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Flashcards in ophthalmology III Deck (23)
1

what is diabetic retinopathy and risk factors

#1 cause blindness working age adults. Risk factors:
Duration of diabetes(50% at 10 yrs, 90% at 30 yrs), Glycemic control – DCCT and UKPDS, Blood pressure –UKPDS, Pregnancy #1 cause blindness working age adults. Risk factors:
Duration of diabetes(50% at 10 yrs, 90% at 30 yrs), Glycemic control – DCCT and UKPDS, Blood pressure –UKPDS, Pregnancy

2

diabetic retinopathy pathophys

Microvascular injury, Hemorrhage, Leakage, Ischemia, Neovascularization

3

non-proliferative diabetic retinopathy signs

Microaneurysms, Flame hemorrhages, Dot-blot hemorrhages, Venous beading and dilation, Macular edema (#1 cause of vision loss in DM), Hard exudates – Lipoprotein, Capillary non-perfusion

4

proliferative diabetic retinopathy sgns

Neovascularization (Optic disc and Retina), Fibrovascular proliferation, All pt’s with DM – 5-10%, Type 1 DM for 30 yrs – 60%

5

proliferative diabetic retinopathy complications

Vitreous hemorrhage, Tractional retinal detachment, Neovascularization of iris leading to Obstruct trabecular meshwork leading to Neovascular glaucoma

6

diabetic retinopathy management

Glycemic control, Blood Pressure control, Screening eye exams, Laser photocoagulation. Diabetic macular edema – Focal laser. PDR – Panretinal photocoagulation. Anti-VEGF injections (improve macular edema), pars plana vitrectomy (for vitreous hemorrhage)

7

Central retinal vein occlusion- what is it, risk factors, findings, treatment

Blockage of the main vein carrying blood from the retina. Risk factors: HTN, age, glaucoma. Findings: dilated and tortuous retinal veins, swollen optic nerve, intraretinal hemorrhages, macular edema. Treatment: anti-VEGF injections (improves macular edema) and laser photocoagulation

8

Hypertensive retinopathy- causes and treatment

Vasoconstriction (Arteriole narrowing), Arteriosclerosis (treatment: Copper and silver wiring, Arterio-venous nicking)

9

Hypertensive retinopathy- symptoms

Retinal hemorrhage, Macular edema and exudate, Optic disc edema (Papilledema-Due to acute, severe HTN)

10

Age related macular degeneration- risk factors

#1 cause blindness >50 yr old
Risk factors: Age – 6% age 65-74, 20% ≥75 yrs, Race – Caucasians , Gender – females, Tobacco smoking, Cardiovascular disease#1 cause blindness >50 yr old
Risk factors: Age – 6% age 65-74, 20% ≥75 yrs, Race – Caucasians , Gender – females, Tobacco smoking, Cardiovascular disease

11

nonexudative (dry) age related macular degeneration- symptoms

Drusen (yellow lipoprotein deposits under retina. Can be hard or soft, soft have higher risk of progression). Retinal pigment epithelium changes (atrophy, hyperpigmentation), geographic atrophy, AREDS vitamins (antioxidants and zinc can prevent AMD)

12

exudative (wet) age related macular degeneration- symptoms

more vision loss, choroidal neovascularization into retinal pigment epithelium (Macular edema and hemorrhage, Pigment epithelial detachment, Fibrotic disciform scar)

13

exudative AMD treatment

Anti-VEGF intravitreal injections - regression of choroidal neovascularization

14

components and attachments of vitreous fluid

main fluid of eye- Water, hyaluronic acid and collagen type II. Attachments to ora serrata, macula, optic nerve

15

posterior vitreous detachment- causes

retinal detachment, epiretinal membrane, macular hole

16

what is the choroid

Vascular layer btw retina and sclera. Aka posterior uvea

17

disease of choroid

age related macular degeneration, choroid neovascular membranes, uveitis, tumors

18

average size of optic disc

Average cup-to-disc ratio 0.3 and 98% of normal eyes are <0.7

19

glaucoma findings

elevated intra-ocular pressure, optic disc hemorrhage, visual field defects, enlarged cup to disc ratio or asymmetry

20

glaucoma management

lower intra ocular pressure with meds (decrease aqueous production or increase outflow), laser, surgery

21

Anterior ischemic optic neuropathy- what is it, risk factors

infarction of optic disc, risk factors: age, caucasians, small C/D ratio, cardiovascular risk factor

22

non-arteritic Anterior ischemic optic neuropathy- symptoms

Painless, Afferent pupillary defect, Visual field defect, Optic disc edema, No specific treatment, Treat comorbidities

23

arteritic Anterior ischemic optic neuropathy symptoms and treatment

Giant cell arteritis, Systemic symptoms – HA, fatigue, Jaw claudication, Scalp tenderness, Worse vision loss, Pallid disc edema. Treatment: steroids, prevent progression, rare vision improvement