Week 2 Flashcards Preview

After adding fluoroscein to an injured eye, the fluid can be visualised becoming more and more diluted as it flows out at the site of injury 

Lipid soluble penetrate the epithelium (which is lipophilic and hydrophobic)

Water soluble penetrate the stroma (which is lipophobic and hydrophilic)

Chloramphenicol has both hydrophilic and lipophilic properties 

Steroids

NSAIDs

Anti-histamines 

Mast cell stabilisers 

Local

• Cataracts
• Glaucoma
• Exacerbation of viral infection (e.g. in Herpes zoster)

Systemic 

• Gastric ulcers 
• Immunosuppression 
• Osteoporosis
• Weight gain 
• Diabetes 
• loads more... 

FML

Predsol

Betamethasone 

Dexamethasone/Prednisolone 

Patients with glaucoma initially lose peripheral vision, then in the later stages central vision is affected

Treatments aim to "turn off the tap or open the drain" i.e. relieve pressure 

Prostanoids e.g. Latanoprost

Beta-blockers e.g. timolol 

Carbonic Anhydrase Inhibitors e.g. Dorzolamide (topical) or Acetazolamide (systemic)

Alpha2 adrenergic agonists e.g. Brimonidine

Parasympathomimetic e.g. pilocarpine

Compliance is the issue!

Can be solved with intravitreal injection - delivers effective conc. of drug to site but many drugs are toxic to the retina 

Can also be done to treat Endophthalmitis and deliver steroids/anti-VEGF

Inflammation of the interior eye, usually due to bacterial infection 

Possible complication of surgeries to the eye, including procedures for glaucoma. Potentially sight-threatening and antibiotics need to be given ASAP

Dry - most common form, slow and gradual progression of blurry vision, painless. "Drusen" (yellow spots) may be seen on fundoscopy

Wet - sudden onset of vision loss, caused by the development of new blood vessels. "Scotoma" (dark spots) may be seen on fundoscopy

Cup size (disc to cup ratio is 0.2-0.6)

Colour 

Contour 

Vascular causes

• occlusion of retinal circulation/optic head circulation
• abnormal blood vessels e.g. diabetes retinopathy, wet ARMD), retinal tear 

Vitreous haemorrhage 

Closed-angle glaucoma 

Central retinal artery - supplies the inner 2/3rds of the retina (outer 1/3rd is supplied by the choroid)

Posterior ciliary arteries - mainly supply the optic head 

Signs

• RAPD (relative afferent pupil defect)
• Pale, oedematous retina, thread-like vessels 

Symptoms 

• Sudden visual loss
• Profound i.e. can't count fingers 
• Painless 

CRAO is a type of stroke, most commonly caused by carotid artery disease but also less commonly caused by emboli from the heart 

If presenting within 24 hours - try ocular massage in an attempt to convert from CRAO to BRAO

Vascular management - establish the source of the embolus via carotid doppler and assess and manage risk factors  

Transient CRAO - temporary, painless visual loss

Described as being like "a curtain coming down" over the vision 

Lasts ~5 mins with full recovery 

Management - urgent referral to Stroke Clinic and give Aspirin

Signs

• Retinal haemorrhages 
• Dilated, tortuous veins 
• Disc and macular swelling 

Symptoms

• Sudden visual loss
• Moderate to severe, anywhere between 6/9 to perception of light