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Ophthalmology > The Eye in Systemic Disease > Flashcards

The Eye in Systemic Disease Flashcards

1
Q

What is the biggest cause of visual loss in the working population?

A

Diabetic retinopathy

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2
Q

Chronic hyperglycaemia results in the formation of what in diabetic retinopathy? What does this lead to?

A

Microaneurysm, which leads to leakage and ischaemia

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3
Q

What is meant by proliferative retinopathy?

A

New vessels start to form

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4
Q

What are some signs of non-proliferative retinopathy?

A

Microaneurysms (dot and blot haemorrhages), hard exudate, cotton wool patches, venous and microvascular abnormalities

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5
Q

Non-proliferative retinopathy can be divided into what?

A

Mild, moderate and severe

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6
Q

Where can new vessels grow in diabetic retinopathy?

A

On the disc (NVD), on the periphery (NVE) and very rarely on the iris

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7
Q

Why do diabetic patients lose vision?

A

Retinal oedema affecting the fovea, vitreous haemorrhage, retinal detachment

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8
Q

What are the 4 stages of diabetic maculopathy?

A

None, observable, referable, clinically significant

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9
Q

What are the management options for diabetic retinopathy?

A

Optimising diabetic control, laser treatments, vitrectomy, rehabilitation

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10
Q

In hypertensive retinopathy, the appearance of the fundus correlates to what?

A

The severity of the hypertension and the state of the retinal arterioles

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11
Q

Which patients with hypertensive retinopathy tend to have severe disease?

A

Young patients

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12
Q

Who does accelerated hypertension occur in and what does it cause?

A

Occurs in young patients and causes a dramatic fundal appearance and decreased vision

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13
Q

What condition does giant cell arteritis have an association with?

A

Polymyalgia rheumatica

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14
Q

What characterises thyroid eye disease?

A

Swelling of the extraocular muscles and orbital fat

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15
Q

What is the most common cause of unilateral and bilateral proptosis? What kind of condition is this?

A

Thyroid eye disease, autoimmune condition

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16
Q

What is the major risk of thyroid eye disease?

A

Compartment syndrome which can affect the optic nerve

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17
Q

What are some extraocular signs of thyroid eye disease?

A

Proptosis, restrictive myopathy (poor movement), lid signs e.g. retraction, oedema, lag, pigmentation

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18
Q

What is chemosis?

A

Swelling of the conjunctiva

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19
Q

Thyroid eye disease can lead to what other eye condition?

A

Glaucoma

20
Q

What may be seen in the posterior segment of an individual with thyroid eye disease?

A

Choroidal folds, optic nerve swelling

21
Q

What are management options for thyroid eye disease?

A

Control of thyroid hormones, lubricants, surgical decompression

22
Q

Which connective tissue diseases can cause eye symptoms

A

SLE, RA, Sjogren’s, Marfan’s

23
Q

What can rheumatoid arthritis cause?

A

Keratoconjunctivitis sicca, scleritis, corneal melt

24
Q

What is the main eye condition that Sjogren’s will cause?

A

Keratoconjunctivitis sicca

25
Q

What eye condition is likely to occur in Marfan’s syndrome?

A

Lens dislocation

26
Q

What is erythema multiforme?

A

A hypersensitivity reaction which occurs following an infection, usually with HSV

27
Q

What are some eye symptoms that Stevens Johnsons Syndrome and erythema multiforme can cause?

A

Conjunctivitis, occlusion of lacrimal glands, corneal ulcers

28
Q

What will a sixth nerve palsy result in?

A

Failure to abduct the affected eye

29
Q

What will a fourth nerve palsy result in?

A

Intorsion, depression in adduction, weak abduction

30
Q

What may patients with a 4th nerve palsy do to try and compensate?

A

Head tilt

31
Q

What can bilateral 4th nerve palsy cause?

A

Torsion and chin depression

32
Q

What usually causes bilateral 4th nerve palsy?

A

Head trauma

33
Q

What muscles does a 3rd nerve palsy affect?

A

MR, IR, SR, IO, sphincter pupillae, LPS

34
Q

What will the ocular position be in a 3rd nerve palsy?

A

Down and out

35
Q

If a 3rd nerve palsy is painful, what is the most likely cause?

A

Aneurysm

36
Q

What is the most likely cause of all nerve palsies?

A

Microvascular or tumours

37
Q

If not microvascular/tumour, what is the most likely cause of a 4th nerve palsy?

A

Trauma or congenital

38
Q

If not microvascular/tumour, what is the most likely cause of a 6th nerve palsy?

A

Raised ICP

39
Q

What are some causes of visual field defects?

A

Vascular disease, space occupying lesion, demyelination, trauma

40
Q

What condition is optic neuritis associated with?

A

MS

41
Q

What will optic neuritis cause?

A

Progressive unilateral visual loss with pain behind the eye, especially on eye movements

42
Q

Optic neuritis results in optic atrophy- what will this show on ophthalmoscopy?

A

Large cup to disc ratio

43
Q

Problems at the optic chiasm cause what visual field defect?

A

Bitemporal hemianopia

44
Q

Defects at the optic chiasm are usually caused by what?

A

Tumours (pituitary tumours, craniopharyngiomas, meningiomas)

45
Q

Are bitemporal hemianopias reversible?

A

Usually once the tumour is removed

46
Q

What kind of visual field defect will problems at the optic tract and radiations cause? What can this result in? Is this incongruous or congruous?

A

Homonomous defects where the macula is not spared - can cause quadrantinopia. This is incongruous.

47
Q

What kind of visual field defect will problems at the visual cortex cause? Is this incongruous or congruous?

A

Homonomous defects which are macula sparing. This is congruous.

Ophthalmology (12 decks)

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