trauma, contacts
- clinical presentation: foreign body sensation, redness / pain
- work-up: f_lourescein staining_
- treatment:
-
psuedomonas covering topical Abx:
- CLS
- fluoroquinilones
- cyclopentate / atropine - for comfort
-
psuedomonas covering topical Abx:
4
Q
what should not be used to to treat corneal abrasian?
A
numbing drops - tetracaine / procrainamide
these can inhibiting growth & healing of corneal epithelium
5
Q
discuss the protocols for prescribing the following ocular treatment
- numbing drops
- topical steroids
A
- numbing drops (procainamide / tetracaine) - NEVER
- topical steroids - only by an eye doctor specifically
6
Q
fill out
A
7
Q
viral conjunctivitis
- clinical presentation?
- type of disarchage?
- inflammation pattern?
- other exam findings
- treatment
A
- presentation: presents with cold sx +/- migrates from one eye → other
- discharge: watery
- inflammation: follicular pattern
- other exam findings: swollen pre-auricular lymph nodes
- treatmentL: typically no meds (is self limited)
8
Q
viral conjunctivitis
- clinical presentation?
- type of disarchage?
- inflammation pattern?
- other exam findings
- treatment
A
- presentation: recent cold sx +/- migrates from one eye → other
- discharge: watery
- inflammation: follicular pattern
- other exam findings: swollen pre-auricular lymph nodes
- treatmentL: typically no meds (is self limited)
9
Q
bacterial conjuncitivitis
- clinical presentation?
- type of discharge?
- inflammation pattern?
- other exam findings
- treatment
A
- presentation: no cold sx
- discharge: mucopurulent
- inflammation: papillary reaction
- other exam findings: n/a
- treatment: topical Abx + consider STIs
10
Q
which STIs are common causes of bacterial conjuncitivis?
how are they different?
how are they treated?
A
- chlamydia - chronic, indolent
- gonococcal - virulent, dangerous
systemic treatment
11
Q
allergic conjunctivitis
- clinical presentation
- treatment
A
- presentation: bilateral itching in young patients
- treatment:
- cool compresses
- artificial tears
- topical / oral: anti-histamines, mast cell stabilizers
12
Q
what is the most common cause of conjunctivitis?
A
viral
13
Q
herpes keratitis
- clinical presentation
- inflammatory reaction
- other exam findings
A
- presentation: foreign body sensation + pain/redness
- inflammatory reaction: follicular
- other exam findings: dendritic branches on flourescein staining
- treatment: anti-virals + referring to opthalmology
14
Q
herpes zoster opthalmicus
- presentation
- treatment
- complications
A
i.e., herpez zoster keratititis
- presentation: unilateral painful rash over CN V area, including multiple crusted blisters on nose
- treatment: oral anti-virals within 72 hours + urgent referral to optho
- complications: post-herpetic neuralgia
15
Q
corneal ulcer from infectious keratititis
- causes
- presentation
- treatment
A
- causes: bacterial m/c, consider herpes, fungal, acanthamoeba
- treatment: based on etiologic agent. NO STEROIDS - they worsen fungal & acanthamoeba causes
16
Q
identify
A
viral conjuncitivitis
watery discharge
follicular reaction
17
Q
identify
A
bacterial conjuncitivits
mucopurulent discharge
papillary reaction
18
Q
identify
A
herpes keratitis
dendritic branching (flourescein staining)
19
Q
- identify
- explain cause
- note the treatment
A
- herpes zoster opthalmicus (keratitis)
- reactivation of VZV via nasocilliary nerve
- treatment: ORAL antivirals within 72 hours + urgent optho referral to prevent post-herpetic neuralgia
20
Q
identify
A
corneal ulcer
21
Q
presbyopia
- definition
- cause
- treatment
A
- definition: age-related far-sightedness (can’t see near)
- cause: hardening of lens throughout aging → inability to acomodate
- treatment: reading glasses + reassurance
22
Q
ambylopia
- definition
- cause
- work-up
A
- ambylopia: delayed eye movement - “lazy eye”
- causes: m/c = strabismus - poor ocular alignment
- work-up:
- cover test / uncover test
- brucker screening test
- deviated eye = whiter / brighter reflex
23
Q
what is this test?
what is showing?
A
bruckner screening test - dx of ambylopia
deviated eye = whiter / brighter reflex
24
Q
define & identify the cause of
- myopia
- hyperopia
- astigmatism
A
25
cataracts
* definition
* cause
* treatment
* definition: painless clouding of the lens
* cause: **aging m/c**
* treatment: surgery
26
glaucoma is the ___ cause of blindness in the US?
2nd leading
27
what are the _risk factors_ for primary open angle glaucoma?
* **increased IOP**
* **increased cup:disc ratio**
* **increased age**
* thinner central corneal thickness
* family hx - *6x inc w/ 1st degree relatives*
* AA - *6x higher \> caucasions*
28
what is normal intraocular pressure (IOP)?
10-21
29
what exam findings are evident of increased cupping of the optic nerve?
* enlarged, hollow spot on disc
* C:D ratio \> 0.5
* assymetry
30
physicians should _check what things_ if suspicious of primary angle glaucoma?
* visual fields
* intraocular pressure - IOP \> 21
* optic nerve cupping - C:D ratio \> 5, assymetry, hollow disc spot
31
primary open angle glaucoma - treatment
**all target lowering IOP:**
* eye drops that reduce production / increase outflow of aqueous humor
* laser procedures / other surgeries
32
which glaucoma eye drops
* decrease aqueous humor synthesis
* increase aqueous humor outflow?
decrease production
* alpha agonists - epinephrine (a1), brimonidine (a2)
* b-blockers - olols: timolol, carteolol, betaxolol
* diuretics - acetazolamide
increase outflow
* cholinomimetics - physiostigmine, pilocarpine, carbachol
* prostaglandins - prosts: bimatoprost, lataoprost
33
place the glaucoma eye drops in their correct position in the cart
34
age related macular degeneration (AMD)
* epidemiology
* cause
* risk factors
* exam finndings
* treatment
* epidemiology: leading cause of irreversible central visual loss amongst people \> 50 in the US
* presentation: **metamorphopsia (distortion) → scotoma (vision loss)**
* cause: macula has **high [] of cones centrally** → **fine detailed central vision**
* exam findings:
* **drusen:** yellow lipid & protein deposits
* **wetness:** choroid neovascularization
* risk factors:
* **smoking**
* **HTN**
* **nutrition**
* treatment:
* dry AMD: high dose anti-oxidants + smoking cessation / lifestyle changes
* wet AMD: anti-vascular endothelial growth factor intraocular injection
35
age related macular degeneration (AMD) is the leading cause of ___ ?
irreversible central vision loss amongs people \> 50 years in the US
36
what major risk factors pre-dispose AMD?
* smoking
* HTN
* nutrition
37
what is the treatment for dry AMD?
* high dose antioxidants
* smoking cessation + other lifestyle changes
38
what exam finding is indicate of wet AMD?
what is the mainstay treatment for wet AMD?
what are the pros / cons of this treatment?
* finding: choroidal neovascularization
* mainstay tx: **anti-vascular endothelial GF intraocular injection**
* ****cons:
* requires monthly visits
* requires many needles
* high tx burden for elderly patints
