systemic

Question 1

classification for hypertensive retinopathy

Answer 1

keith wagener

Question 2

stage I –> IV hypertensive retinopathy

Answer 2

I = arteriolar narrowing + torturous, increased light reflex // II = ateriovenous nipping // III = cotton wool exudate, flame + blot haemorrhages // IV = papilloedema

Question 3

leading cause of blindness in adults 35-65

Answer 3

diabetes

Question 4

pathophysiology diabetic retinopathy

Answer 4

hyperglycaemia –> endothelial dysfunction –> permeability –> exudate + aneurysms + neovascularisation

Question 5

signs diabetic retinopathy

Answer 5

microaneurysm // blot haemorrhage // hard exudate // cotton wool spot // Intra retinal microvascular abnormalities

Question 6

mild non-proliferative diabetic retinopathy

Answer 6

1 or more microaneurysm

Question 7

moderate non-proliferative diabetic retinopathy

Answer 7

microaneurysm + blot haemorrhage + hard exudate + cotton wool spots, maybe venous beading

Question 8

what are cotton wool spots

Answer 8

soft exudate - area of retinal infarction

Question 9

severe on-proliferative diabetic retinopathy

Answer 9

blot haemorrhage + microaneurysm in all quadrants // benous beading 2/4 quadrants // IRMA in 1 quadrant

Question 10

proliferative diabetic retinopathy

Answer 10

(bad) neovascularisation (–> vitreous haemorrhage) // fibrous tissue on retinal disc

Question 11

diabetic maculopathy

Answer 11

hard exudate + macula changes

Question 12

what type of retinopathy is more common in T1dm and T2DM

Answer 12

proliferative = T1DM // maculopathy = T2DM

Question 13

mx non-proliferative diabetic retinopathy

Answer 13

observation - if severe laser photocoagulation

Question 14

mx proliferative diabetic retinopathy

Answer 14

panretinal laser photocoag // intravitreal VEGF eg ranibizumab

Question 15

mx diabetic maculopathy

Answer 15

if changes in acuity –> intravitreal VEGF

Question 16

causes optic neuritis

Answer 16

MS!!! // (syphilis, diabetes)

Question 17

symptoms optic neuritis

Answer 17

unilateral decreased acuity // red desaturation // pain worse on movement // RAPD // central scotoma (blind spot)

Question 18

invx optic neuritis

Answer 18

MRI brain + orbits with GADOLINIUM contrast (if 3+ white matter lesions may be MS)

Question 19

mx optic neuritis

Answer 19

high dose steroids

Question 20

ocular manifestations RA

Answer 20

keratoconjunctivitis // episcleritis // scleritis // corneal ulcer // keratitis

Question 21

what is papilloedema

Answer 21

bilateral optic disc swelling secondary to raised ICP

Question 22

fundoscopy papilloedema

Answer 22

venous engorgement // blurred optic disc margin // swollen optic disc // red

Question 23

causes papilloedema

Answer 23

SOL // extreme HT // idiopathic intracranial hypertension // hydrocephalus // hypercapnia // (vit A toxicity, hypoparathyroid, hypoCa)

Question 24

causes tunnel vision

Answer 24

papilloedema // glaucoma // retinitis pigmentosa // choroidretinitis // optic atrophy // hysteria

Question 25

causes Retinitis pigmentosa

Answer 25

inherited

Question 26

symptoms Retinitis pigmentosa

Answer 26

night blindness (first sign) // tunnel vision

Question 27

fundoscope Retinitis pigmentosa

Answer 27

black curved pigmentation on peripheral retina

Question 28

assoc conditions Retinitis pigmentosa

Answer 28

refsum // usher // alports

Question 29

where are haemorrhages often seen in hypertensive retinopathy

Answer 29

around macula ‘macula sunburst star’