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Optometric Practice 2 Flashcards

1
Q

FUNDUDS ANOMALIES

A

Diseases of the:

OPTIC NERVE
CHOROID
RETINA
MACULA

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2
Q

3 Diseases of the Optic Nerve

A

A. Optic Neuritis
B. Papilledema
C. Optic Atrophy

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3
Q

3 Diseases of the Choroid

A

A. Choroiditis
B. Posterior Uveities
C. Malignant Melanoma of the Choroid

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4
Q

8 Diseases of the Retina

A
  1. Retinal Tear
  2. Retinal Detachment
  3. Hypertensive Retinopathy
  4. Diabetic Retinopathy
  5. Circinate Retinopathy
  6. Retinal Hemorrhages
  7. Retinitis Pigmentosa
  8. Retinoblastoma
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5
Q

8 Diseases of the Macula

A
  1. Senile or Age-related Macular Degeneration
  2. Angioid Streaks
  3. Hole in the Macula
  4. Glaucomatous Cupping
  5. Myopic Degeneration
  6. Fundus in Leukemia
  7. Toxoplasmosis
  8. Fundus in AIDs
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6
Q

2 Types of Optic Neuritis

A

Papillitis and Retrobulbar Neuritis

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7
Q

Degeneration, demyelinization, inflammation or infection of the optic nerve

A

Optic Neuritis

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8
Q

Papillitis is also known as:

A

Intraocular Optic Neuritis

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9
Q

Optic Nerve Head is involved and there are visible changes in the disk

A

Papillitis

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10
Q

Inflammation occurs behind eyeball therefore disk changes are slight or even absent, diagnosis based on symptoms

A

Retrobulbar Neuritis

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11
Q

SYMPTOMS OF PAPILLITIS

A

great disturbance of vision & usually unilateral
pain around the eye or on movement of the eyeball
globe tender to palpation

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12
Q

PAPILLITIS OPHTHALMIC SIGNS

A

Very Early Stage:
The optic disc shows signs of congestion.
The disc’s edges blurry or have (stripes).

Fairly Established Condition:

The optic disc becomes swollen and takes on a whitish or grayish color.
The center of the disc may appear reddish.
Striations and white spots are often present.
Hemorrhages (bleeding) may occur.
Arteries look thin, while veins appear distended and twisted (tortuous).

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13
Q

surrounding retina involved & edema may accumulate in the macula to produce radiating streaks, described as

A

MACULAR STAR

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14
Q

most common cause of papillitis

A

SYPHILIS

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15
Q

Less frequent causes:

(LOVEUMMF)

A

Lead poisoning
Orbital Inflammation
Vascular disease
Encephalitis
Uveities
Meningitis
Multiple Sclerosis
Focal Infection

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16
Q

Prognosis of Papillitis

A

if unchecked, vision is finally much impaired or lost

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17
Q

TREATMENT OF PAPILLITIS

A

Directed against the cause and LOCALLY, rest the eye and from light

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18
Q

Involves the orbital or intracranial portion of the optic nerve

A

RETROBULBAR NEURITIS

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19
Q

SYMPTOMS OF RETROBULBAR NEURITIS

VETH

A

Headache on one side of the head.
Eye pain that gets worse when moving the eye or pressing it backward.
Vision problems that are getting worse quickly.
The pupil (the black part in the center of the eye) may not react quickly to light.

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20
Q

OPHTHALMIC SIGNS OF RETRO

A

first none, later slight hyperemia, disk margins haziness and sometimes, diminishsed caliber of retinal vessels

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21
Q

most common cause of Retro

A

MULTIPLE SCLEROSIS

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22
Q

less frquent causes:

A

syphilis, rheumatism or diabetes
acute infectious diseases (influenza
septic foci/poisons

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23
Q

PROGNOSIS OF RETRO

A

In multiple sclerosis, involvement of optic nerve rarely leasds to COMPLETE BLINDNESS

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24
Q

TREATMENT OF RETRO

A

cause should be attacked
large doses if VITAMIN B COMPLEX

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25
A noninflammatory swelling of the optic nerve head resulting from increased intracranial pressure of some interference of the optic nerve circulation, particularly venous drainage
PAPILLEDEMA
26
SYMPTOMS OF PAPILLEDEMA
Early stages - nothing ENLARGED BLINDSPOT Later - reduction in vision to blindness IF INTRACRANIAL PRESSURE IS NOT REDUCED
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OPHTHALMOSCOPIC SIGNS OF PAPILLEDEMA
in early stages, slight edema of the disk later examination shows great swelling & protrusion of the disk distortion & tortuosity of the retinal veins hemorrhages upon & near the edematous papilla
28
Most frequent cause of Papilledema:
BRAIN TUMOR
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LESS FREQUENT CAUSE: BMIS
Brain abcess Meningitis Intracranial hemmorhage Syphilis & malignant hypertension
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PROGNOSIS OF PAPILLEDEMA
more or less permanent loss of vision associated with secondary optic atrophy
31
TREATMENT OF PAPILLEDEMA
vision restored if intracranial pressure is reduced in time removal or treatment of lesion
32
2 CLASSIFICATION OF OPTIC ATROPHY
1. Simple or Primary Atrophy 2. Secondary or Postneuritic or Secondary Inflammatory Atrophy
33
SYMPTOMS OF OA
reduction in the acuteness of vision diminution in the light sense color blindness when atrophy is complete, pupils are dilated & immobile
34
OPHTHALMOSCOPIC SIGNS (SIMPLE ATROPHY)
disk is white, grayish or bluish white edges of the disk are sharply defined and regular size of disk is diminished & presents saucer- shaped excavation minute vessels have disappeared arteries are diminished in caliber
35
OPHTHALMOSCOPIC SIGNS (SECONDARY ATROPHY)
disk is dense white or grayish in color margins are irregular & hazy minute vessels are lost retinal arteries are narrow arteries & veins enclosed by white lines
36
CAUSE OF SIMPLE ATROPHY
cerebrospinal diseases multiple sclerosis systemic syphilis malaria diabetes excessive hemorrhage arteriosclerosis certain poisons(arsenic, wood alcohol) choroiditis retinitis glaucoma
37
CAUSE OF SECONDARY ATROPHY
papilledema optic neuritis tumors of the optic nerve
38
PROGNOSIS OF OA
simple atrophy occurs in middle life; the course is slow extending over many months & prognosis is unfavorable, the condition progessses to absolute blindness secondary atrophy, prognosis is better & depends upon extent optic nerve has escaped from destructive influences
39
TREATMENT OF OA
control the cause scleral or extraocular muscle surgical transplantation have been tried to initiate scleral vascularization which may induce choroidal & retinal neovascularization
40
inflammation of the choroid classified as ACUTE OR CHRONIC
CHOROIDITIS
41
Under Acute Choroiditis:
exogenous and endogenous
42
due to perforating wounds of the eyeball
EXO Acute Choroiditis
43
caused by infection localized elsewhere in the body
ENDOGENOUS ACUTE CHOROIDITIS
44
Occurs as an ocular manifestation of some internal disease such as syphilis or tuberculosis
CHRONIC CHOROIDITIS
45
6 CLINICAL VARIETIES OF POSTERIOR UVEITIES (DDCJAC)
Diffuse Choroiditis Disseminated Choroiditis Circumscribed Choroiditis Juxtapapillary Choroiditis Anterior Choroiditis Central Choroiditis
46
patches of exudation, each gradually shading into the surrounding portions of the choroid
DIFFUSE CHOROIDITIS
47
numerous round or irregular yellowish spots with fluffy borders scattered over the fundus
DISSEMINATED CHOROIDITIS
48
single patch of yellowish color with fading edges is seen near the macula
CIRCUMSCRIBED CHOROIDITIS
49
form of circumscribed choroiditis which is adjacent to the disk, its shape is usually oval
JUXTAPAPILLARY CHOROIDITIS
50
presents foci of exudation similar to those found in disseminated choroiditis but limited to the periphery of the choroid
ANTERIOR CHOROIDITIS
51
A form of circumscribed choroiditis situated in the macular region
CENTRAL CHOROIDITIS
52
SYMPTOMS OF CENTRAL CHOROIDITIS
severe reduction or loss of central vision but peripheral vision is preserved seeing a black spot & distortion of objects flashes of light, sparks of bright circles before the eyes
53
OPTHALMOSCOPIC SIGNS
gray or white spot, usually about half the size of the disk, either mottled or uniform in color, with more or less pigmentation scattered in irregular deposits or forming a border choroidal vessels seen on surface lesion found in the macular area
54
CAUSES OF CENTRAL CHOROIDITIS
tuberculosis - most common cause syphilis Infection resulting from a perforating injury acute infectious diseases of childhood
55
PROGNOSIS OF CENTRAL CHOROIDITIS
dependent upon position of patches of exudation with subsequent atrophy a single patch involving the macular region will seriously impair vision
56
TREATMENT OF CENTRAL CHOROIDITIS
removal of etiologic factor atropine may be indicated to rest the eyes
57
always primary and involves ONE EYE ONLY - occurs in adults between 40-60
MALIGNANT MELANOMA OF THE CHOROID
58
SYMPTOMS OF MALIGNANT MELANOMA of the CHOROIDITIS
1. Insidious Stage - no symptoms & only sign may be discovered by chance; a brown or black, flat or slightly elevated, circumscribed mass in the choroid which slowly increases in size; tumor may exist for a long time without causing symptoms 2. Stage of Clinical Symptoms defect in visual field or diminution in vision is the initial symptom, depending upon the location of the tumor definite elevation of the tumor but remains circumscribed, yellowish brown, brown or black area around tumor becomes detached 3. Stage of Secondary Glaucoma tumor continues to increase in size & produce inflammatory signs as a result of glaucoma & of release of irritating necrotic products 4. Stage of Extraocular Extension or Metastasis - tumor grows out of the globe; metastasis frequently occurs in the liver
59
OPHTHALMOSCOPIC SIGNS OF MALIGNANT MELANOMA
Round or spindle-shaped cells, usually pigmented Begins as a flat disk-shaped mass in the outer layers of the choroid Later, it perforates the lamina vitrea(Bruch’s membrane) & forms mushroom-shaped mass pushing the retina forward & drusen
60
cause of malignant melanoma
unknown although found in 10% of eyes blind from injury of inflammation
61
PROGNOSIS OF MALIGNANT MELANOMA
when enucleated early, cure results in about 1/2 of the cases;even after removal , death results from metastasis
62
TREATMENT OF MALIGNANT MELANOMA
enucleation is indicated as soon as diagnosis is established, cutting the optic nerve back, but it is necessary to remove the entire contents of the orbit if the growth has broken through the globe tumors located in anterior portion may be removed by a resection of the sclera
63
Torn by mechanical force, usually vitreous traction
RETINAL TEAR
64
A separation of the retina occuring between the layer of pigment epithelium and the layer of rods and cones. DARK CLOUD BEFORE THE EYE
RETINAL DETACHMMENT
65
A disease of the retina associated with essential or malignant hypertension (where blood pressure is severely high)
HYPERTENISVE RETINOPATHY
66
4 CLASSIFICATIONS OF HYPERTENSIVE RETINOPATHY
GRADE 1, 2 ,3 AND 4.
67
arterioles are reduced from ¾ to ½ of the corresponding vein & no hemorrhages, patches or edema are seen
GRADE 1
68
further reduction of arteries from ½ to 1/3 of the corresponding vein & no hemorrhages or patches seen
GRADE 2
69
aside from arteriole constriction, there are flame-shaped hemorrhages and/or cotton-wool patches & edema residues
GRADE 3
70
onset of papilledema with partial or complete star-shaped figure of edema residues at the macula(macular star)
GRADE 4
71
5yr. Survival rate of patients in group 1 is 70%; group 4 is 1% Adequate control of hypertension improves the prognosis
PROGNOSIS:
72
Associated with diabetes mellitus(where tissues are unable to utilize the available or deficient insulin coming from the pancreas which results in the inability to utilize glucose) It is always bilateral
DIABETIC RETINOPATHY
73
OPHTHALMIC SIGNS OF DM
Earliest sign is venous dilatation (because of obstruction of venous drainage) Numerous small round red spots are seen which are small hemorrhages in the deeper layer of the retina Small clusters of red dots at end of vascular twigs
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74
CIRCLE AROUND THE MACULAR
circinate retinopathy or retinitis circinata
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Ocular Pharmacology (3 decks)

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