Eye Disease Flashcards

1
Q

highlights of eyedrops administration

A

contacts must be removed

pull eyelid back to form pocket

don’t touch eye with dropper

keep eye closed 1-3 min following administration

wait 10 minutes between administration of multiple drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

nasal lacrimal occlusion

A

essential part of eye drop administration

cover the nasal lacrimal duct with index finger to prevent systemic absorption

decreases side effects and dose, allows for better drug potency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

eye ointment administration highlights

A

warm ointment in hand 1-2 minutes

discard first .25 in of medication

close eye and don’t rub for 1-2 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

eye diseases

A

cataracts
macular degeneration
retinopathy
glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

leading cause of blindness around the world

A

cataracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

cause of cataracts

A

aging **

also sunlight, smoking, family history, trauma, DM and steroid use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

clinical features of cataracts

A

yellowing of the lens

myopic shift (brief improvement in near vision)

lost color discrimination and distant vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cataracts pathophys

A

as lens ages, new layers are added

these layers compress lens nucleus and it becomes harder

yellowing of lens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cataracts dx and treatment

A

opthalmic exam (slit lamp, direct light) and decreased visual acuity

treatment: surgery (lens implant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

2 blood supplies to retina

A

choroidal blood vessels (outer retina, photoreceptors -75%)

central retinal artery (supplies central portion of retina)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

retinopathy risk factors

A

DM

HTN

smoking

hyper cholesteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

diabetic retinopathy (clinical features)

A

asymptomatic finding

loss of vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

diabetic retinopathy fundus exam findings

A

cotton wool patches

neovascularization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

cotton wool patches

A

diabetic retinopathy

caused by infarcted nerve fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

neovascularization

A

diabetic retinopathy

hypoxia of retina causes formation of new blood vessels in the eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hypertensive retinopathy

A

asymptomatic but can have decreased vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hypertensive retinopathy fundoscopic exam findings

A

papilledema
AV nicking
Retinal hemorrhages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

AV nicking

A

hypertensive retinopathy

indentation in veins where there are arteries that cross

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

macular degeneration

A

degenerative changes to central retina

causes loss of central vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

macular degeneration risk factors

A
age
family history 
female 
caucasian 
smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

macular degeneration exam

A

ophthalmic exam shows scattered pale yellow spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

pharmacologic treatment of macular degeneration

A

ranibizumab/Lucentis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ranibizumab/Lucentis

Indication

A

neovascular macular degeneration

improves remaining vision, may preserve vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ranibizumab/Lucentis

MOA

A

inhibits VEGF so REDUCES new blood vessel growth

via monthly eye injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
ranibizumab/Lucentis | ADR
increased IOP Traumatic cataract detached retina
26
vitamins used in macular degeneration
``` ascorbic acid vitamin E beta carotene Zinc Oxide Cupric oxide ```
27
Open angle glaucoma
pathophysiology not understood BUT decreased aqueous humor outflow and increased aqueous production
28
clinical features of open angle glaucoma
asymptomatic slow loss of vision (peripheral first then central) optic neuritis
29
testing for open angle glaucoma
peripheral and central field examination measure IOP
30
OAG goals of therapy
prevent further loss of visual function minimize adverse effects of therapy maintain IOP below pressure at which further optic nerve damage is unlikely
31
which agents increase aqueous humor outflow
prostaglandin analogs a-adrenergic agonists cholinergics
32
classes of agents that decrease aqueous humor production
b-adrenergic antagonists a-adrenergic agonists carbonic anhydrase
33
first line agents in OAG
b-blockers prostaglandin inhibitor
34
second line agents in OAG
selective a-2 receptor agents cholinergic agents
35
third line agents in OAG
topical carbonic anhydrase
36
b-blockers
traditional first line for both open and closed angle glaucoma decrease IOP by reducing formation of aqueous humor
37
b-blokcers list
timolol (Timoptic) levobunolol (betagan) betaxolol (Betoptic)
38
B-blockers adr (systemic)
bronchospasm pulmonary edema respiratory arrest bradycardia
39
CIs to beta blockers
COPD Asthma CHF PE betazolol is less likely to cause some of these diseases
40
prostaglandin
1B agent in treating OAG better compliance but more expensive $$$
41
prostaglandin local ADR
increased iris pigmentation hypertrichosis (excessive hair growth) darkening of eyelashes
42
A-2 adrenergic agonists (list)
bromonidine/Alphagen combination w/t 1st line agents
43
A-2 adrenergic agonists MOA
decreases IOP by increasing humor outflow
44
carbonic anhydrase inhibitors route + indication
brinzolamide/Azopt (Topical/DROPS) - open angle acetazolamide/Diamox (systemic) - closed angle
45
carbonic anhydrase inhibitors CI
SULFA ALLERGIES
46
cholinergic lis and MOA
pilocarpine soln/isopto carpine increase outflow by pulling open trabecular meshwork
47
cholinergic and angle closer glaucoma treatment
pilocarpine doesn't work until we already get the pressure reduced
48
Pinguecula
yellow-white, flat/raised lesions over the sclera doesn't involved cornea slit lamp exam protect eyes, moisture, topical steroid or NSAIDS
49
Pterygium
fold of fibrovascular tissue that extends onto cornea slit lamp dx topical steroid or NSAID, surgical exception if in visual access
50
ophthalmic lubricants indicaitons and MOA
relief of eye irritation and dry eyes tonicity, adjust pH, increase eye contact time OTC
51
Opthalmic NSAIDs list of drugs (2)
Ketoralac (Acular) | Diclofenac (Voltaren)
52
ophthalmic NSAID indications (4)
post operative inflammation after cataract surgery ocular itching Pingueceula pterygium
53
ophthalmic NSAID MOA
reduce prostaglandin E2 production minimal systemic absorption
54
ophthalmic corticosteroids
prenisolone (Pred-Forte) Triamcinolone (Triesence) Tobamycin/Dexamethasone (tobraDex)
55
ophthalmic corticosteroids indications
ocular inflammatory conditions
56
ophthalmic corticosteroids ADRS
can cause glaucoma
57
ophthalmic corticosteroids | CIs
pts w/herpes keratitis pts w/problems of elevated IOP
58
blepharitis | clinical features
crusty, thick eyelid margins itching, burning, foreign body sensation, tearing
59
blepharitis treatment
scrub margins with baby shampoo warm compress if severe can add ABX
60
Dacryoadentitis
inflammation of lacrimal gland pain, swelling, redness over outer one third of upper eyelid must rule out cellulitis
61
dacryoadentitis treatment
mild cases treat augmenting or kelfex severe- admit with IV ABX
62
chalazion clinical features
sub acute non tender papule on inner surface of eyelid cause: blocking meibomian gland
63
chalazion treatment
warm compress refers if not relieved
64
hordeolum
"sty: rapid onset painful, tender, erythematous pustule on lid of margin commonly caused by staph aureus