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78 Cards in this Set

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legal definition of blindness
best corrected of 20/200 or less than 20deg in best eye
name the dz: bilateral drusen and RPE hyper/hypo pigmentation
dry macular degeneration
Clinical course of dry macular degeneration?
slowly progressive, peripheral vision remains intact
Tx for Dry macular degen?
Zn and antioxidants slow progression
Name the dz: sudden visual loss with distortion, hemorrhage, edema, exudates, RPE changes
wet macular degeneration
Tx for wet macular degeneration?
lasers, VEGF inhibition
Glaucoma definition:
iop that is high enough to damage the optic nerve and cause visual loss
What does an increased cup/disc ratio mean?
Name the dz: hazy cornea, red eye, fixed mid dilated pupil
closed angle glaucoma
Indication for cataract surgery?
when vision loss impacts daily life
Tx for closed angle glaucoma?
laser iridotomy in BOTH eyes
Which class of glaucoma medications stings?
carbonic anhydrase inhibitors (diamox and trusopt)
Common ADRs of carbonic anhydrase inhibitors (diamox/trusopt)
bitter taste/tingling (systemic), burning (ocular), STEVENS JOHNSON
Common ADRs of alpha agonists in the eye?
allergic conjuctivitis, mydriasis (local)
Contraindications to alpha agonists?
kids, MAOIs
Which classes of glaucoma meds DO NOT work by decreasing aqeous production?
PGF2a analogues (incr uveoscleral outflow); miotics (increased trab flow, decr uveoscleral flow)
Contraindications for beta blockers?
pulmonary dz, heart dz
Side effects of beta blockers in the eye?
blurred vision, depression, impotence (systemic)
Which hyperosmolar agent is safest in DM?
When do you use miotics for glaucoma?
acute only
Contraindications to miotics?
parkinsons, inflamed eye, angle closure glaucoma
Side effects of Prostaglandins (xalatan)?
eyelash growth, skin/iris darkening, eye redness (take in PM)
Which drug is first line in glaucoma?
PGF2a analogues
Contraindications for PGF2a analogues?
pregnancy, inflammatory conditions
Ocular complications of roids?
roid induced glaucoma (GAGs in trabecular network), cataracts
Name the Dz and Tx: lots and lots of purulent discharge from eye
hyperacute conjuctivitis (gonococcal) tx w/systemic abx
Tx of corneal ulcers
abx drops around the clock
Name the Dz and Tx: tree branch pattern in eye w/fluorescein dye
HSV keratitis. No roids.
Tx for chalazion
warm compresses
Tx for uncomplicated conjuctivitis
cool compress and artificial tears
Which red eye conditions require referral?
corneal infxn, iritis, angle closure glaucoma, trauma
Name the Dz: dishcarge from eye, no pain, nl, vision, nl pupil
Name the dz: d/c from eye, pain, decreased va, small pupil
Name the dz: no d/c, pain (light sensitivity), decreased va, small pupil
Name the dz: no d/c, pain, decreased va, dilated pupil
Tx for chlamydia
tetracycline or emycin for 3-6 weeks
Sequelae for chlamydia in the neonate?
systemic dz (otitis, pneumonitis)
Requirements for normal visual development>
symmetric refraction error, straight eyes
Up to what age does a lack of a clear image focused on the retina lead to amplyopia?
7 years old
What is amblyopia?
impairment not due to an ocular lesion and not fully correctable by an artificial lens
Etiology of comitant strabismus?
Etiology of incomitant strabismus?
cranial nerve palsy, graves, myasthenia, mechanical restriction of muscle
Tx for congenital esotropia?
Tx accommodative esotropia?
glasses (85%)
Tx for sensory comitant strabismus?
surgery is cosmetic and lasts 10yrs
Sxs of 3rd nerve palsy?
ptosis, mydriasis, eye down and out
tx for 4th or 6th nerve palsies?
prism glasses (if not surgery)
Indications for surgery in orbital injuries?
persistent diplopia (7-10 days), fracture which will result in enophthalmus
pathophys of cotton wool spots?
microinfarcts and axoplasmic damming in the nerve fiber layer (cytoid bodies?)
Which layer are hard exudates seen in?
outer plexiform layer
Name the dz: slow visual loss, rubeosis iridis, dilated non-tortuous retinal veins, periorbital pain (caused by?)
occular ischemic syndrome (due to 90% carotid occlusion)
name the dz: cherry red foveola
central retinal artery obstruction
Most common causes of cotton wool spots?
What defines Grade III HTN in the eye? (pressure?)
hemorrhage, cotton-wool spots, exudates (diastolic over 110)
What defines Grade IV HTN in the eye? (pressure?)
optic disc swelling (diastolic over 130)
What defines grade II HTN in the eye?
AV nicking
Which Hgb phenotype is the worst for retinopathy?
Hgb SC
Tortuous vs non tortuous veins in the eye?
tortuous = venous dz; non-tortuous = arterial dz
When do you watch out for retinopathy of prematurity/
less than 1500g, less than 36wks
Risk factors for retinal detachment?
myopia, cataract extraction, ocular trauma, FH or other eye hx, lattice degeneration
Causes of exudative retinal detachments?
tumor, infxn, inflammation
Early findings in diabetic retinopathy?
pericyte dropout, microaneurysms, basement membrane thickening
Leading cause of vision loss in DM?
macular edema
Indications for vitrectomy?
non clearing vitreous hemorrhage, traction retinal detachment
When would a diabetic not have an eye exam immediately after diagnosis?
If age of onset is less than 30 (exam 5 yrs after dx)
When do you get eye exams more often than yearly/
preggers (q 3 months)
what imaging studies are useful for optic neuritis?
mri or T2 FLAIR
what should you do for a pt w/optic neuritis?
MRI, IV corticosteroids (if lesions on MRI), NO ORAL ROIDS
what to do? Pt w/bilateral optic disc swelling
REFER to ophto immediately
name the dz: sudden painless unilateral vision loss in a vasculopath
non arteritic ischemic optic neuropathy
Tx for NAION?
What key sxs are associated with AION?
Jaw claudication and elevated CRP
Tx for Giant Cell Arteritis?
immediate high dose roids to protect the other eye
Which muscles are most affected in Graves'?
Imaging for Graves'?
Indications for orbital decompression?
Optic Neuropathy, exposure keratopathy, high IOP, globe luxation, cosmetic
Definative dx for giant cell arteritis?
temporal artery bx w/in 10 days of onset
Tx for thyroid related orbitopathy?
during inflammatory phase give roids or rad…when stable for 6 months do surgery