Cfmp Ophamalogic Diseases

Front 1

Central Retinal Vein Occlusion

Back 1

Defect: analogous to haemorrhagic stroke in brain
Onset: several days
Sxs: slowly progressing painless mild to profound visual dimming/blurring.
Signs: marked retinal vnous congestion/tortuosity, multiple blot, dot, linear retinal haemorrhages.
Assoc.: arterosclerotic retinopathy, ↑'d intracocular pressure, polycythaemia, hyperviscosity/coagubility.
Risks: neovascular glaucoma, retinal neovascularisation.

Front 2

Acute Angle Glaucoma

Back 2

True ophthalmic emergency
Defect: shallowing of ant. chamber, closure of ant. chamber angle, abrupt profund ↑ in intraocular pressure.
Sxs: profound progressive dimming/darkening of vision in eye. Severe pain/pressure sensation.
Signs: Red, congested eye, pupils dilated, poorly reactive to light.
Tx: anti-HTN, iridotomy.

Front 3

Primary Open Angle Glaucoma

Back 3

Defect: ↑intraocular pressure
Sxs: often asymptomatic. Slow bilat. loss of peripheral vision.
Signs: cup to disc ratio > 0.5.
Tx: Anti-glaucoma eyedrops, laser/metal surgery.

Front 4

Microbial Corneal Infiltrates (Corneal ulcers)

Back 4

Defect: infxn after corneal injuries or microbial conjunctivitis.
Sxs: painful
Signs: irregular white corneal lesions, intensely red eye, WBCs attracted to aqueous humour, layer out in anti. chamber to form hypopyon.
Tx: Ocular antibiotic drops.

Front 5

Background Diabetic Retinopathy

Back 5

Defect: Macular retinal oedema and progressive retinal capillary obliteration.
Sxs: progreesive loss of visual acuity.
Signs: tiny intraretinal red dots, "hard exudates", "cotton wool spots".
Tx: Focal laser therapy, intravitreal corticosteroid injection.

Front 6

Proliferative Diabetic Retinopathy

Back 6

Defect: Neovascularisation of the disc (NVD), which tend to be fragile and hemorrhage, obstructing vision. Proliferation of fibroblasts; vitreoretinal fibrovascular bands that contract to detach/distort retina.
Sxs: vision loss, blindness.
Tx: panrentinal photocoagulation, post. vitrectomy.

Front 7

Hard exudate

Back 7

Lipoproteinaceous intraretinal deposits, seen in Background Diabetic Retinopathy

Front 8

Cotton Wool Spots

Back 8

Ischaemic white spots of inner retina, seen in background diabetic retinopathy, vasospastic hypertensive retinopathy, arteriosclerotic hyptertensive retinopathy, and AIDS retinopathy.

Front 9

Flame-Shaped Retinal Haemorrhage

Back 9

Linear collexions of extravasated blood in the rential nerve fibre layer. Seen in Vasospastic and Arteriosclerotic HTN retinopathy.

Front 10

Retinal Arterial Vasospasm

Back 10

Marked ↓ of calibre and straightening of retinal arterioles. Primarily seen in vasospastic HTN retinopathy.

Front 11

Elschnig Spots

Back 11

Nummular patches of ischaemic outer retinal (pigment epithelial) clouding. Seen in vasospastic HTN retinopathy.

Front 12

Vasopastic Hypertensive Retinopathy

Back 12

Defect: acute systemic HTN.
Signs: cotton wool spots, flame-shaped retinal haemorrhages, retinal arterial vasospasm, Elschnig spots, exudative subretinal fluid in macula, intraretinal exudates, optic disc swelling (assoc. with HTN encephalopathy, poor prognosis)

Front 13

Arteriiosclerotic Hypertensive Retinopathy

Back 13

Defect: chronic HTN
Signs: ↑'d calibre/turtuosity of larger retinal arterioles, broadened light relfection along sclerotic arterioles, sclertotic clouding of arteriolar walls, venous nicking, flame-shaped retinal hemorrhage, cotton wool spots.

Front 14

Venous Nicking

Back 14

Compression of underyling rential veins, seen in Arteriosclerotic HTN retinopathy.

Front 15

Combined Arteriosclerotic-Vasospastic Hypertensive Retinopathy

Back 15

Development of vasospastic features superimposed on a prexisiting case of arteriosclerotic HTN retinopathy.

Front 16

AIDS Retinopathy

Back 16

Signs: cotton wool spots, which are not viral infiltrates, but Ag-Ab rxns. Occur in nearly 100% of pts. with HIV infxn.

Front 17

Cytomegalovirus (CMV)

Back 17

Class: Microbial Retinopathy in Immunosuppressed Pts.
Signs; 1+ broad, confluent white patches of necrotising retinitis with associated patches of extravasated intraretinal blood.

Front 18

Retinal Detachment

Back 18

Defect: separation of the outermost (retinal pigment epithelium) from the rest of the layers (sensory retina).
Process: mechanical tearing of the periphery when vitreous gelatin settles abruptly.

Front 19

Age-related maculopathy

Back 19

Defect: Age-related inability of the retinal pigment epithelium to fully digest photopigments. These accumulate as Drüsen, and build up as small droplets in Bruch's membrane.

Front 20

die Drüsen

Back 20

(German: glands)
Accumulations of un- or incompletely digested photochemical pigments from rods and cones. Appear as discrete or smudgy golden dots or globules deep to the retina. Tend to be concentrated in the macula. Seen in macular degeneration.

Front 21

Dry Age-Related Maculopathy

Back 21

Defect: Drüsen buildup, often assoc. with clumps of black macular pigment in early stages, central macular chorioretinal degeneration in late stages.
Onset: chronic, slow progression over course of years.
Tx: limited to oral antioxidants and zinc.

Front 22

Wet Age-Related Maculopathy

Back 22

Defect: choroidal neovascularisation; causes exudate of subretinal serosanguinous fluid, which becomes transformed into fibrotic disc/plate due to ingrowth of fibroblasts.
Sxs: abrupt onset, punctated progression of central vision loss.
Tx: focal laser photocoagulation, photodynamic therapy, intralesional injection of anti-VEGF, corticosteroids, submacular surgery, macular displacement.

Front 23

Retinoblastoma

Back 23

Defect: Malignant 1° intraocular neoplasm.
Sxs: leukocoria, strabismus, enlargement/clouding of cornea, eventual destruction of eye and metastasis.
Nonhereditary: usu. unilat. Tx: enucleation
Familial: bilat., autosomal dominant. Tx: chemo, then transcleral cryotherapy, laster, plaque radiation therapies.

Front 24

Pseudotumour Cerebri

Back 24

Defect: cause uncertain. ↑intracranial CSF pressure. Usu. affects obese, adolescent women.
Sxs: headaches, transient vision obscuration.
Signs: prominent swelling of optic disc, small brain ventricles.
Tx: CSF tap, drugs to reduce CSF production, CSF shunt.

Front 25

Proptosis/Exophthalmos

Back 25

Defect: ant. displacement of one or both eyes within the orbis.
Path: thyroid disease (thyroid eye disease), orbital tumours, inflammatory processes.
Sxs: if acute, eye appears congested and red.

Front 26

CN III Palsy

Back 26

Defect: CN III controls medial, sup., inf. rectus mm, sup. oblique, levator palpebrae sup., and sphincter mm.
Causes: Aneurysm of post. communicating art., enlarging neoplasm within cavernous sinus, or microvascular disease.
Sxs: ptosis, dilated pupils, nonreactive to consensual light, eye down and out, diplopia.

Front 27

CN VI Palsy

Back 27

Defect: CN VI controls the lat. rectus.
Causes: microvascular disease due to DM or HTN, neoplasm, demyelinating disease, aneurysm at base of brain.
Sxs: affect eye pulled in. Horisontal diplopia that's worse on attempted gaze into field of action of paretic mm.
Signs: frequ. face turn toward side with palsy to compensate.
Tx: usu. self-rresolves in 6-8 wks. if due to microvascular disease.

Front 28

Horner's Syndrome

Back 28

Defect: Interruption of sympathetic nn to the eye and face on one side.
Cause: Pancoast tumour (apex of lung) interrupt nn.
Sxs: ptosis, miosis, loss of facial sweating.

Front 29

Ischaemic Optic Neuropathy in Giant Cell Arteritis

Back 29

Defect: acute/subacute swelling of optic disc.
Cause: microcirculatory basis.
Sxs: profound dimming of vision, ↓visual acuity, Signs: Marcus Gunn pupil (relative afferent pupillary defect), oedematous/pale optic disc.
Tx: high dose corticosteroid.
Notes: usu. pts. 50+ age

Front 30

Optic Neuritis in Multiple Sclerosis

Back 30

Defect: MS; demyelination of CN II.
Sxs: ↓visual acuity, colour saturation. Dimming of vision, esp. peripheral.
Tx: Usu. self-limiting, resolves in 6-8 wks. High dose IV corticosteroid followed by po prednisone.
Notes: usu. pts. <30 age.

Front 31

Myasthenia Gravis (ocular manifestations)

Back 31

Defect: Type II autoimmune disease; Abs against ACh R. on mm fibres.
Path: extraocular mms particularly vulnerable.
Sxs: bilateral ptosis, diplopia, worse with exertion.
Notes: >50% pts. with ocular signs progress to systemic MG.

Front 32

Cataract

Back 32

Defect: clouding/opacification of the lens.
Sxs: progressive blurrin gof vision.
Signs: Red reflex contains dark spots or irregularities. Eventually, red reflex disappears when lens becomes completely opaque.
Tx: microsurgical replacement with inert polymeric lens. (IOL, intraocular lens)

Front 33

Central Retinal Artery Occulsion (CRAO)

Back 33

Defect: analogous to ischaemic stroke in brain.
Cause: atherosclerotic cartoid art. plaque, calcific cardiac valvular vegetations may provide source of embolus.
Sxs: sudden painless profound darkening of vision.
Sings: diffuse inner retinal cloudy swelling, marked attenuation of retinal arterioles and venules. Inner retinal neurones absent in the fovea. Embolus may be visible.
Tx: none available.