Eye Flashcards
(53 cards)
What is the pathology of diabetic retinopathy?
thickening basement membrane and increased permeability of retinal arteries - leads to ischaemia, nerve fibre damage, vascular leakage
What are some things you would see in the eye of someone with diabetic retinopathy?
cotton wool spot - ischaemic nerve fibres
small vessels around optic disc
yellow patches = hard exudate
Flame haemorrhages
What are the stages of diabetic retinopathy?
Non-proliferative
- mild, moderate, severe
- background retinopathy, pre-proliferative retinopathy
Proliferative: fine new vessels in optic disc/retina
Maculopathy: oedema due to leakage
What do you urgently refer a patient with suspected diabetic retinopathy?
From severe non-proliferative onwards
How do you treat diabetic retinopathy?
good glycaemic control
pranretinal photocoagulation causes regression of new blood vessels
What would be seen on the retina in severe HTN retinopathy?
arteriolar constriction arteries nipping veins when they cross cotton wool spots exudates papilloedema
How would you treat HTN retinopathy?
good BP control
What are the grades of HTN retinopathy?
I - thickening of arterioles
II - focal arteriolar spasms, vein constriction
III - haemorrhages, dot-blot, cotton wool, hard exudates
IV - papilloedema
What is malignant retinopathy?
very high BP, accelerated vascular damage with necrosis of small arteries (papilloedema), end stage organ damage
What are some causes of HTN retinopathy?
uncontrolled BP -phaeochromocytoma = adrenaline
neuroendocrine tumour of medulla of adrenal glands = catecholamines
What are some risk factors for cataracts?
steroids, DM, age, smoking, eye trauma, uveitis, congenital, congenital infection
What are some things you would see on examination of someone with cataracts?
clouding of the lens, absent light reflex, increasing myopia
What tests would you do if you suspect cataracts?
blood glucose
serum calcium
liver biochemistry
How would you treat cataracts?
phacoemulsification
- breaks the lens US guided, aspiratte, replace lens
Which type of glaucoma is primary degenerative condition? What is it?
open angle glaucoma
Drainage of fluid is blocked (due to iris pushed up by trabecular meshwork)
What are some symptoms of glucoma?
heading, nausea and vomiting, blurred vision, decreased visual acuity, pain, unilateral, red eye, dilated pupil, halo around lights, raised ICP
What are some treatments of glucoma?
constrict pupil and decrease aqueous fluid
- acetazolamide (reduces secretion)
- timolol (suppresses aqueous humour secretion)
- pilocarpine (pupil constriction)
What is normal eye pressure?
11-21 mmHg
What is the most common cause of visual loss in elderly?
age related macular degeneration
- 30% of adults >75
What are some symptoms of ARMD?
blurring lines, central vision loss, painless, confabulatory hallucinations (Charles Bonnet)
How would you test for ARMD?
amsler chart, tomography
What are the two types of ARMD and how do you treat them?
Wet - exudate, neovascular
- anti-VEGF, laser photocoagulation, intravitreal steroids
Dry - not treatable, vitamins only
smoking cessation, inform DVLA
What is ARMD pathology?
deteriorating central vision secondary to pathological neovascularisation under retina
- leak fluid and blood and form a scar
What are some causes of red eye?
conjunctivitis, glaucoma, iritis, dry eyes, local trauma, lid disorders
