Ocular Manifestations of Systemic Disease Flashcards
(37 cards)
Traumatic Disorder
- Shaken baby syndrome is increasingly evident in our society.
- Fundoscopy may reveal preretinal, intraretinal or vitreous hemorrhages.
Hypertensive Retinopathy
- Occurs in 15% of patients with just HTN.
- Rarely by itself causes significant vision loss.
Hypertensive changes in the eye (Mild)
- Retinal artery narrowing
- Arterial wall thickening or opacification
- Arteriovenous nicking (nipping)
Hypertensive changes in the eye (Moderate)
- Hemmorhages: flame or dot shaped
- Cotton-wool spots
- Hard exudates
- Microaneurysms
Hypertensive changes in the eye (Severe)
- Some or all of moderate
- Optic disc edema
- Presence of papilledema mandates lowering of the BP!
Focal narrowing, exudates and flame hemorrhages are related to _________ BP levels
Current
Copper wire
Arteriolar sclerotic changes with arteriolar narrowing.
A long-lasting HTN ocular effect.
Silver wire
With halogen light source, sclerosis of vessel is seen. Appears white.
HTN retinopathy S/S
Sx:
- Normal vision, turning to a blurred or sudden decrease.
- Scotoma, diploplia
Signs: Ateriolar narrowing in chronic HTN
- Focal spasm in acute
- Retinal edema
- Microaneurysm
HTN retinopathy treatment
- Control HTN
- Manage renal disease associated w/ HTN.
- Refer to optho
Swelling of the optic disc
- Hallmark of malignant HTN.
- A sudden drop in perfusion can result in optic disc infarction and blindness.
- BP must be controlled immediately.
Intracranial HTN
- Most common ocular manifestation is optic disc swelling (papilledema)
- Transient visual symptoms
Grave’s Opthalmopathy
- Occurs in about 20% of patients w/ grave’s.
- More common in women
- Smoking is a risk factor
Grave’s O Patho
T lymphocytes cause inflammation and accumulation of hydrophilic glycosaminoglycans (GAG).
- Restricts upward gaze
- Results in vertical diploplia
Grave’s O S/S
Signs:
- Proptosis (exopthalmus)
- Preorbital Edema
VIsual Symptoms:
-Excessive tearing, eye pain, blurred vision, diploplia, occasional loss of vision
Grave’s O complications
Exopthalmus
Dry eyes, corneal ulceration
EOM impairment
-Diploplia, no upward vision, cannot achieve or maintain convergence.
Tx of Grave’s O
Treat underlying Hypothyroidism
Mild:
-Dark glasses, artificial tears, elevate head, Oral selenium.
Severe:
-Glucocorticoids, Radiation or surgery.
Ocular Myasthenia Gravis
- Autoimmune disorder characterized by weakness and fatigue of skeletal muscle.
- Ptosis fluctuation and oculomotor paresis.
- Muscle fatigue of levator muscle
- Results in binocular diploplia
- Often asymptomatic in morning, and feel effects during the day. **
HIV
Most common ocular finding are cotton wool spots. Infxns: - CMV retinitis - Toxoplasmosis Kaposi Sarcoma
AIDS Retinal Disease
- CMV retinitis is most common serious complication of AIDS.
- 25-40% have retinal detachment because of CMV
AIDS Retinal S/S
Floaters, decreased or blurred vision, scotoma, photopsia (flashing lights).
Toxoplasmosis Retinitis
Potentially blinding, necrotizing retinitis.
Toxoplasmosis S/S
- Wavy or distorted vision, floaters, pain, decreased or blurred vision.
- May see old scars, vitreous debris, yellow-white areas on retina, optic nerve yellow-white and swollen, macular edema.
Toxoplasmosis Tx
- Pyrethamine and folate
- Sulfisoxalone
- Clindamycen (triple therapy) + Pred
