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Flashcards in Systemic Disease Deck (26)
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1
Q

How does diabetes cause eye problems?

A

Chronic hyperglycaemia causes glycosylation of the basement membrane in the ocular capillaries which leads to loss of pericytes (make up the tight junctions), leading to out pouching and micro aneurysm

2
Q

Name the two aspects of a micro-aneurysm

A
  • leakage

- ischaemia

3
Q

Other than micro aneurysms what else can lead to visual loss

A

Retinal scarring and retinal oedema (affecting the fovea)

4
Q

How do micro aneurysms lead to vision loss?

A

Ischaemia leads to new vessels formation which are prone to haemorrhage

5
Q

How does retinal oedema occur?

A

The increased accumulation of sorbitol (converted from glucose) creates a hyperosmotic effect that results in an infusion of fluid to countervail the osmotic gradient.

6
Q

New vessels on which part of the eye cause most damage?

A

Disc or iris

7
Q

How is retinopathy classified?

A
  • None
  • Non-proliferative (mild/moderate/severe)
  • Proliferative
8
Q

How is maculopathy classified?

A

None
Observable
Referable (thick)
Clinically significant (involving the fovea)

9
Q

How is diabetic eye disease managed?

A

Control diabetes
Laser treatment - pan retinal photocoagulation or macular grid
Vitrectomy
Biologics

10
Q

How does hypertension cause ocular manifestations?

A

Stress on the vessels causes the lumen to narrow and the walls to thicken.

11
Q

What are the features of ocular manifestations of hypertension?

A
Attenuated blood vessels (copper/silver wing) 
Cotton wool spot 
Hard exudate (follows axon alignment) 
Haemorrhage 
Oedema
12
Q

Name the infective causes of uveitis

A

TB, herpes, candida, toxoplasmosis, syphillus, lyme’s disease

13
Q

Name the non-infective causes of uveitis

A

HLA B27, Bechet’s, Juvenile arthritis

14
Q

What is giant cell arterities and what disease is it associated with?

A

Inflammation of middle sized arteries associated with polymyalgia rheumatica

15
Q

What are the symptoms of GCA?

A

Headache, jaw claudication, malaise, blinding

16
Q

What are the extra-ocular manifestations of thyroid eye disease?

A

Proptosis
Lid retraction, oedema, lag, pigmentation
Restrictive myopathy

17
Q

What are the ocular manifestations of thyroid eye disease?

A

Anterior - chemosis, injection, glaucoma

Posterior - nerve swelling, choroidal folds

18
Q

What is thyroid eye disease characterised by?

A

Swelling of extra ocular muscles and orbital fat due to autoimmune condition

19
Q

How is thyroid eye disease treated?

A

Lubricants

Surgical decompression

20
Q

What are the ocular manifestations of rheumatoid arthritis?

A

Dry eyes, scleritis, corneal melt

21
Q

How does scleritis present?

A

Deeps dusky and painful inflammation

22
Q

What are the ocular manifestations of sjogrens and why?

A

Dry eyes, xerostomia due to infiltration of lacrimal glands

23
Q

Describe the ocular manifestations of marfans and explain why they occur

A

Disease of collagen, the zones ‘ping’ causing upwards lens dislocation

24
Q

What dermatological condition can cause severe ocular problems?

A

Steven Johnson Syndrome

25
Q

Describe steven johnson syndrome

A

Exfoliation of skin, in the eye leads to symblepharon, occlusion of lacrimal gland, corneal ulcers

26
Q

What is symblepharon?

A

Eyelid attaches to the conjunctiva