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ophthalmology > general diseases > Flashcards

general diseases Flashcards

1
Q

what is a refractive error

A

the eye cannot focus properly

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2
Q

give examples of refractive errors

A

Myopia
Hypermetropia
Astigmatism
Presbyopia

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3
Q

what is myopia

A

short-sighted

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4
Q

how is myopia treated

A

concave lens (glasses)

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5
Q

what is hypermetropia

A

long-sighted

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6
Q

how is hypermetropia treated

A

convex lens (glasses)

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7
Q

what is astigmatism

A

two focal points usually due to irregular corneal curve

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8
Q

what is presbyopia

A

loss of accommodation with ageing

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9
Q

what are the common causes of sudden visual loss

A 
vascular
retinal detachment
wet macular degeneration
closed angle glaucoma 
optic neuritis
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10
Q

what are the vascular causes of sudden visual loss

A

Occlusion of retinal circulation (retinal artery or vein)
Occlusion of optic nerve circulation
Vitreous Haemorrhage

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11
Q

what are the causes of gradual visual loss

A 
cataract
refractive error
dry macular degeneration
open angle glaucoma
diabetic retinopathy
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12
Q

what are cataracts

A

opacification within the lens

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13
Q

what causes opacification found in cataracts

A

abnormal changes in the lens proteins (crystallins) result in chemical and structural alteration leading to loss of transparency

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14
Q

what are the causes of cataracts

A

old age
cumulative UVB damage
diabetes
hypertension

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15
Q

what are the symptoms of cataracts

A

gradual visual loss = “hazy” “blurred”
visual loss can’t be fixed with glasses
may get glare

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16
Q

what is the treatment of cataracts

A

surgical removal with intra-ocular lens implant

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17
Q

what is glaucoma

A

group of diseases characterised by progressive optic neuropathy resulting in characteristic field defects

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18
Q

what is the only modifiable risk factor for glaucoma

A

intra-ocular pressiure

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19
Q

what are the 3 types of glaucoma

A

open angle
closed angle
rubeotic glaucoma

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20
Q

what causes open angled glaucoma

A

blockage in canal of schlemm or trabecular meshwork

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21
Q

what are the symptoms of open angled glaucoma

A

slow onset peripheral visual loss

cupped disc

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22
Q

what causes closed angle glaucoma

A

iris is opposed to the anterior eye so the fluid can’t reach the meshwork to drain away

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23
Q

what are the symptoms of closed angle glaucoma

A 
acute red eye
acute visual loss
headache
nausea 
vomiting
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24
Q

what is the treatment of closed angle glaucoma

A

drops/oral medication

laser

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25
Q

what is rubeotic glaucoma

A

glaucoma in diabetes

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26
Q

what causes rubeotic glaucoma

A

new vessel formation obstructing the angle and preventing drainage

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27
Q

what is the investigation of glaucoma, what would you expect find

A

ophthalmoscope

cupping of the optic disc
large cup to disc ratio

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28
Q

what is the normal disc to cup ratio

A

0.2 - 0.6

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29
Q

what is the cause of dry macular degeneration

A

unknown, related to age

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30
Q

what are the symptoms of dry macular degeneration

A

gradual visual loss

central vision is lost

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31
Q

what would you expect to see on ophthalmoscopy of dry macular degeneration

A

drusen = white spots

atrophic patches of retina

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32
Q

what is drusen

A

build up of waste products below retinal pigment epithelial

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33
Q

what is the cure of dry macular degeneration

A

NO CURE:

supportive
visual aids

34
Q

what is the cause of wet macular degeneration

A

new blood vessels grow under the retina. these are leaky which causes a build up of blood/fluid eventually.

35
Q

what is the cause of wet macular degeneration

A

unknown but related to age and diabetes

36
Q

what are the symptoms of wet macular degeneration

A

sudden, central visual loss

metamorphopsia

37
Q

what is metamorphopsia

A

distortion of vision

38
Q

what is the investigation of wet macular degeneration, what would you expect to see

A

OCT showing neovasculariastion in choroid

39
Q

what is the treatment of wet macular degeneration

A

anti-VEGF

40
Q

what is papilloadema

A

this is optic disc swelling due to increased ICP

41
Q

how does increased ICP lead to papilloadema

A

pressure is transmitted to the eye via the subarachnoid space surround the optic nerve

42
Q

what are the causes of papilloadema

A

SECONDARY TO RAISED ICP:

hypertension
space occupying lesion

43
Q

what are the symptoms of papilloadema

A

enlarged blind spot
blurred vision
visual obstruction

44
Q

describe the disc in papilloadema

A

atrophic = pale

unclear margins

45
Q

what are the causes of central retinal artery occlusion

A

carotid artery disease

emboli from heart

46
Q

what are the symptoms of central retinal artery occlusion

A

sudden, profound vision loss
painless
relative afferent pupil defect

47
Q

describe what you would see with an ophthalmoscope in central retinal artery occlusion

A

pale, swollen retina
red cherry spot at fovea
thread-like retinal vessels = “cattle tracking”

48
Q

what would branch retinal artery occlusion result in

A

loss of peripheral vision

49
Q

what is amaurosis fugax

A

transient central retinal artery occlusion

50
Q

what are the symptoms of amaurosis fugax

A

transient, painless visual loss for about 5 mins with full recovery
normal exam findings

51
Q

what is the treatment of amaurosis fugax

A

urgent referral to stroke clinic

52
Q

what is the cause of central retinal vein occlusion

A

vichow’s triad:

Endothelial damage e.g. diabetes
Abnormal blood flow e.g. hypertension
Hypercoagulable state e.g. cancer

53
Q

what are the symptoms of  central retinal vein occlusion

A

sudden, painless visual loss

54
Q

what would you see on ophthalmoscope of central retinal vein occlusion

A

retinal haemorrhages
dark in colour
dilated and tortuous veins
disc and macular swelling

55
Q

what is ischaemic optic neuropathy

A

occlusion of the optic nerve head circulation

56
Q

what is the cause of ischaemic optic neuropathy

A

posterior ciliary arteries become occluded resulting in infarction of the optic nerve head

57
Q

what condition can cause ischaemic optic neuropathy

A

giant cell arteritis

58
Q

what are the symptoms of ischaemic optic neuropathy

A

sudden, irreversible visual loss

59
Q

what would you see on ophthalmoscope ofischaemic optic neuropathy

A

swollen optic nerve

pale, swollen disc

60
Q

what is vitreous haemorrhage

A

haemorrhage occurring into the vitreous cavity

61
Q

what are the causes of vitreous haemorrhage

A

abnormal vessels = retinal ischaemia or retinal vein occlusion

normal vessels bridging a tear (trauma)

62
Q

what are the symptoms of vitreous haemorrhage

A

sudden loss of vision
floaters
loss of red reflex

63
Q

what are the symptoms of retinal detachment

A

sudden, painless loss of vision
flashes
floaters
relative afferent pupillary defect

64
Q

what may you see on ophthalmoscope of vitreous haemorrhage

A

haemorrhage

65
Q

what may you see on ophthalmoscope of retinal detachment

A

tear

66
Q

what are the symptoms of sjogren’s syndrome

A

dry eyes = keratoconjunctivitis sicca
dry mouth = xerostomia
Rheumatoid Arthritis

67
Q

what are the symptoms affecting the eyes in rheumatoid arthritis

A

dry eyes = keratoconjunctivitis sicca
scleritis
corneal melt

68
Q

what is SLE, what does it cause in the eye s

A

multisystem immunological disease associated with anti-DNA ab. It causes ocular inflammation

69
Q

what is giant cell arteritis

A

inflammation of middle sized arteries

70
Q

what are the symptoms of giant cell arteritis

A 
headache
jaw claudication 
tender scalp
malaise
blindness
71
Q

what is the cause of thyroid eye disease

A

autoimmune

72
Q

what are the ocular symptoms of thyroid eye disease

A

swelling
glaucoma
optic nerve swelling

73
Q

what are the extra-ocular symptoms of thyroid eye disease

A 
proptosis
restrictive myopathy
retracted lid
oedema
lid lag
74
Q

what is the treatment of ocular symptoms of thyroid eye disease

A

control of thyroid dysfunction
lubricants
surgical decompression

75
Q

what are the symptoms of diabetic retinopathy

A

loss of vision

peripheral neuropathy of pupils = prostitute’s pupil

76
Q

what causes visual loss in diabetic retinopathy

A

Retinal oedema affecting the fovea
Vitreous haemorrhage
Scarring/tractional retinal detachment

77
Q

what can be seen on fundoscopy in diabetic retinopathy

A

cotton wool patches = BUZZWORD
hard exudate
micro-aneurysms
new vessel growth

78
Q

how is retinopathy graded in diabetic retinopathy

A 
none
mild
moderate
severe 
proliferative
79
Q

how is maculopathy graded in diabetic retinopathy

A

none
observable
referable
clinically significant

80
Q

what is the management of diabetic retinopathy

A

Optimise diabetic control
Laser; causes PRP (pan retinal photocoagulation)
Surgery – vitrectomy
Rehabilitation (blind/partial sighted)

81
Q

what does laser treatment in diabetic retinopathy cause

A

pan-retinal photocoagulation

ophthalmology (7 decks)

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