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MODHIII - Unit 3 > Diseases of the Eye > Flashcards

Flashcards in Diseases of the Eye Deck (54)
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1

Xeropthalmia: where does it occur

- primarily in developing country due to diet low in vitamin A

2

Why does vitamin A cause xeropthalmia

- vitamin A necessary for cells of conjunctiva, which produce mucus of tear film

3

Xeropthalmia: disease process

- chronic reduction in corneal tear film leads to loss of corneal transparency and in growth of blood vessels

4

Xeropthalmia is exacerbated by what disease in children

- measles

5

Treatment for Xeropthalmia

- limited
- corneal transplant results are poor

6

Other effect seen in Xeropthalmia

- vitamin A deficiency also affects rod photoreceptors, can lead to night blindness

7

Similar outcomes of xeropthalmia due to other causes

- observed in individuals with chemical or thermal corneal burns or chronic breakdown of corneal epithelium (dry eye, diabetes complications)

8

Keratoconus: incidence & who it effects

- incidence: 1/2000; typically BILATERAL
- associated with down syndrome, marfan syndrome

9

Keratoconus: disease process

- progressive thinning and ectasia of the cornea; occurs in ABSENSE of inflammation of vascularization
- results in a cornea with a conical shape

10

Treatment for keratoconus & exacerbation

- difficult with glasses
- corneal transplantation has high degree of success
- exacerbated by eye rubbing; should be discouraged

11

Corneal Dystrophies

- heterogenous condition
- Fuchs Endothelial Dystrophy

12

Fuchs Endothelial Dystrophy: early and late

- early: enothelial cells produce guttata (raised wart like growths)
- late: endothelial cells die

13

Fuchs endothelial dystrophy: cause

- loss of endothelial cells, which results in edema and bullous keratopathy (stomal swelling)

14

Vitamin A deficiency leads to what disease

- Xeropthalmia

15

Metabolic Diseases

- heterogenous
- hunter's and hurler's syndrome

16

Metabolic diseases: disease process

- deposition of compounds in various parts of the body where they should not be
- may affect cornea, retina, and/or optic nerve

17

Metabolic diseases: treatment

- corneal transplant is an option, but many diseases affect retina and optic nerve as well, which would not help visual outcomes
- hematopoietic stem cell transplants may help improve corneal clearity

18

Treatment for corneal damage and disease

- eye drops & topical lubricating ointments: problem with compliance
- amniotic membrane transplant
- corneal transplant
- artificail corneal-boston keratoprosthesis (KPro): will develop glaucoma, risk of retinal detachment

19

Cataract: disease process, causes, treatment

- loss in lens transparency
- causes: congenital or acquired-drugs(corticosteroids), genetic, infections of mother during pregnancy, biochemical disorders
- early treatment important for children with congenital cataract, outcomes are typically good

20

Glaucoma: basics

- visual field loss from peripheral to central
- most due to high IOP but normal & low tension glaucoma exist
- can be open-angle or closed angle and primary or secondary

21

Importance of IOP in glaucoma

- high IOP is a risk factor for glaucoma, not guaranteed to get it if you have IOP

22

Primary open angle glaucoma

- iridocorneal angle is open; few changes is trabecular meshwork
- most genes unknown

23

Secondary open angle glaucoma

- angle is open but is occluded
- example: pseudoexfoliation glaucoma - pigment from iris breaks off and blocks the angle

24

Primary angle closure glaucoma

- angle is closed, reducing aqueous humor outflow
- iris pushes forward angle narrows or closes
- typically found in hyperopic individuals w/ shallow anterior chambers

25

Secondary angle closure glaucoma

- results from pathologies that draw iris over trabecular meshwork
- medical emergency****

26

Treatments for glaucoma

- nothing new since the 80s
- only approved treatments rely on reduction of IOP
- eye drops: many different types & can be combined
- sugery

27

Treatments for glaucoma: eye drops

- beta blockers: decrease amount of aqueous humor produced
- prostaglandin analogs: increase the outflow from the eye
- carbonic anhydrase inhibitors: decrease production of intraocular fluid
- alpha agonists: decrease production and increase drainage of fluid

28

Treatments for glaucoma: surgery

- laser trabeuloplasty: increases drainage of the angle in POAG
- iridotomy: laser treatment for narrow angle glaucoma that creates tiny holes in the iris
- operative shunt: creates bypass drainage channel to lower eye pressure

29

Age related macular degeneration: result, forms

- results in damage to macula
- occurs in dry or wet form
- dry: characterized by drusen deposits in Bruch membrane
- wet: neoangiogenesis (absent in dry form)

30

Treatment for dry AMD

- NO TREATMENT

31

Treatment for wet AMD

- injection of VEGF antagonists into vitreous every 3 months
- risk is needle being put into retina every 3 months

32

Diabetic retinopathy: types

- non proliferative & proliferative

33

Diabetic neuropathy: cause

- result of damaged blood vessels

34

Non-proliferative DR: why non proliferative & abnormalities seen

- non proliferative b/c eye doesn't make new blood vessels during eary stage of disease
- microaneurysms, breakdown of blood retinal barrier, macular edema

35

Non proliferative DR: exudate location

- exudates occur in outer plexiform layer
- may have micro occlusions

36

Proliferative DR

- characterized by neovascularization of optic nerve head or retina
- may have hemorrhage; vitreous detachment

37

Retinal detachment: disease process & types

- separation of neural retina from retinal pigment epithelium
- non rhegmatogenous: without a break in retina-vitreous border
- rhegmatogenous: with a break of retina-vitreous border

38

Retinal detachment: causes & treatment

- causes: typically associated with trauma
- treatment: laserpexy or cryopexy to reattach retina + virectomy + gas to press retina to the globe
- outcomes are typically good

39

Retinitis pigmentosa: cause, affect, treatment

- inherited condition, 1/3600 incidence
- affects rods, cones, and or RPE
- affects peripheral vision first and early night blindness
- NO treatments

40

Retinal artery occlusion

- sudden unilateral visual loss
- results in diffuse infarct of retina
- PALLOW OPTIC DISK AND CHERRY RED FOVEA
- varied treatments to reduce occlusion

41

Retinal vein occlusion

- sudden unilateral vision loss
- results in diffuse infarct of retina
- OPTIC DISK SWELLING, RETINAL HEMORRHAGE AND DIALTED VEINS

42

Compressive optic neuropathy: cause, associated with, treatment

- results from pressure on the optic nerve in orbit
- associated with Grave's disease or neoplasm affecting orbit
- treatments: removal of neoplasm, orbital decompression, CORTICOSTEROIDS

43

Optic neuritis: key feature

- orbital or ocular pain when moving eyes

44

Optic neuritis: process

- loss of vision secondary to demyelination and inflammation of optic nerve

45

Optic neuritis: result, cause, treatment

- results in scotoma of visual field
- cause: MULTIPLE SCLEROSIS, infection, autoimmune, drug induced
- treatment: corticosteroids does NOT show long term benefit

46

Anterior ischemia optic neuropathy: types

- non arteritic
- arteritic

47

Anterior ischemia optic neuropathy: non arteritic cause

- results from CV risk factors in patients w/ crowded optic disks
- most cases are idiopathic

48

Non arteritic AION: disease process

- isolated white matter stoke in optic nerve
- sudden unilateral visual loss
- optic disk edema
- MORE COMMON

49

Non arteritic AION: treatment

- high dose corticosteroids may be useful, no consensus

50

Arteritic AION: cause

- due to temporal arteritis
- inflammation of medium sized blood vessels
- occurs with advancing age

51

Arteritic AION: result and treatment

- results in complete vision loss in one eye, followed by other eye if left untreated
- treatment: long course of corticosteroids

52

Posterior ischemia neuropathy: when is ti diagnosed

- disease of occlusion
- rule out all other disease then say it's this

53

Posterior ischemia optic neuropathy: affect, cause

- affects retrobulbar portion of optic nerve
- occurs in patients with HTN, diabetes, smokers
- can occur as complication of spinal surgery
- due to decreased blood flow, leading to death of optic nerve cells

54

Posterior ischemia optic neuropathy: disease process

- death of optic nerve cells causes inflammation, which compresses optic nerve in the optic canal