Neuro-Ics-Opthalmology I & Ii

Front 1

"lazy eye"

Back 1

amblyopia

Front 2

"ghost image"

Back 2

refractive error

Front 3

blurry vision, worse late in day and improves briefly with blinking

Back 3

ocular surface D/O

Front 4

-chronic irritated feelings of lids and lashes
-itching of lid margins

Back 4

ocular surface D/O

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stinging and burning of eyes, worse at end of day and with reading/watch TV/computer

Back 5

ocular surface D/O

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examples of ocular surface D/O

Back 6

meibomitis
blepharitis
rosacea

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excessive tearing

Back 7

dry eye (paradoxical)

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blurry vision

Back 8

corneal opacity

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what corneal opacity can cause progressive or chronic blurred vision

Back 9

-Decompensated cornea w/edema
-corneal Dystrophy or Degen
-corneal Scar
"3 D'S"

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acute onset blurriness w/pain

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1. cloudy anterior chamber
2. corneal opacity (can cause acute or chronic)

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painless, progressive decline in acuity

Back 11

cataract

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opacity in visual axis, with hazy view of fundus

Back 12

cataract

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Tx cataract

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phacoemulsification (emulsify abnl (opaque) lens and place artificial intraocular lens)

Front 14

"bugs", "spider webs" or "clouds" in visual field

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vitreous opacity

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are vitreous opacities painful

Back 15

no

Front 16

vision change with vitreous opacities

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-all normal (nl pupils, no afferent defect; nl anterior segment) EXCEPT:

-fundus (hazy)
-confrontation fields
-acuity

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Hx of vitreous opacities

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bugs, clouds, spider webs

Front 18

ex's of vitreous opacities

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-posterior vitreous detachment
-vitritis
-vitreous hemorrhage

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-hazy vision
-pain, photophobia, injection

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vitritis

Front 20

"bugs"
good acuity, no field defect

Back 20

posterior vitreous detachment

Front 21

"bugs"
no pain
assoc w/trauma, diabetes, retinal detachment

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vitreous hemorrhage

Front 22

is retinal detachment vision-threatening

Back 22

yes

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distorted vision

Back 23

retinal disorder

Front 24

flashing lights
not painful
monocular

Back 24

retinal d/O

Front 25

what are photopsias?
what do they suggest?

Back 25

=flashing lights
suggest retinal d/o

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blind spot or visual field defect (scotoma)

Back 26

retinal d/o

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elderly person c/o blurred vision--distortion of vision and central scotoma

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Age-Related Macular Degen (ARMD)
(type of retinal d/o)

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-yellow lesions (drusen)
-pigment mottling with atrophic areas within macula

Back 28

Age-Related Macular Degen (ARMD)

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leading cause of central vision loss among elderly

Back 29

Age-Related Macular Degen (ARMD)

*Wikipedia: macula (near the retina) contains the fovea, which contains the CONE CELLS:
*central vision
*photoreceptors

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AV nicking
copper wiring
silver wiring

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Hypertensive Retinopathy

Front 31

retina capillary damage leads to exudates and hemorrhages

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hypertensive retinopahty (mimics diabetic retinopathy)

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-unilateral, painless loss of vision or blurred vision
-onset of scotoma or field defect

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Retinal Vein Occlusion (CRVO or BRVO)

Front 33

if vision loss, scotoma, or field defect affects 4 quadrants

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Central Retinal Vein Occulsion (CRVO)

Front 34

if vision loss, scotoma, or field defect affects retinal sector

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Branch Retinal Vein Occulsion (BRVO)

Front 35

what can cause Central Retinal Vein Occlusion

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-HTN
-DM
-Hypercoagulable states
-Glaucoma

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what can cause BRVO (Branch Retinal Vein Occulsion)

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-HTN
-DM

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what can cause amaurosis fugax

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Retinal Artery Occlusion (CRAO or BRAO [Central Retinal Artery Occlusion or Branch Retinal Artery Occlusion])

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"cherry red" spot

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Retinal Artery Occlusion (CRAO or BRAO [Central Retinal Artery Occlusion or Branch Retinal Artery Occlusion])

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Hollenhorst plaque

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Retinal Artery Occlusion (CRAO or BRAO [Central Retinal Artery Occlusion or Branch Retinal Artery Occlusion])

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how manage Retinal Artery Occlusion

Back 40

work up for embolic, thrombotic, or arteritic Dz (Giant cell arteritis)

Front 41

pathogenesis of vitreous attachment

Back 41

viretrous gel shrinks and liquefies (d/t trauma, aging, post-ocular surgery)
==>the gel causes portions still attached to it to pull on it
==>this "tugging" stimulates the retina--causes flashing lights (photopsias)
==>condensed collagen fibers form opacities (floaters)

Front 42

retinal breaks:
pathogenesis?
Sx?
Tx?

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-vitreous traction of retina causes retina breaks
-occurs in periphery

Sx: "floaters and flashes"
Tx: laser Tx to avoid vision-threatening detachments of retina

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"floaters and flashes"

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retinal d/o (retinal break, retinal detachment)

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curtain sensation

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retinal detachment

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how Tx retinal detachment

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scleral buckle

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leading cause of blindness in adults

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diabetic retinopahty

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primatry pathology of diabetic retinopahty?

Back 47

vasculr damage

Front 48

clinically significant macular edema indicates what?

Back 48

early stage of NPDR (Non-proliferative diabetic retinopathy)

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capillary occlusion and "ddropout"

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advanced stage of NPDR (Non-proliferative diabetic retinopathy)

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NPDR (Non-proliferative diabetic retinopathy)--what happens?

Back 50

early stage: clinically significant macular edema
pathogen:
1. injure capillaries
2. serum from blood leaks into tissues
3. tissue swells up like a sponge (EDEMA)

advanced stages: capillary occlusion and "dropout"

Front 51

pathogensis of PDR (Proliferative Diabetic Retinopathy)

Back 51

nonperfusion==>ischemia==>abnl bv growth (=NEOVASCULARIZATION)

*These bv are very fragile; cough/Valsalva can cause them to rupture==>bleed into eye and can't see

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complication of PDR (Proliferative Diabetic Retinopathy)

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vitreous hemorrhage
tractional retinal detachment

Front 53

how Tx Clinically Significant Macular Edema
is it curative?
does it reverse damage?

Back 53

*found in early NPDR

Tx with focal laser Tx
not curative
does not reverse damage

Front 54

how Tx PDR
is it curative?
does it reverse damage?

Back 54

Pan-Retinal Photocoagulation

not curative
does not reverse damage

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how Tx vitreous hemorrhages

Back 55

vitrectomy

Front 56

eye complications in sickle cell dz?
pathogenesis?

Back 56

-Peripheral Retinal Artery Occlusions==>capillary nonperfusion
==>neovascularization

Front 57

how Tx eye complications in sickle cell dz?

Back 57

you get neovascularization (proliferative bv),

thus Tx with Pan-Retinal Photocoagulation (like for advanced PDR in diabetics)

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pathogenesis of eye prob in systemic inflammatory dz

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retinal vasculitis==>vascular damage, ischemic and vision loss

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pathogenesis of eye prob in hyperviscosity syndromes

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engorged retinal veins rupture==>retinal hemorrhages==>retina becomes ischemic

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pathogenesis of eye prob in HIV

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microangiopathy==>focal retina ischemia==>nerve fiber layer infarcts, retinal hemorrhages and exudates

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when is vascularization of retina complete in fetal life?

Back 61

by 40 wks

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retinopathy of prematurity

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A-V shunts, true neovascularization==>tractional retinal detachment and blindness

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neoplasms of fundus

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1. choroidal nevi (nevi=moles)
2. choroidal melanoma(MC ocular malignancy in adults)
3. retinoblastoma (infants and toddlers)

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MC ocular malignancy in adults

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choroidal melanoma

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eye neoplasm in infants/kids

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retinoblastoma

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what is the problem in glaucoma?

Back 66

-Glaucoma is considered an optic neuropathy!! (EXAM)
(damage of optic NERVE with loss of tissue and enlargement of optic cup)

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how test for glaucoma

Back 67

EXAM-A measurement of IOP is NOT a test for glaucoma

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are headaches common in ocular problems

Back 68

no

Front 69

goal of glaucoma drugs?

Back 69

lower IOP

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is glaucoma just an increased IOP

Back 70

no; it comprises various pathologic ocnditions. It involves optic nerve loss with loss of tissue and enlargement of optic cup.

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how Tx glaucoma

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-first give drugs to lower IOP
-if fail, do surgery:
1. trabeculoplasty (laser)
2. trabeculectomy
3. shunt placement
4. cyclodestruction

Front 72

what is amblyopia

Back 72

loss of visual acuity NOT correctable with glasses in an otherwise healthy eye
-onset in infancy or early childhood

Front 73

what causes amblyopia?
-monocular or binocular?

Back 73

failure of development (not an organic problem): ignored or "lazy" eye does not develop its normal structures and becomes ambloyopic`
-monocular

Front 74

strabismus
-2 types

Back 74

-misalignment of eye
-both eyes cannot simultaneous look at object of regard
2 types:
1. concomitant (nonparalytic)
2. incomitant (paralytic or restrictive)

Front 75

concomitant strabismus- define

Back 75

non-paralytic

-angle of deviation is the same in all fields of gaze
-extraocular muscles fxn normally
-onset in childhood

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incomitant strabismus

Back 76

=paralytic
-angle of deviation varies with direction of gaze (b/c one eye is paralyzed and can't move, but the other eye can move)
-muscles or nerves might not be functioning

Front 77

what causes cloudy anterior chamber

Back 77

hyphema or hyphopyon

Front 78

how test for strabismus

Back 78

1. corneal light reflex
2. cover test

Front 79

pseudostrabismus

Back 79

=broad epicanthal fold
(looks like strabismus b/c broad epicanthal fold)

Front 80

pathogenesis of retinal detachment

Back 80

vitreous detachment==>retinal break==>retinal detachment

Front 81

how Tx angle closure glaucoma

Back 81

laser iridotomy