Sensory

Question 1

Cataracts

Answer 1

cloudy lens, gradual painless blurriness; if untreated, can go blind

Question 2

Risk for cataracts

Answer 2

old (almost all will get), eye trauma (babies get premature cataracts), congenital risk, DM, steroid use, smoke and alc

Question 3

Cataract manifestations of vision

Answer 3

-Painless
- Uni- or bilateral vision changes
- Blurry
- Halo around lights
- Altered color perceptions
- Glare issues at night
- Decreased
accommodation

Question 3

Cataracts tx

Answer 3

laser eye tx
- no pharm

Question 3

Retinopathy most common type

Answer 3

diabetic retinopathy (40% over 40 have it)

Question 4

Nonprolific retinopathy

Answer 4

• Capillary microaneurysms, retinal swelling, hard exudate
• Macular edema- plasma leaks
  from macular blood vessels
• Capillaries rupture, leading to “dot or blot” hemorrhaging

Question 5

Proliferative retinopathy

Answer 5

• All patho of nonproliferative plus advanced retinopathy
• New blood vessels are fragile and leaky

Question 6

Hypertensive retinopathy

Answer 6

• Etiology: high blood pressure creates blockages in retinal bloodvessels
• no initial chx
• sustained, severe HTN can cause sudden visual loss related swelling of the optic disc and nerve–ischemia
• exudative and hemorrhage like with diabetic retinopathy

Question 7

Retinal detachment

Answer 7

• retinal has tear or leak
• vitreous humor flows behind retina
• rapid, prog detach from choroid (spontaneous)

Question 8

Risks for detached retina

Answer 8

Myopia, over 40, trauma to eye like eye tumor and complication of cataract surgery

Question 9

CM of detached retina

Answer 9

 SUDDEN, unilateral
vision loss
 Painless
 May see floaters
 Flashes of light

Question 10

Macular degneration

Answer 10

Most common irreversible vision loss over 60

Question 11

Dry MD

Answer 11

• most common, 90%
• yellow deposits in retinal pigment epithelium

Question 12

Wet (exudative) MD

Answer 12

• 10%
• more hemorrhagic
• grow new leaky (hemorrhagic) BVs in abnormal part of retina

Question 13

Protection for MD

Answer 13

 Dark green, leafy vegetables protective

Question 14

Risk factor for MD

Answer 14

Family history, genetics, UV light,
hyperopia, smoking, light-colored eyes

Question 15

CM for MD and tx

Answer 15

Early on– usually no symptoms
Later:
 Blurred, darkened vision
 Blind spots (scotomas)
 Distorted vision (metamorphopsia)
Vision does not improve, treatment
is limited
 Medications are injected into the eye

Question 16

Glaucoma

Answer 16

inc IOP plus vision change or optic nerve damage
- chronic
- usually bilateral

Question 17

Open angle risk for glaucoma

Answer 17

• still some flow
   Elevated IOP
   Age- older
   Race: African-Americans 3-4x higher
  risk
   Family history
   Myopia
   Diabetes, HTN, migraines

Question 18

Open-angle glaucoma patho

Answer 18

• Abnormal trabecular meshwork
• Reduced drainage of aqueous humor into canal of Schlemm
• Imbalance between inflow and outflow
• Results in increased IOP and vision problems

Question 19

Open angle glaucoma CM

Answer 19

 None usually
 Progressive loss of sight
 Vague eye pain
 Halos around lights
 Tunnel vision

Question 20

Closed angle glaucoma

Answer 20

• Much less common
• Abnormal angle between the iris and later cornea
• Outflow is blocked when the pupil is DILATED
• Aka acute angle-closure glaucoma
  (AACG) or narrow-angle glaucoma

Question 21

Acute angle closure glaucoma is an

Answer 21

EMERGENCY - sudden complete closure - outcome based on time of tx

Question 22

Closed angle glaucoma risks

Answer 22

• Asian American ethnicity
• Females
• Hyperopia
• Family history
• older age

Question 23

What triggers acute angle closure glaucoma

Answer 23

Anticholinergic drugs

Question 24

Acute closed angle glaucoma CM

Answer 24

 Typically UNILATERAL but other eye is at risk  SEVERE eye pain  Nausea and vomiting  Blurry vision, halos  Reddened eyes  Dilated pupil– non-reactive to light  Cloudy cornea

Question 25

Glaucoma and blindness

Answer 25

 Due to the increased IOP  More pressure on inner eye structures  Decreased blood flow to optic nerve  Nerve fiber death blindness

Question 26

Pharm for glaucoma

Answer 26

 Drugs that DECREASE aqueous humor production  INCREASE aqueous humor drainage  Or both

Question 27

How to use eye drops

Answer 27

use nasolacrimal pressure for 2 min to prevent from spreading systemically

Question 28

Drugs that dec AH prod

Answer 28

beta blocker, alpha adrenergic agonist

Question 29

Drugs that inc AH drainage

Answer 29

prostaglandin analogs, alpha 2 adrenergic agonist (maybe)

Question 30

Meniere disease

Answer 30

Endolymphatic hydrops - unilateral or bilateral excessive endolymp and pressure in membranes disrupt vestibular and hearing fxn

Question 31

Meniere CM

Answer 31

Recurring episodes of vertigo [usually with nausea & vomiting], hearing loss, ringing in the ears (tinnitus), and feeling of fullness

Question 32

Meniere tx

Answer 32

Symptomatic - diet change (lower salt), caffeine, alc, stress, MSG, allergies

Question 33

When does Meniere start

Answer 33

age 20-40 usually

Question 34

HTN retinopathy tx

Answer 34

- normal vision can be restored with HTN tx - no pharm - meet with dr regularly to control progression

Question 35

Etiology for macular degneration

Answer 35

Retinal aging

Question 36

Tx for acute open angle glaucoma

Answer 36

Surgical intervention

Question 37

What drug might you give with Meniere's

Answer 37

Ones that help with dizziness