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42 Cards in this Set
- Front
- Back
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Topical cycloplegics
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Homatropine 5%
Cyclopentolate 1% |
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Complications of topical steroids for the eye
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Facilitate corneal penetration of HSV (permanent scarring/perforation)
Elevate IOP Increase risk of fungal ulcers Long-term: cataracts; glaucoma; precipitate HSV activation; perforation in some CT disorders |
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Name the two types of age-related macular degeneration.
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Atrophic type/drusen (gradual)
Exudative type (acute) |
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Early and late symptoms of age-related macular degeneration.
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Early: straight lines look crooked.
Late: central scotoma. Note that peripheral vision is spared. |
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Conservative treatment measures for age-related macular degeneration.
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Monitor vision w/ Amsler grid for distortion
Smoking cessation CVD control Diet – fruits/veggies +/- dietary antioxidants |
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Top 4 causes of vision loss in elderly.
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1. age-related macular degeneration
2. glaucoma 3. cataracts 4. diabetic retinopathy |
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What is considered normal intraocular pressure?
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10-21 mmHg
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What are signs/symptoms specific to angle-closure glaucoma, as opposed to primary open angle glaucoma?
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Sx specific to ACG:
Ocular pain Blurred vision Halos/coronas around lights Headache, N/V Signs specific to ACG: Conjunctival injection/red eye Hazy/cloudy cornea Pupil fixed, mid-dilated High IOP on affected side |
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What is considered a normal cup:disk ratio?
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cup:disc ratio = <0.5 has LOW level of glaucoma risk;
0.6-0.8 = moderate risk; 0.9+ high risk |
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Drug classes used to treat glaucoma.
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Prostaglandins
Beta blockers Alpha agonists Cholinergic agonists Carbonic anhydrase inhibitors Osmotic agents |
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How to screen for primary open angle glaucoma?
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IOP + optic disc eval + visual fields
Periodic, comprehensive eye exams for pts @ risk |
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Causes of secondary glaucoma.
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Trauma
Uveitis Chronic steroid use DM retinopathy Vascular occlusions |
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What is the danger of acetazolamide + rebreathing CO2 in a patient with central retinal artery occlusion?
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Could precipitate sickle cell crisis in a patient with sickle cell disease.
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Why does large cell lymphoma cause eye problems?
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Tumor affects eye and nervous system, causes chronic vitreous inflammation.
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What is lost with compression of CN III first - PNS or somatic fibres?
How about ischemia of CN III? |
Compression: PNS first, therefore blown pupil seen first.
Ischemia: somatic first, therefore movements lost before pupil blown. |
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What is hyphema, and what is the treatment?
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Blood in anterior chamber.
Restrict activity, metal eye shield. Topical cycloplegic Topical steroid +/- systemic steroid or aminocaproic acid |
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Treatment of corneal abrasions.
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Topical anesthetic, vison assessment, remove foreign bodies, florescein + cobalt blue light to assess.
Topical cycloplegic to decrease ciliary body spasm Topical antibiotic Pressure patch x 24 hours Analgesics F/u in 24 hours to re-check (should heal in 24-48 hours) If contact lens wearer, then refer. - also include gram -ve coverage in antibiotic. Do not patch the eye, since there is increased risk of corneal ulceration. |
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Causes of red eye (non-traumatic)
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Conjunctivitis
Uveitis Corneal inflammation/infection Acute angle closure glaucoma |
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What is the treatment for bacterial conjunctivitis?
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Topical antibiotics:
- adult: sulfacetamide 10% qid x 4 days - children: erythromycin ointment qid x 4 days |
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Conditions associated with iritis.
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Arthritis
Sarcoidosis Reiter's urethritis/bowel disease Blunt trauma |
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What is the difference between preseptal cellulitis and orbital cellulitis?
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Preseptal cellulitis does not affect the globe - vision ok, movements ok, no proptosis. Not as urgent - can refer to ophtho on a non-urgent basis. Manage with warm compress, systemic antibiotics.
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Common causes of sudden loss of vision.
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Central retinal artery or vein occlusion.
Retinal detachment. Vitreous hemorrhage. Optic neuropathy (temporal arteritis or other causes). |
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What is an obstructed eyelash follicular sebaceious gland called?
obstructed Meibomian gland? |
Hordeolum.
Chalazion. |
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What are some conditions associated with blepharitis?
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Seborrheic dermatitis
Rosacea |
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What is a complication of nasolacrimal duct cyst?
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Dacryocystitis (inflammation of the lacrimal sac). Requires systemic abx.
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What is the name of the condition where there is a yellow-white deposit on the sclera adjacent to the limbus?
What if it extends into the cornea? |
Pinguecula.
Pterygium. |
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Causes of corneal opacity.
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Bacterial keratitis.
Glaucoma. |
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Symptoms of iritis.
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Redness
Photophobia Decreased vision |
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What does distortion of an image indicate?
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Macular pathology, eg AMD
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Causes of floaters.
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Vitreous detachment
Retinal detachment |
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Which drugs can cause toxic retinopathy?
Toxic optic neuropathy? |
CHTT - chloroquine, hydroxychloroquine, tamoxifen, thioridazine
FINE - fluoroquinolones, isoniazid, ethambutol |
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What is amblyopia?
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Amblyopia is a functional reduction in the visual acuity of an eye caused by disuse or misuse during the critical period of visual development.
Strabismus, refractive error, cataracts. |
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What are some consequences of long term steroid eye drops?
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Glaucoma
Fungal corneal ulcers Cataracts |
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Risk factors for angle-closure glaucoma.
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a. Asian race
b. hyperopic refractive error c. positive family history of angle-closure glaucoma |
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What can cause corneal opacification?
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Corneal edema (secondary to increased IOP).
Corneal inflammation/infection (e.g. HSV keratitis). |
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Symptoms of retinal detachment.
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Flashing lights.
Floaters. Shade over the vision in one eye. |
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Risk factors for open-angle glaucoma.
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• Age - older
• Race - blacks 3 x higher than whites • Family history • Elevated IOP |
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Symptoms of cataracts.
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• Blurred vision
• Monocular diplopia • Starburst glare around lights (can't drive at night) • Objects may appear more brown/yellow, and color discrimination may become difficult |
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Secondary causes of cataracts
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• Trauma
• Inflammation • Chronic steroid use • Metabolic and nutritional defects |
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What is metamorphopsia?
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Central visual distortion (indicates macular disease).
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What is photopsia?
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Flashing lights (indicates possible retinal detachment).
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If acute angle closure glaucoma suspected, which drugs should be prescribed stat, if an urgent consult cannot be obtained?
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Pilocarpine 2% gtt q15min x 2
Acetazolamide 500 mg PO or IV glycerine or isosorbide 1mL/kg PO (over ice) +/- Mannitol 20% 300-500mL IV |
