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Flashcards in The eye in systemic disease Deck (43):
1

Presentationof CN VI palsy?

Can't abduct the eye

2

Causes of CN VI palsy

Microvascular
Raised ICP
Tumour
Congenital

3

Presentation of CN IV palsy

wEAK DEPRESSION IN ADDUCTION

4

Clinical features of bilateral IV palsy

ToRsion
Chin depressed

5

Cause of bilateral CN IV palsy

Blunt head trauma

6

Causes of CN IV palsy

Congenital decompensated
Microvascular
Tumour

7

Presentation of CN III palsy

Down & out

8

Causes of CN III palsy

Microvascular
Tumour
Aneurysm
MS
Congenital

9

What causes a painful CN III palsy?

Aneurysm

10

Causes of inter-nuclear opthalmoplegia

MS
Vascular
Lots of small print

11

What is inter-nucleur opthalmoplegia?

When patients eyes are directed away from the side of the lesion the affected eye will not move past the midline and the non-affected eye will have nystagmus

12

Causes of visual field defect

Vasclar disease
Scape occupying lesion
Demyelination (MS)
Trauma

13

Who is optic neuritis common in?

MS patients

14

What tumours can affect the optic nerve?

Meningioma
Glioma
Haemangioma

15

Presentation of optic neuritis

Progressive visual loss (unilateral)
Pain behind eye, especially on movement
Colour desaturation
Central scotoma

16

What can cause compression on the optic chiasm?

Pituitary tumour
Craniopharyngioma
Meningioma

17

What causes bitemporal field defect?

Optic chiasm compression

18

Is visual loss or disturbance permanent with a pituitary tumour?

It is commonly reversed after the tumour is decompressed or removed

19

WHat can affect the occipital cortex?

Vascular disease (CVA)
Demyelination

20

Pathogenesis of diabetic retinopathy

Chronic hyperglycaemia
Glycosylation of protein/basement membrane
Loss of pericytes
microanuerysm
Microaneurysm can lead to leakage & ischaemia

21

Signs of non-proliferative retinopathy on fundoscopy

Microaneurysms/ dot & lot haemorrhages
Hard exudate
Cotton wool patches
Aormalities of venous calibre
Intra-retin

22

In what stages do new vessels grow in diabetic retinopathy?

Grow on disc
Grow in the periphery
Grow on iris if ischaemia is severe

23

What can cause diabetics to lose vision?

Retinal oedema
Vitreous haemorrhage
Scarring/tractional retinal detachment

24

How is diabetic retinopathy classified?

Mild
Moderate (non-proliferative retinopathy)
Severe (non-proliferative retinopathy)
Proliferative retinopathy

25

How is diabetic maculopathy classified?

No maculopathy
Observable maculopathy
Referable maculopathy
Clinically significant maculopathy

26

Management of diabetic retinopathy

Optimise medical management
Laser
Vitrectomy
Rehabilliatation

27

Features of hypertensive retinopathy on fundoscopy

Atenuated blood vessels/ copper or silver wiring
Cotton wool spots
Hard exudates
Retinal haemmorhage
Optic disc oedema

28

How does accelerated hypertension tend to present?

Particularly in young patients
Very dramaic fundal appearance
Can have decreased vision

29

Presentation of central retinal artery occlusion

Sudden painless loss of vision
Very profound loss of vision
Retinal nerve fibre layer becomes swollen except at fovea (cherry red spot)

30

Presentation of central retinal vein occlusion

Sudden pailess visual loss
range of visual loss
Ischaemia correlates to degree of reduced vision and fundal appearances

31

How does a branch vein occlusion present?

Painless disturbance in vision
May be assymptomatic
May be aware of loss of part of field

32

Infective causes of uveitis

TB
Herpes Zoster
Toxoplasmosis
Candidiasis
Syphilis
Lyme disease

33

Non-infective causes of uveitis

Idiopathic syndromes
HLA-B27
Juvenile Arthritis
Sarcoidosis
Behcet's disease

34

Presentation of GCA

PMR
Headache
Jaw claudication
Malaise
Raised P.V.
Blinding condition

35

Extraocular features of thyroid eye disease

Proptosis
Lid retraction
Lid oedema
Lid lag
Lid pigmentation
Restrictive myopathy

36

What is chemosis?

Oedema of the conjunctiva

37

Ocular features of thyroid eye disease

Chemosis
Injection
Exposure
Glaucoma
Choroidal folds
Optic nerve swelling

38

What is the most common cause of unilateral and bilateral proptosis

Thyroid eye disease

39

How is thyroid eye disease treated?

Control of thyroid dysfunction
Lubricants
Surgical decompression
Smoking

40

What efect can SLE have on the eyes?

Ocular inflammation

41

What effect can RA have on the eyes?

Dry eyes
Scleritis
Corneal melt

42

What is the triad of Sjogren's syndrome?

Keratoconjunctivitis sicca
Xerostomia
RA

43

Ocular features of Steven-Johnson syndrome

Symblepharon
Occlusion of lacrimal glands
Corneal ulcers