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Lecture 5 Flashcards

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1
Q

leukocytes in the anterior chamber is indicative of

A

Acute Uveitis (iritis)

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2
Q

epidemiology of Acute Uveitis (iritis)

A

associated with many infections/diseases:
Betche’s, Chrons, gout, Zoster, Reiter’s Syndrome** (triad of arthritis, urethritis and uveitus, r. arthritis, sarcoid and TB

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3
Q

s&s of Acute Uveitis (iritis)

A

pain, photophobia, redness, miosis (small pupil)

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4
Q

tx/management for Acute Uveitis (iritis)

A

emergent opthoalmogist consult

-tx based on cause

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5
Q

sudden monocular loss of vision with cherry-red spot* “box car segment” is indicative of

A

Central Artery Occlusion

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6
Q

risk factors for Central Artery Occlusion

A

> 50 y/o, r/o Giant Cell Arteritis, DM, hyperlipidemia, HTN, oral contraceptives, AFIB, emboli

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7
Q

diagnostic studies for Central Artery Occlusion for Giant Cell Arteritis

A

erythrocyte sedimentation rate ESR, C-reactive protein

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8
Q

diagnostic studies for Central Artery Occlusion screening for DM

A

fasting glucose and A1c

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9
Q

diagnostic studies for Central Artery Occlusion screening for hyperlipidemia

A

fasting lipid levels and LFTs

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10
Q

diagnostic studies for Central Artery Occlusion screening for Cardiac

A

CBC w plt

  • electrolytes
  • TSH/FT4
  • renal fxn
  • carotid arteries (U/S, EKG, echo of heart)
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11
Q

referral for Central Artery Occlusion

A

Admit to hospital

-emergent consult to optho and cardio

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12
Q

treatment for Central artery Occlusion with Giant Cell Arteritis

A

high dose of steroids and possible artery biopsy

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13
Q

treatment for Central Artery Occlusion with cardiac

A

tx underlying cause, may need anticoagulant therapy, at risk for stroke

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14
Q

a pt has sudden monocular loss of vision, no pain, no redness, with “blood and thunder” retinal. This is indicative of?

A

central vein occlusion

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15
Q

risk factors for central vein occlusion

A

DM, HTN, hyperlipidemia, OCs, smoking, glaucoma

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16
Q

diagnostic studies for Central Vein Occlusion

A

fundoscopic exam - blood and thunder retinal and neovascualrization

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17
Q

treatment and management for Central Vein Occlusion

A

refer: emergent consult to optho to prevent retinal detachment
- PCP tx underlying cause (dm etc)

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18
Q

pt has sudden loss of vision and floaters, this indicates….

A

Vitreous Hemorrhage

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19
Q

risk factors of Vitreous Hemorrhage

A

retinal tears, retinal detachment, DM, sickle cell, blood dycrasias, trauma, ARMD

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20
Q

referral for Vitreous Hemorrhage

A

emergent consult to optho

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21
Q

pt has an abrupt monocular (bino) loss of vision (partial or completer) that lasts only a FEW minutes, AKA: ocular transient ischemic attack (TIA); this is indicative of….

A

Amaurosis Fugax

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22
Q

risk factors or Amaurosis Fugax

A

DM, HTN, hyperlipidemia, Giant Cell Arteritis, migraine

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23
Q

epidemiology of Amaurosis Fugax

A

caused by an emboli if vascular

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24
Q

PE of Amaurosis Fugax

A

complete ocular exam, cardiac, and neurological exam

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25
diagnostic studies for Amaurosis Fugax
lipid panel | -glucose, A1c, CBC, TSH/FT4, electrolytes, carotid artery U/S, EKG, echo
26
complications of Amaurosis Fugax
central retinal artery occlusion, stroke
27
treat/referral for Amaurosis Fugax
referral emergent consult to optho | tx underlying cause
28
pt has a reduction in VA (> 2-line differences b/w eyes) usually unilateral... this is indicative of
Vision abnl - Amblyopia
29
epidemiology of Amblyopia
strabismus amblyopia - misalignment | -refractive amblyopia
30
most common cause of pediatric visual impairment
Amblyopia
31
risk factors of Amblyopia
premature, small size for gestational age, 1st degree relative with amblyopia, neurodevelopment delay
32
tx and management for Amblyopia
pediatric optho consult | -tx based on cause
33
an elevated IOOP, progressive loss of VF, pathologic cupping of optic disc (>0.5) is indicative of...
Chronic Open-Angle Glaucoma
34
risk factors for Chronic Open-Angle Glaucoma
> 40 yo - genetics - DM - Steroid use
35
diagnostic studies for Chronic Open-Angle Glaucoma
IOP > 22
36
complications for Chronic Open-Angle Glaucoma
blindness
37
referral and f/u for Chronic Open-Angle Glaucoma
routine consult to optho f/u: annually/Q6m optho sooner if sx inc
38
medication for Chronic Open-Angle Glaucoma
timolol 0.25% opth sol
39
non Pharma for Chronic Open-Angle Glaucoma
diet modification, no smoking, decrease caffeine
40
if pos FMHx for Chronic Open-Angle Glaucoma when should pt begin screening
at 40 yo
41
what should pt with Chronic Open-Angle Glaucoma avoid?
beta blocker in pt with asthma, COPD, 2nd and 3rd degree AV block
42
a sudden onset of severe pain, steamy cornea, fixed mid-dilated pupil, halos around lights, blurred vision with shallow anterior chamber is indicative of
Acute Closed-Angle Glaucoma
43
risk factors for Acute Closed-Angle Glaucoma
-drugs: some bronchodilators, furosemide, thiazides, antidepressants, sulfonamides, cocaine, ecstasy -trauma
44
diagnostic studies for Acute Closed-Angle Glaucoma
IOP > 22 (40-70mmHg)
45
complications of Acute Closed-Angle Glaucoma
cataract, decrease VA, repeat episodes
46
referral for Acute Closed-Angle Glaucoma
emergent consult to optho w/in 1 hr of pt presentation | -may go immediate to surgery
47
medications for Acute Closed-Angle Glaucoma
1 drop each 1 minute apart: timolol 0.5% apraclonidine 1%, pilocarpine 2%; possible IV acetazolamide 500 mg (check eye pressure every 30 min) may be d/c PO Rx
48
a painful, diffuse anterior sclera - 50%, local tenderness to touch, sclera edema is indicative of
vision loss due to scleritis
49
epidemiology of vision loss due to scleritis
inflammatory and autoimmune process
50
risk factors of vision loss due to scleritis
RA and Wegeners granulomatosis
51
referral for scleritis
emergent consult to optho and rheumatologist
52
medications for Scleritis
consider NSADs- indomethacin (25-75 mg PO TID) | -consider glucocorticoids - prednisone 1 mg/kg per day maximum 80 mg (tapering regimen - for d/c prednisone)
53
eye deviation from anatomical position - trope (constant) is indicative of
strabismus
54
risk factors for Strabismus
positive FMHx, low birth weight, Downs or cerebral palsy
55
epidemiology of Strabismus (2 laws)
Herings law or Sherringtons law
56
congenital epidemiology of Strabismus
- congenital: poor central vision, retinoblastoma, trauma with CN palsies
57
acquired epidemiology of Strabismus
intracranial hemorrhage, abscess, encephalitis, Guillain- Barre syndrome, measles, orbital fracture, tumors, CN palsy
58
s&S of strabismus
diplopia, slit images, HA, n/v, fever
59
diagnostic studies for strabismus
MRI and CT; CBC w diff
60
treatment for strabismus
consult optho, tx will be based on cause
61
Hering's law
agonist muscles in both eyes receive equal innervation to ensure binocular eye movement (right lateral rectus m. abducts right eye = left medial rectus m. to adduct the left eye)
62
Sherringtons law
agonist/antagonist muscle pairs of each eye receive reciprocal innervation (right medial rectus m. contracts adducting right eye; antagonist - right lateral rectus m relaxes)
63
if you have vision loss on an entire eye, a tumor is most likely blocking your .... (visual fields)
both optic nerves of eye
64
if your have vision loss on the inner half of an eye, a tumor could be blocking your (visual fields)
outer optic nerve
65
if you lose your peripheral vision, tumor is most likely blocking (visual fields)
optic chiasm
66
if you lose vision on one side of both eyes.. tumor is affecting .... (visual fields)
optic tract or lateral geniculate nucleus

CMS- opts (3 decks)

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