Ophthalmology Clinical Flashcards Preview

Neuro > Ophthalmology Clinical > Flashcards

Flashcards in Ophthalmology Clinical Deck (11):
1

Age related, any time after age 50, usually greater than 70. Presents with decreased central vision. What are the two types?

-Dry macular degeneration (Nutritional recommendations, AREDS supplements; antioxidants, luteine)
-Wet macular degeneration (growth of blood vessels under/in retina, edema and hemorrhage, eventual fibrosis and scarring; anti-vegf drugs and lasers)

2

Increased ocular pressure causes optic nerve loss. What are the two main types?

Glaucoma
-Open angle (trabecular meshwork goes bad)
-Narrow angle (acute/closed angle); medical emergency! Pilocarpine 15 minutes and azetazolamide and then laser iridotomy

*treatment is to lower eye pressure (medical, surgical, laser). Check the cup/disc ratio! Larger cup over time can indicate worsening of glaucoma, asymmetry is common in glaucoma.

3

How does diabetic retinopathy occur?

Increased glucose damages blood vessel walls, causing VEGF to be released. Fluid leaks into retina, causing visual damage.

4

What are the three clinical stages of diabetic retinopathy?

- Nonproliferative diabetic retinopathy (NPDR): blot hemorrhages, cotton wool spots, micro aneurysms, macular edema, hard exudates
- Preproliferative diabetic retinopathy: more significant; intraretinal vascular abnormalities and venous beading
- Proliferative diabetic retinopathy (PDR): neovascular vitreoretinopathy, vitreous hemorrhage

*treat with pan-retinal photocoagulation (laser)

5

How often do diabetics need eye exams?

-Type II at diagnosis and annually thereafter
-Type I annually after 5 yrs of disease duration, more freq if develop retinopathy.

6

Narrowing and sclerosis of arterioles, flame hemorrhages, cotton wool spots, optic nerve edema in severe cases.

Hypertensive retinopathy. Treat by keeping BP down.

7

-Sudden loss of vision in one eye
-Generally lasts only minutes
-Painless
- Embolic material within retinal arteriole (Hollenhorst plaque)

Amaurosis fugax. Usually temporary vascular insufficiency, req cardio workup first and optho eval second.

8

Hallmark is scintillating scotoma
-painless and temporary
-involves both eyes causing temporary hemianopsia
- Lasts 20-30 minutes
- kind of looks like heat waves

Opthalmic migraine: spasm of arteriole in the occipital cortex.

9

-Sudden partial vision loss in one eye
-Painless
- May be progressive, always sustained (does not resolve spontaneously)
- Often accompanied by floaters and photopsias (flashes)
-Higher frequency in myopia
-Usually spontaneous

Retinal detachment. Refer to optho for surgery.

10

-Sudden severe loss of vision in one eye
-Painless
-Vision loss usually perm, may recover if treated rapidly
-Cherry red spot

Retinal arterial occlusion. Can breathe into paper bag to inhale carbon dioxide and dilate vessels.

11

Squashed tomato look

Central retinal vein occlusion