Ophthalmology Key Points Flashcards
What are cataracts?
Opacity of the normally clear lens caused by age, metabolic disorder, trauma, or heredity
What are the indications for cataract surgery?
- severity of vision loss
- functional needs of patient
- need to improve view of posterior segment of the eye to care for ocular pathology
When does macular degeneration usually occur?
Anytime after age 50, usually >70 years old
What type of vision loss is present first in macular degeneration?
Central vision
What does eye exam show in minor Dry Macular Degeneration?
- drusen
- pigmentary changes
- vision probably fine
What does eye exam show in more significant Dry Macular Degeneration?
- drusen
- pigmentary retinopathy
- atrophy of the retina
- vision probably diminished
What is the treatment for Dry Macular Degeneration?
- Quit smoking
- nutritional changes (dark, green vegetables)
- manage systemic diseases (DM, HTN)
- AREDS supplements - antioxidant vitamins (beta carotene, vitC, vitE), minerals (zinc, copper)
What does eye exam show in Wet Macular Degeneration?
- Defects develop in deep retinal layers
- Growth of blood vessels under/in retina
- Edema
- Hemorrhage
- Eventual fibrosis/scarring
- Serious loss of vision
What are the treatment options for Wet Macular Degeneration?
- Dry recommendations
- Conventional laser
- Photodynamic therapy
- Anti-VEGF drugs (Avastin, Eyelea, Lucentis, Macugen) injected intravitreally can dry up exudative changes
What is Glaucoma?
Increased ocular pressure causing optic nerve loss.
What causes blockage in Open Angle Glaucoma?
- The trabecular meshwork is normally the main blockage
- Aqueous humor cannot drain out as well
What are the symptoms of Narrow (Acute/Closed) Angle Glaucoma?
- Acute onset
- Severe pain with loss of vision
- +/- nausea
- red eye
- cloudy cornea
- photophobia
- halo around lights
- fixed/mid dilated pupil
- extremely high IOP >40 mmHg
How do glaucoma medications decrease intraocular pressure?
- Decreasing aqueous production
- Increasing outflow
What three medications are suggested in the treatment of Acute Glaucoma?
- Pilocarpine (Q15min)
- Acetazolamid (Diamox IV/PO)
- Glycerine OR Isosorbide (PO)
What procedure do ophthalmologists perform to treat Acute Glaucoma?
Surgical or Lasor Peripheral Iridotomy
What are key eye exam findings in Nonproliferative Diabetic Retinopathy?
- Blot Hemorrhages
- Cotton Wool Spots
- Microaneurysms
- Macular Edema
- Hard Exudates
What is the treatment for Diabetic Retinopathy?
Panretinal Photocoagulaton (PRP)
- ablate supporting retina
- stops release of VEGF
What are the 7 things that should be on your differential diagnosis for a patient with sudden visual loss?
- Amaurosis Fugax
- Migraine Scotoma
- Retinal Detachment
- Retinal Artery Occlusion
- Retinal Vein Occlusion
- Temporal Arteritis (Giant Cell Arteritis)
- Stroke
What is the hallmark of Amaurosis Fugax?
Quick loss of vision in one eye
(lasts minutes)
Who do you refer a patient with Amaurosis Fugax to?
Cardiology!
(Impending stroke until proven otherwise!)
What is a Retinal Cholesterol Emboli a warning sign of?
Future disaster in vascular system.
(need Carotid US & Echocardiogram)
What causes an Ophthalmic Migraine (aura w/ or w/o headache)?
Spasm of arteriole in occitpital cortex
What are the clinical hallmarks of Retinal Detachment?
- Sudden partial vision loss in one eye
- Painless
- Sustained, may be progressive
What is the clinical hallmark on eye exam for Retinal Arterial Occlusion?
Cherry Red Spot
(indicates acute central retinal artery occlusion)
