Disorder of the Retina Flashcards
(31 cards)
A pt comes in with eye pain, blurred vision, redness, and decreased visual acuity. You notice the pt also has inflammation of the retina. What is the most likely diagnosis for this pt?
Posterior uveitis
A pt comes in complaining of eye pain and decreased vision. On the physical exam you notice inflammation of the vitreous, erythema, and hypopyon. What are the likely causes of this pt’s disorder?
Autoimmune disease Inflammatory bowel disease Syphilis TB Multiple sclerosis (pt has posterior uveitis)
What are the treatment options for posterior uveitis?
Treat the underlying condition
Systemic steroids (anti-inflammatories)
Abx if suspect infection
URGENT ophthalmologist referral
A pt comes in with unilateral blurry vision. You notice redness in one eye along with decreased visual acuity. What is the most likely cause of this pt’s condition?
Infection
pt has choroiditis
How do you treat choroiditis?
Treat underlying infection
Steroids if non-infectious
Refer to ophthalmologist
What are the 3 forms of diabetic retinopathy?
Proliferative diabetic retinopathy
Diabetic macular edema
Ischemia of the macula
A pt comes in complaining of a sudden decrease in vision. She says she sees a lot of floaters, almost like a shower, and has two blind spots. On the physical exam you notice neovascularization and loss of the red reflex. What is the most likely diagnosis?
Proliferative diabetic retinopathy
A 65-year old male comes in complaining of a loss of vision over the past few weeks. He has floaters, and on the physical exam you notice neovascularization, preretinal hemorrhages, and cotton wool spots on the retina. What treatment would you recommend for the pt?
Glycemic control!
Retinal laser photocoagulation to adhere the retina to the choroid
(the pt has proliferative diabetic retinopathy)
What are the causes of proliferative diabetic retinopathy?
Compromised retinal perfusion
Retinal ischemia leads to neovascularization
A pt comes in with decrease of vision in her left eye. You notice an opaque macula and microaneurysms. What is the best treatment for this pt?
Refer to an ophthalmologist
pt has diabetic macular edema
“Copper wiring” and “silver wiring” are associated with what condition?
Hypertensive retinopathy
A pt comes in with slightly blurred vision and diplopia. You notice arteriolar narrowing and AV nicking. What is the most likely cause of this pt’s condition?
Thickened vessel walls
Narrow lumen
(pt has hypertensive retinopathy)
A pt presents with suddenly decreased vision and a blind spot. You notice cotton wool spots on the retina and the vessels appear sclerotic. What condition is this likely to be?
Hypertensive retinopathy
What are the treatment options for hypertensive retinopathy?
Treat underlying cause of HTN
Non-specific
Refer to ophthalmologist if needed
A pt with a history of carotid disease comes in because he lost vision in his left eye earlier that day. His vision has been restored, but this has happened twice in the past. You notice a white retina and a cherry red spot in the macula. What is the best treatment for this pt?
EMERGENCY referral to an ER or ophthalmologist
pt has retinal artery occlusion
A pt comes in with profound vision loss and a cherry red spot on her macula. What is the most likely cause of the pt’s condition?
An embolus
the pt has retinal artery occlusion
A pt with a history of hypertension presents with retinal hemorrhages and dilated, tortuous veins. What is the most likely cause of the pt’s condition?
Thrombosis of the retinal vein
the pt has retinal vein occlusion
How do you treat retinal vein occlusion?
EMERGENCY referral to an ER or ophthalmologist
A pt presents complaining of shimmering lights and a blind spot. She has night blindness, but the fundus is normal. What condition does the pt likely have?
Retinitis pigmentosa
A pt comes in with decreased vision, night blindness, and light sensitivity. You notice a normal fundus but a pale optic nerve. What is the most likely cause of this pt’s condition?
Maternal infections (syphilis, rubella, toxoplasmosis) Vitamin A deficiency (the pt has retinitis pigmentosa)
How do you test for retinitis pigmentosa?
Test visual field
Obtain family history
Genetic studies
A pt comes in with night blindness, photophobia, and blind spots. What treatment do you recommend for this pt?
Vitamin A supplements
pt has retinitis pigmentosa
A 65 year old man presents with sudden vision loss in one eye. He complains of jaw pain, scalp tenderness, and neck pain. What diagnostic test should you perform on this pt?
Test for a Marcus-Gunn pupil
the pt has ischemic optic neuropathy
A pt with a history of diabetes presents with sudden visual loss and recent weight loss. On exam the pt has a Marcus-Gunn pupil. What is the next step for this pt?
Immediate referral to an ophthalmologist
the pt has ischemic optic neuropathy
