general diseases Flashcards by Eilidh Edmiston

what is a refractive error

the eye cannot focus properly

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give examples of refractive errors

Myopia
Hypermetropia
Astigmatism
Presbyopia

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what is myopia

short-sighted

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how is myopia treated

concave lens (glasses)

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what is hypermetropia

long-sighted

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how is hypermetropia treated

convex lens (glasses)

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what is astigmatism

two focal points usually due to irregular corneal curve

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what is presbyopia

loss of accommodation with ageing

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what are the common causes of sudden visual loss

vascular
retinal detachment
wet macular degeneration
closed angle glaucoma 
optic neuritis

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what are the vascular causes of sudden visual loss

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

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what are the causes of gradual visual loss

cataract
refractive error
dry macular degeneration
open angle glaucoma
diabetic retinopathy

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what are cataracts

opacification within the lens

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what causes opacification found in cataracts

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

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what are the causes of cataracts

old age
cumulative UVB damage
diabetes
hypertension

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what are the symptoms of cataracts

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

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what is the treatment of cataracts

surgical removal with intra-ocular lens implant

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what is glaucoma

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

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what is the only modifiable risk factor for glaucoma

intra-ocular pressiure

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what are the 3 types of glaucoma

open angle
closed angle
rubeotic glaucoma

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what causes open angled glaucoma

blockage in canal of schlemm or trabecular meshwork

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what are the symptoms of open angled glaucoma

slow onset peripheral visual loss

cupped disc

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what causes closed angle glaucoma

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

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what are the symptoms of closed angle glaucoma

acute red eye
acute visual loss
headache
nausea 
vomiting

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what is the treatment of closed angle glaucoma

drops/oral medication

laser

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what is rubeotic glaucoma

glaucoma in diabetes

what causes rubeotic glaucoma

new vessel formation obstructing the angle and preventing drainage

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

ophthalmoscope cupping of the optic disc large cup to disc ratio

what is the normal disc to cup ratio

0.2 - 0.6

what is the cause of dry macular degeneration

unknown, related to age

what are the symptoms of dry macular degeneration

gradual visual loss | central vision is lost

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

drusen = white spots | atrophic patches of retina

what is drusen

build up of waste products below retinal pigment epithelial

what is the cure of dry macular degeneration

NO CURE: supportive visual aids

what is the cause of wet macular degeneration

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

what is the cause of wet macular degeneration

unknown but related to age and diabetes

what are the symptoms of wet macular degeneration

sudden, central visual loss | metamorphopsia

what is metamorphopsia

distortion of vision

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

OCT showing neovasculariastion in choroid

what is the treatment of wet macular degeneration

anti-VEGF

what is papilloadema

this is optic disc swelling due to increased ICP

how does increased ICP lead to papilloadema

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

what are the causes of papilloadema

SECONDARY TO RAISED ICP: hypertension space occupying lesion

what are the symptoms of papilloadema

enlarged blind spot blurred vision visual obstruction

describe the disc in papilloadema

atrophic = pale | unclear margins

what are the causes of central retinal artery occlusion

carotid artery disease | emboli from heart

what are the symptoms of central retinal artery occlusion

sudden, profound vision loss painless relative afferent pupil defect

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

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

what would branch retinal artery occlusion result in

loss of peripheral vision

what is amaurosis fugax

transient central retinal artery occlusion

what are the symptoms of amaurosis fugax

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

what is the treatment of amaurosis fugax

urgent referral to stroke clinic

what is the cause of central retinal vein occlusion

vichow's triad: Endothelial damage e.g. diabetes Abnormal blood flow e.g. hypertension Hypercoagulable state e.g. cancer

what are the symptoms of  central retinal vein occlusion

sudden, painless visual loss

what would you see on ophthalmoscope of central retinal vein occlusion

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

what is ischaemic optic neuropathy

occlusion of the optic nerve head circulation

what is the cause of ischaemic optic neuropathy

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

what condition can cause ischaemic optic neuropathy

giant cell arteritis

what are the symptoms of ischaemic optic neuropathy

sudden, irreversible visual loss

what would you see on ophthalmoscope ofischaemic optic neuropathy

swollen optic nerve | pale, swollen disc

what is vitreous haemorrhage

haemorrhage occurring into the vitreous cavity

what are the causes of vitreous haemorrhage

abnormal vessels = retinal ischaemia or retinal vein occlusion normal vessels bridging a tear (trauma)

what are the symptoms of vitreous haemorrhage

sudden loss of vision floaters loss of red reflex

what are the symptoms of retinal detachment

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

what may you see on ophthalmoscope of vitreous haemorrhage

haemorrhage

what may you see on ophthalmoscope of retinal detachment

tear

what are the symptoms of sjogren's syndrome

dry eyes = keratoconjunctivitis sicca dry mouth = xerostomia Rheumatoid Arthritis

what are the symptoms affecting the eyes in rheumatoid arthritis

dry eyes = keratoconjunctivitis sicca scleritis corneal melt

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

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

what is giant cell arteritis

inflammation of middle sized arteries

what are the symptoms of giant cell arteritis

``` headache jaw claudication tender scalp malaise blindness ```

what is the cause of thyroid eye disease

autoimmune

what are the ocular symptoms of thyroid eye disease

swelling glaucoma optic nerve swelling

what are the extra-ocular symptoms of thyroid eye disease

``` proptosis restrictive myopathy retracted lid oedema lid lag ```

what is the treatment of ocular symptoms of thyroid eye disease

control of thyroid dysfunction lubricants surgical decompression

what are the symptoms of diabetic retinopathy

loss of vision | peripheral neuropathy of pupils = prostitute's pupil

what causes visual loss in diabetic retinopathy

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

what can be seen on fundoscopy in diabetic retinopathy

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

how is retinopathy graded in diabetic retinopathy

``` none mild moderate severe proliferative ```

how is maculopathy graded in diabetic retinopathy

none observable referable clinically significant

what is the management of diabetic retinopathy

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

what does laser treatment in diabetic retinopathy cause

pan-retinal photocoagulation

general diseases Flashcards

(81 cards)