Eyes Flashcards
1
Q
general things to check for during an eye exam
A
- physical exam
- visual acuity
- visual field
- color vision
- eye movements
- pupils
- IOP
2
Q
components of anterior segments
A
- lids
- conjunctiva
- cornea
- iris
- lens
- anterior chamber
- anterior vitreous
3
Q
how do you best view the anterior segment
A
slit lamp
4
Q
how do you best view the posterior segment
A
fundoscopy
5
Q
components of the posterior segment
A
- retina
- optic disc
6
Q
what is the best imaging for the eye
A
CT
7
Q
what bones of the orbit are most likely to break?
A
- maxilla
- zygoma
- frontal
8
Q
medial canthal ligament
A
- attaches corner of the tarsal plate to the orbital wall
- found inside eyelid
- disruption -> malposition of eyelids
9
Q
lateral canthal ligament
A
- attaches to lateral aspect of orbit
- found inside eyelid
- disruption -> malposition of eyelids
10
Q
who is most likely to get orbital fx?
A
- children and adolescents d/t sports trauma
- adults d/t assaults or MVA
11
Q
clinical presentation of orbital fx
A
- deformity
- pain
- hematoma
- subconjunctival hemorrhage
- pain with eye mvmt
- diplopia
- facial numbness
- N/V
- bradycardia
12
Q
physical deformities possible d/t orbital fx
A
- proptosis d/t hematoma
- enopthalmus d/t herniation of globe contents into sinus
- extrusion of intraoccular contents
- subcutaneous emphysema
- widened intracanthal distance
13
Q
orbit fx types
A
- orbital zygomatic fx
- nasoethmoid fx
- orbital roof fx
- orbital floor fx
14
Q
orbital zygomatic fx
A
- most common fx of orbital rim
- d/t high impact blow to lateral orbit
- usually associated with orbital floor fx
15
Q
nasoethmoid fx
A
- medial orbital rim
- disruption of medial canthal ligament and lacrimal duct system
- medial rectus muscle entrapment
16
Q
orbital roof fx
A
- more common in kids
- expose larger portion of upper surface
- high association with intracranial injury
17
Q
orbital floor fx
A
- aka blowout fx
- d/t small round object hitting eye
- displacement of globe backwards
18
Q
concerns associated with orbital floor fx
A
- entrapment of inferior rectus m
- orbital fat
- resulting ischemia and loss of muscle fn
- fx fragment or compression by hematoma
- herniation of tissue into maxillary sinus
19
Q
hyphema
A
- blood in anterior chamber
- usually assoc with corneal abrasions
- may be visible on gross inspection
20
Q
what is the most common source of blood in hyphemas?
A
- tear in anterior face of ciliary body
- direct blow can also rupture vessels at root of iris
21
Q
common causes of hyphema
A
- blunt trauma or penetrating injury
- finger
- hockey stick
- deployed airbag
- paintball
- assault
22
Q
clinical presentation of hyphema
A
- vision loss
- eye pain with pupillary constriction
- photophobia
23
Q
management of hyphema
A
- slit lamp to exclude open globe injury like laceration
- tetracaine
- pain control, N/V control
- keep head at 30 degrees to promote settling of blood
- patch
- ophthalmic consult
- monitor IOP
- topical steroids
24
Q
who has a poorer prognosis for hyphema?
A
- anyone with bleeding disorders or sickle cell
- need to order lab work
- also depends on grading
- grade 4= 100% anterior chamber filling
25
corneal abrasion
- result of eye trauma, retained foreign body, or improper contact use
- defect in corneal surface epithelium
26
what innervates the cornea
trigeminal nerve
27
how many layers does the cornea have
six
28
what is the most frequent cause for ophthalmic emergencies?
- foreign body with corneal abrasion
29
clinical presentation of corneal abrasion
- eye pain
- tearing
- redness
- photophobia
- blurred vision
- foreign body sensation
- can sometimes see epithelial defect on gross exam
- normal or decreased visual acuity
- corneal edema
30
diagnosis of corneal abrasion
- gross exam
- fundoscopy
- slit- lamp exam
- flourescein after globe ruled out
31
management for corneal abrasions
- topical erythromycin, polymyxin, or sulfacetamide
- no patching
- dont need f/u for small abrasions
32
management for corneal abrasions in contact wearers
- antipseudomonals
- ciproflox drops
- oxiflox drops
- gentamicin or tobramicin
- ophthalmology f/u
33
indications for ophthalmologist f/u with corneal abrasions
- large abrasions
- contact lens wearers
- young children
- vision changes
- rust ring
34
corneal ulcers
- serious
- involves multiple layers of cornea
- major cause of impaired vision and blindness
- extends through stroma
35
causes of corneal ulcers
- exposure keratitis
- allergies
- severe dry eye
- autoimmune disease
- vit A deficiency
- trauma
- direct microbial invasion
36
common bacteria that cause corneal ulcers
- pseudomonas
- staph
- strep
- MRSA
- moraxella liquefaciens
37
common virus that cause corneal ulcers
HSV/ zoster
38
corneal ulcers risk factors
- contact lens wearer
- previous eye surgery
- eye injury
- hx of herpes
- use of topical or systemic . steroids
- immunocompromised
39
clinical presentation of corneal uclers
- red eye*
- ocular pain*
- discharge
- swelling of eyelids
- photophobia
- foreign body sensation
- blurred vision
- eyelids and conjunctiva erythematous
- mucopurulent discharge
- round or irregular ucler with white hazy base
40
corneal ulcer exam
- slit lamp
| - r/o herpes zoster
41
corneal ulcer diagnosis
- made clinically
- scrape ulcer and culture to determine pathogen
- done by ophthalmologist
42
corneal ulcer treatment
- aggressive topical treatment
- abx- fluoroquinolones
- topical antifungals- fluconazole, amphoteracin
- antivirals- ganciclovir, acyclovir
43
when should you refer someone to ophthalmologist for corneal ulcers
- within 12-24 hours
44
complications of corneal ulcers
- corneal scarring
- corneal perforation
- glaucoma
- cataracts
- blindness
45
what is the worst chemical injury to the eye
- alkali burns
46
acid burns
- dissociate into H ions in cornea
- damage ocular surface by changing pH
- produce protein coagulation which prevents deeper penetration of acids into eye
47
common acids that injure eye
- battery acid
- bleach
- glass polish
- vinegar
- hydrochloric acid
48
alkali burns
- dissociate into hydroxyl ion
- liquifies fatty acid of cell membrane
- can penetrate cell membrane
49
common alkali that injure eye
- ammonia
- lye
- lime
- airbag rupture
- fireworks
50
chemical injury managment
- litmus paper
- copious irrigation with saline
- morgan lens use until pH is neutral
- emergent consult and f/u with ophthalmology
51
corneal foreign body clinical presentation
- pain
- foreign body sensation
- photophobia
- tearing
- red eye
- blurred vision
52
diagnosis of foreign body
- clinical exam
- evert eyelid
- fluorescein
- slit lamp
53
exam findings for foreign bodys
- normal or decreased visual acuity
- conjunctival injection
- ciliary injection
- visible foreign body
- rust ring
- epithelial surface defects with fluorescein
- excessive tearing
- corneal edema
54
foreign body management
- remove foreign body
- topical abx if no open globe injury
- irrigation
- can use q-tip, sterile needle tip
- no contacts
- ophthalmology referral
55
topical drops for foreign body management
- erythromycin
- cipro
- cycloplegic
56
open globe injury
- may accompany multiple trauma or serious head injury
- tetanus prone wound
- can be occult on gross exam
57
clinical presentation of open globe injury
- obvious corneal or scleral laceration
- volume loss
- protruding foreign body
- extruding intraocular contents
- decreased visual acuity
- relative afferent pupillary defect
58
diagnosis of open globe injury
- CT
59
management of open globe injury
- NPO- may need sx
- dont remove FB
- patch both eyes
- place head at 30 degrees
- treat nausea and pain aggressively
- provide sedation
- IV abx
- ophthalmic consult
- surgical repair within 24 hours
60
subconjunctival hemorrhage cause
- fragile conjunctival vessel rupture
- trauma
- increased venous pressure
- spontaneous
61
treatment for subconjunctival hemorrhage
- reassurance
- will resolve in 2-3 weeks
- multiple episodes warrant further work up
62
topical cyclopelgics
- paralyze ciliary muscles
- cyclopentolate
- homatropine
63
conjuctivitis
- red eye d/t inflammation of conjunctiva
| - usually self limited
64
conjunctivitis and contact lens wearers
- high risk of pseudomonal keratitis
| - higher risk for extended wear pts
65
red flags associated with conjunctivitis
- reduction of visual acuity
- ciliary flush
- photophobia
- severe foreign body sensation
- corneal opacity
- fixed pupil
- severe HA with nausea
66
bacterial conjunctivitis
- more common in kids
- spread- direct contact
- usually unilateral
- yellow/ green/ white d/c
- eye sticks shut, crusting
- sand/gritty feeling
67
common causes of bacterial conjunctivitis
- s. aureus
- s. pneumoniae
- h. flu
68
what should you do in any eye complaint
- fluorescein
| - fundoscopy
69
management of bacterial conjunctivitis
- erythromycin ophthalmic ointment
- trimethoprim- polymyxin drops
- fluoroquinolone drops for contact wearers
70
viral conjunctivitis
- usually have viral prodrome of sore throat, fever, LAD, pharyngitis
- spread by direct contact
- watery d/c with burning
- gritty feeling
- usually affects both eyes
71
common cause of viral conjunctivitis
- adenovirus
| - have rapid test for adenovirus now
72
management of viral conjunctivitis
- self limited
- gets worse in first 3-5 days
- can use topical antihistamines and compresses
73
allergic conjunctivitis
- airborne allergens come in contact with eye
- very itchy eyes- possible corneal abrasions
- bilateral
- marked chemosis (swelling)
- allergic shiners
74
management for allergic conjunctivitis
- remove offending agent
- wear sunglasses
- change filters, clothes
- antihistiamine/ vasoconstrictor combo (naphcon-A)
- steroids (can raise IOP)
75
traumatic conjunctivitis
- d/t foreign body
| - treatment is removal of fb
76
toxic conjunctivitis
- due to chemical burns
77
diagnosis of conjunctivitis
- clinical dx
- based on hx and exam
- fluoroscein and fundoscopy exam
78
preseptal/ periorbital cellulitis
- infection of anterior eyelid
- no orbit involvement
- mild with rare complications
- usually d/t external sources
79
causes of periorbital cellulitis
- insect/ animal bites
- foreign body
- dacryocystitis
- conjunctivitis
- hordeolum
80
common bacterial causes of periorbital cellulitis
- s. aureus
- s. pneumoniae
- MRSA
81
clinical manifestations of periorbital cellulitis
- ocular pain
- eyelid swelling
- erythema
- warmth
82
diagnosis of periorbital cellulitis
- history and PE
| - Ct or MRI
83
management of periorbital cellulitis
- doxycycline
- clindamycin PO
- keflex PO
- for MRSA can give bactrim plus amoxicillin or ceph
84
orbital cellulitis
- infection of contents of orbit
| - no globe invovement
85
causes of orbital cellulitis
- rhinosinusitis**
- orbital trauma
- dacryocystitis
- tooth infection
- opthalmic surgery
86
most common bacterial causes of orbital cellulitis
- s. aureus
| - strep
87
clinical manifestations of orbital cellulitis
- swelling
- erythema
- warmth
- ophthalmoplegia
- proptosis
- pain with eye movement
- diplopia
88
complications of orbital cellulitis
- orbital abscess
- subperiosteal abscess
- brain abscess
- cavernous sinus thrombophlebitis
89
dx of orbital cellulitis
- clinical
| - confirmed with CT or MRI
90
management of orbital cellulitis
- vanco plus ceph
- unisyn/ zosyn plus ceph
- should see improvement in 24-48
hours
- may require surgery
91
herpes keratitis
- corneal infection and inflammation
- major cause of blindness
- spread- direct contact
- mostly unilateral involvement
92
what is the most common type of herpes keratitis
- infectious epithelial keratitis
| - endemic in humans
93
clinical manifestations of herpes keratitis
- pain
- visual burning
- tearing
94
diagnosis of herpes keratitis
- conjunctival injection
| - dendritic lesions on fluorescein
95
management of herpes keratitis
- topical antivirals for mild cases
| - PO plus topical antivirals for more severe cases
96
what are the meibomian glands?
- found on inside rim of eyelids
- sebaceous glands that secrete oily substance to keep eyes lubricated
- dysfunction -> dry eye
97
blepharitis
- chronic inflammation of eyelids
- intermittent exacerbations
- anterior less common
- posterior more common
98
anterior blepharitis
- inflammation at base of eyelids
- more common in young females
- 2 types- staph or seborrheic dermatitis
99
clinical manifestations of anterior blepharitis
- eyelid edges are pink, irritated, swollen with crust
- malposition of eyelids with chronic
- eyelashes misdirected or thinning
- diffuse conjunctival injection
100
posterior belpharitis
- associated with other skin conditions like rosacea and seborrheic dermatitis
- gland gets plugged and inflamed -> dry eye
101
clinical manifestations of posterior blepharitis
- red, swollen eye
- gritty sensation
- burning, excessive tearing
- itchy eyelids
- crusting
- flaking eyelid skin
- photophobia
- blurred vision
102
diagnosis of blepharitis
- clinical, history and PE
| - distinguish anterior from posterior
103
management of blepharitis
- counseling
- alleviate acute sx
- warm compresses
- lid massage and washes
- artificial tears
- topical abx for anterior, PO abx if severe
104
hordeolum
- aka stye
- acute, purulent inflammation of eyelid
- can be sterile or show bacteria (staph)
105
internal hordeolum
- infection of meibomian gland
| - conjunctival side
106
external hordeolum
- infection of eyelash follicle
| - lid margin
107
management of hordeolum
- warm compress
- +/- topical abx
- may harden to chalazion
108
chalazion
- chronic inflammatory lesion
- d/t blockage and swelling of meibomian gland of eyelid
- usually in pts with eyelid margin blepharitis and rosacea
109
progression of chalazion
- may start as small, red, tender, swollen
- 2-3 days becomes painless and larger, rubbery, nodular
- inflammation and blockage, not infection
110
treatment of chalazion
- self limited to few weeks- months
- warm compresses
- eyelid massage
- if non-resolving refer to optho for I&D
111
ectropion
- lower eyelid rolled out
- sagging eyelid -> dry eye, irritation
- usually d/t aging, can be d/t facial nerve paralysis
112
clinical manifestations of ectropion
- excessive tearing
- chronic inflammation
- redness
- gritty
- dry eye
- crusting
- multiple infections
- eyelids dont close properly
113
management of ectropion
- artificial tears as temp fix
| - requires surgery
114
entropion
- eyelid rolls inward
- eyelashes rub against conjunctiva
- causes chronic irritation
- d/t aging, trauma, scarring, surgery
115
clinical manifestations of entropion
- red eye
- irritated
- gritty
- tearing
- mucous discharge
- photophobia
- corneal abrasions
- absent eyelashes
116
management of entropion
- artificial tears as temp fix
| - surgery
117
dacryoadenitis
- inflammation of lacrimal glands
- usually d/t bacteria or virus
- most common in kids and neonates
118
what is the most common viral cause of dacryoadenitis
- mumps
119
clinical manifestations of dacryoadenitis
- unilateral
- severe pain
- redness
- swelling
- supraorbital pressure
- rapid onset
- conjunctival swelling
- submandibular LAD
- exopthalmos
- ocular motility restrictions
- can have systemic sx
120
chronic manifestations of dacryoadenitis
- usually bilateral
- painless enlargement
- present more than a month
- more common than acute
121
dx of dacryoadenitis
- lacrimal gland enlarged
- easily seen with eversion of upper lid
- CT
122
management of dacryoadenitis
- most common cause= mumps, self limiting
- bacterial- keflex
- inflammatory cause- look for systemic causes like autoimmune diseases
123
dacryostenosis
- nasolacrimal duct obstruction
- most common cause of persistent tearing in infants
- spontaneous resolutino in 6-12 mo
124
treatment of dacryostenosis
- massage
| - lacrimal duct probing
125
retinal detachment
- seperation of retina from pigment epithelium and choroid
- traction or tears -> fluid accumulation -> detachment
- can result in permanent blindness
- most uncomplicated spontaneous detachments can be cured
126
risk factors for retinal detachment
- myopia
- previous ocular surgery
- fluorquinolone use
- trauma
- family hx
- marfan disease
127
causes of retinal detachment
- tears or holes either traumatic or spontaneous
- traction of retina- usually diabetic retinopathy
- tumors
- exudative process
128
clinical manifestation of retinal detachment
- increasing number of floaters
- flashes of lights
- shower of black spots
- curtain spreading over visual field
- progression varies
- on exam see "billowing sail" or "ripple on pond" appearance
129
differentail dx for retinal detachment
- vitreous hemorrhage
- vitreous inflammation
- ocular lymphoma
- intra-ocular FB
130
- treatment for retinal detachment
- ophthalmologist consult immediately
- drain subretinal fluid
- laser photocoagulation
- cryotherapy
- pneumoretinopexy
- scleral buckle placement
- vitrectomy
- goal= close tears
131
optic neuritis
- inflammation of optic nerve
- normal fundus exam
- closely associated with MS
132
causes of optic neuritis
- MS***
- sarcoidosis
- neuromyelitis optica
- herpes zoster
- SLE
133
clinical manifestations of optic neuritis
- unilateral vision loss*
- pain exacerbated by movement*
- central vision loss
- pain behind eye
- usually improves in 2-3 weeks
134
differential dx for optic neuritis
- infections of optic n
- retinal detachent
- giant cell arteritis
135
treatment of optic neuritis
- brain MRI- MS dx
- consult neurologist
- systemic steroid use controversial
- treat MS plaques with interferon beta-1a
136
papilledema
- PE finding
- loss of definition of optic disc d/t edema
- central vessels get pushed forward and veins dilated
- cause= increased ICP
- may be confused with HTN retinopathy
137
causes of papilledema
- mass lesions
- cerebral edema
- hydrocephalus
- obstruction of venous outflow
- idiopathic intracranial HTN
138
clinical manifestations of papilledema
- HA that is worse in AM or when lying down**
- N/V
- diplopia
- transient visual blurring
139
stages of papilledema
- early
- fully dev
- late chronic
140
early papilledema
- loss of venous pulsations
| - optic cup retained
141
fully dev papilledema
- disc margins obscured
- cup obliterated
- blood vessels blurred
- flamed hemorrhage
- cotton wool spots
142
late chronic papilledema
- cup obliterated
- hemorrhage and exudative components resolved
- nerve is flat
- disc pallor
143
diagnosis of papilledema
- MRI or CT
- LP to check for opening pressure
- visual field test
144
treatment for papilledema
- reduce and monitor ICP
- diuresis
- hypertonic saline
- steroids
- hyperventilation- ICU
- barbituates
- remove CSF- shunting
- decompressive craniectomy- emergency only
145
idiopathic intracranial HTN
- bilateral papilledema
- N/V
- HA
- blurred vision/ visual field defects
- CN VI paresis
- most common in obese women of childbearing age
146
management of idiopathic intracranial HTN
- usually self limited
- weight loss
- serial LPs
- high dose steroids
- surgery for severe cases
147
retinal a occlusion
- usually d/t embolism
- sudden painless loss of vision
- form of stroke
- vision loss depends on a affected
148
central retinal a occlusion
- sudden loss of vision in one eye
- transient monocular blindness, stuttering, or fluctuating course
- painless
149
branch retinal a occlusion
- monocular vision loss
| - restricted to just one part of visual field
150
what is the most common cause of retinal a occlusion
- carotid artery atheroscleorsis
151
associated sx of retinal a occlusion
- HA if from GSA or carotid dissection
- unilateral numbness, weakness, slurred speech
- marcus gunn pupil
- cherry red spots on macula
- check inflammatory markers on labs
152
retinal vein occlusion
- d/t chronic diseases that slow venous BF
- results in neovascularization which are fragile and prone to hemorrhage
- either branch, central, or hemiretinal v occlusion
- sudden painless vision loss
153
conditions associated with retinal v occlusion
- DM
- HTN
- leukemia
- sickle cell disease
- multiple myeloma
154
esotropia
- eye points in
155
exotropia
- eye points out
156
hypertropia
- eye points up
- not common
- usually d/t CN IV palsy from trauma
- pt presents with head turn and head tilt to minimize diplopia
157
hypotropia
- eye points down
158
causes of strabismus
- congeital
- refractive error -> esotropia
- convergence error -> exotropia
- certain medical conditions are at higher risk
159
medical conditions at higher risk of strabismus
- down's syndrome
- cerebral palsy
- stroke
- head injuries
- prematurity and low birth weight
160
causes of strabismus in children
- RB
- thyroid eye disease
- oblique palsy
- brown syndrome
- duane syndrome
- down syndrome
- head trauma
- cerebral palsy
161
treatment for strabismus
- lenses
- prism
- vision therapy
- surgery
- botox
162
ambliopia
- aka lazy eye
- happens when there is a disruption between retina and brain as a child
- suppression of vision in one eye d/t strabismus -> nerves dont develop
163
new onset strabismus/diplopia in adults
- aneurysm until proven otherwise (often CN 3 palsy and aneurism in middle cerebral a or posterior communication a)
- gradual onset- tumor
- transient or persisting- temporal arteritis
- variable diplopia
164
pterygium
- triangular thickening of bulbar conjunctiva growing toward cornea
- usually d/t excessive sun exposure
- aka surfers eye
- 2X more common in males
165
pathophys of pterygium
- benign fibro-vascular proliferation and basophilic degeneration of corneal collagen
- matrix metalloproteases break down proteins
- destroys bowmans layer -> scarring and vision loss
166
differential dx for pterygium
- pannus- contact lens overuse
| - phlyctenular keratitis- TB or staph sensitivity
167
treatment for pterygium
- prevention*- sunglasses or hats
- topical lubricants and steroids
- surgery
168
complications of pterygium
- irritated gritty eyes
- cosmetic appearance
- contact lens intolerance
- astigmatism
- decreased vision
169
cataracts
- denatured protein in eye, usually d/t UV light
- can be congenital, age related, traumatic, or secondary (DM, steroids)
- creates a lot of glare
170
nuclear cataracts
- earliest cataracts
- minimal impact on vision
- often assoc with fetal alcohol syndrome or congenital issues
- can dev from rubella or syphillis
171
cortical cataracts
- added layers to lens throughout life
- starts at edge of lens and grows in like spokes to center
- impacts visual acuity
172
posterior capsular cataracts
- looks like smudge or dirt on lens
| - most visually devistating
173
treatment for cataracts
- new glasses or prescription
- sunglasses for glare
- surgery (around 20/40 vision mark)
174
complications of cataracts
- hyper-mature cataract
- decreased vision
- riskier surgery
175
glaucoma
- increased IOP
- puts pressure on optic N and can result in vision loss (increased cup to disc ratio)
- impacts portions of visual field
176
what is the most common type of glaucoma
- open angle
177
types of glaucoma
- primary open angle
- congenital
- secondary
- angle closure glaucoma
- low tension glaucoma
- pigmentary glaucoma
178
low tension glaucoma
- pressure is not high but is high enough to damage already unhealthy optic n
179
criteria for legally blind
- 20/200 visual acuity OR
| - 10 degrees of visual field
180
treatment for glaucoma
- topical meds***
| - surgery
181
what are the topical meds commonly used for glaucoma?
- prostaglandins*
- beta blockers*
- alpha adrenergic agonists
- carbonic anyhdrase inhibitors
- miotics
182
prostaglandins
- glaucoma topical drops
- increase uveoscleral outflow
- ADRs- lash and hair growth, atrophy of orbital fat, worsens ocular inflammation
183
beta blockers
- glaucoma topical drops
| - decrease aqueous humor production
184
alpha adrenergic agonists
- glaucoma topical drops
| - decrease aqueous production and increase outflow
185
carbonic anhydrase inhibitors
- glaucoma topical drops
| - decrease aqueous production
186
miotics
- glaucoma topical drops
| - increase outflow through trabecular meshwork
187
angle closer glaucoma
- usually unilateral
- occurs in pts with anatomically narrow angles- iris sits closer to cornea
- can occur in pts with cataracts
- very red eyes
- very nauseas
- poor pupillary reaction
188
meds associated with angle closer glaucoma
- cholinergic meds
- anticholinergic meds
- SSRIs
- antihistamines
- adrenergic agonists
189
treatment for angle closer glaucoma
- laser peripheral iridotomy
190
macular degeneration
- accumulation of waste products in the eye (drusen)
- leads to thinning and atrophy of macula
- neovascularization -> vessels susceptible to rupture
- visually devistating
191
types of macular degeneration
- dry - without new BV
| - wet- with new BV that are very leaky (worse prognosis)
192
risk factors for macular degeneration
- age
- family history
- caucasian
- smoker
- obesity
- CV disease
193
sx of macular degeneration
- blurry, distorted vision
| - blind spots that move wherever the patient looks
194
management of macular degeneration
- VEGF injections in eye for wet
- lifestyle changes
- vitamins
- photodynamic therapy
- photocoagulation
195
hypertensive retinopathy
- arteriosclerosis d/t chronically elevated BP
- >140/90
- dev dot hemorrhages and flame hemorrhages
196
signs of hypertensive retinopathy
- widening of arteriole light reflex
- arteriovenous crossing signs
- copper or silver wire arteries
- retinal hemorrhages
- cotton wool spots
- exudates (lipids)
- papilledema
197
diabetic retinopathy
- damage to small blood vessels of eye by sugar in the blood
| - blacks, latinos, and native american's significantly higher risk
198
stages of diabetic retinopathy
- non-proliferative
- proliferative
- macular edema (can happen in proliferative or nonproliferative)
199
what does the health of the retina directly reflect?
- kidney health
200
symptoms of diabetic retinopathy
- blurry vision
- spots or floaters
- dark spot in vision
- difficulty seeing well at night
- occurs as early as A1C of 5.9
- dev fibrovascular structures which can lead to retinal detachment
201
treatment for diabetic retinopathy
- tight control of sugar and BP
- anti-VEGF injections
- steroid injections/ implants
- laser
- vitrectomy
